Author Contributions: Dr Volpp had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Shea, Small, Novak, Mollicone, Dinges, Volpp.
Acquisition of data: Norton, Ecker, Novak, Bellini, Dine, Mollicone, Dinges.
Analysis and interpretation of data: Shea, Small, Basner, Zhu, Novak, Bellini, Dinges, Volpp.
Drafting of the manuscript: Shea, Small, Basner, Novak, Volpp.
Critical revision of the manuscript for important intellectual content: Small, Basner, Zhu, Norton, Ecker, Novak, Bellini, Dine, Mollicone, Volpp.
Statistical analysis: Small, Basner, Zhu.
Obtained funding: Shea, Dinges, Volpp.
Administrative, technical, or material support: Norton, Ecker, Novak, Bellini, Mollicone, Volpp.
Study supervision: Shea, Norton, Bellini, Dinges, Volpp.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Dinges served as an unpaid committee member on the 2009 IOM report, and he currently is an unpaid advisor to the American College of Surgeons Committee to Enhance Peak Performance in Surgery through Recognition and Mitigation of the Impact of Fatigue, and the Royal College of Canada Patient Safety Expert Working Group for the National Steering Committee on Resident Duty Hours. Dr Volpp reported having served as an unpaid member of the ACGME Committee on Innovations from 2005-2009. No other financial disclosures were reported.
Funding/Support: This work was funded by educational grant 08-429 from the Veterans Affairs Health Services Research and Development Service. Dr Dinges was also supported in part by grant NR004281 from the National Institutes of Health.
Role of the Sponsor: The sponsors/funders have had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Disclaimer: These contents do not represent the views of the Department of Veterans Affairs or the US government.
Online-Only Material: The Author Video Interview is available .
Additional Contributions: We thank Ilene Rosen, MD, MSCE, University of Pennsylvania, Perelman School of Medicine, and Karen Warburton, MD, Philadelphia VA Medical Center, for their assistance in conducting the study. Neither received any compensation from the supporters of this research grant for their role in this study.