Fatigue in Aeromedicine: A Validity Study of the Flight Risk Assessment

ABSTRACT

Objective: A validation study was conducted on the Flight Risk Assessment (FRA), a unique self-report fatigue measure for flight medics on duty.

Background: Air medical professionals face unique challenges above and beyond the difficulty of working in a hospital setting or prehospital ground medicine. Providers frequently work multiple 24-hour shifts, resulting in circadian rhythm disturbance and cumulative sleep loss. The plane environment and the effects of flight are also contributory to fatigue; however, air medics must engage in emergent, time-sensitive, life-saving procedures despite these challenging circumstances. Although the aeromedical industry has rapidly expanded in the past several decades, the field of flight medicine lacks validated tools to evaluate fatigue levels, and many companies rely on flight providers’ recognition of fatigue to prevent work-related mistakes.

Method: To establish construct validity, scores on the FRA were compared to scores on the Psychomotor Vigilance Test (PVT), an objective measure of fatigue.

Results: The results indicate that a total of five questions on the FRA was significantly and strongly correlated with mean reaction time on the PVT (r = .60, p = .001). Perceived fitness for duty was poorly correlated with fatigue levels as measured by the FRA (r < .01) suggesting medics may have difficulty recognizing when they are fatigued and fit for duty.

Conclusion: The air medical industry is rapidly expanding, and valid and reliable measures are indicated to assess fatigue levels among providers. Initial findings suggest the FRA is an efficient tool to objectively measure the fatigue levels of air medics through a self-report measure.

Acknowledgments

We would like to acknowledge the significant contributions of the participating flight providers and their diligence in completing the study requirements. We would also like to thank Pulsar Informatics for the use of the Psychomotor Vigilance Test in our study. Finally, a sincere appreciation is given to the anonymous reviewers for critically reading the manuscript and providing suggestions that improved its clarity.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data Availability statement

The data that support the findings of this study are available on request from the corresponding author, J.N. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Additional information

Funding

The study from which these data originate was funded by Fielding Graduate University.