Decision volume and temporal workload structure as dissociable correlates of fatigue and mood in intensive care physicians: a real-time observational study

Background

Intensive care physicians make hundreds of decisions per shift under sustained cognitive and emotional demands. Decision fatigue, the tendency towards less effortful choices as cumulative decision load increases, may affect clinician wellbeing and decision processes. However, the associations of decision volume and temporal workload structure with within-shift fatigue and mood in intensive care unit (ICU) physicians remain unclear. This study explored whether decision volume and temporal clustering show distinct associations with fatigue, sleepiness, mood, and post-shift decision responses.