Biosensors, Biometrics and Capabilities in Practice (CiP): A WHOOP 4.0 perspective.

Barlow, E., Robinson, D., James, O., Luton, O., Eley, C., Bowman, C., Kearns, M., Powell, A. G. M. T., Hanratty, D., Barry, J. D., Egan, R. J. and Lewis, W. G. 2025. Biosensors, Biometrics and Capabilities in Practice (CiP): A WHOOP 4.0 perspective. Journal of Surgical Education 82 (8) , 103549. 10.1016/j.jsurg.2025.103549

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Abstract

This study aimed to measure physiological stress response related to Capabilities in Practice (CiPs) using wearable technology. Surgical residents wore WHOOP4.0 sensors for 6-weeks with CiP event diaries and Abbreviated Maslach Burnout Inventory (AMBI) scores recorded. A surgical training program serving a single UK (Wales) deanery. 23 Surgical residents participated (13 male, median age 30 [26-35] year). Median Heart Rate Variability (HRV) varied by resident grade (Core Surgical Training (CST) resident 58 vs. Higher Surgical Training (HST) resident 48 ms, p < 0.001) and duty shift (HRV: Off Duty 51 milliseconds (ms), Normal Working Day (NWD) 48, On Call Day (OCD) 45, p = 0.009) and CiP (Inpatient work 48, Elective Operating 47, Emergency Operating 44, Emergency Day Shift 46, Emergency Night Shift 63 ms, p = 0.017). Emergency shifts were associated with adverse sleep profiles with median sleep performance varying from 74.0% (Night Shift) to 98.0% (Off Duty, p < 0.001). On average, residents had 13.4% and 27.2% less sleep related to OCDs or Night Shifts respectively (p < 0.001), and 20.2% less sleep related to Emergency Night Shifts when compared with Elective Day time CiPs (p < 0.001). HRV was related to sleep efficiency (rho 0.38, p < 0.001) and REM sleep (rho 0.211, p < 0.001). AMBI score >3 (consistent with burnout) was found in 71.4% CST vs. 30.1% HST (p < 0.001) and 49.1% males vs. 60.9% females (p < 0.001) and was inversely related to HRV and sleep efficiency (p < 0.001). Stress response varied by 20% (shift profile) and 30% (CiP) highlighting daily clinician physical demand. Adverse sleep profiles were seen related to emergency work, in particular night shifts, impacting sleep quantity and quality. [Abstract copyright: Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.]

Item Type:	Article
Date Type:	Publication
Schools:	Schools > Medicine
Publisher:	Elsevier
ISSN:	1931-7204
Date of Acceptance:	22 April 2025
Last Modified:	09 Jun 2025 14:30
URI:	https://orca.cardiff.ac.uk/id/eprint/178927

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