Is Fatigue Training Really Necessary in an FRMS?

All of the fatigue risk management systems (FRMS) rules, regulations and guidelines I have reviewed, state that training on the topics of sleep and fatigue are an integral component of a robust FRMS[1]. This is with good reason.  Educational programs designed to play a role in FRMS positively improve knowledge and change behaviour[2].

Depending on the content of your training, you can expect to see positive changes in personnel safety, patient safety, personnel performance, acute fatigue, sleep and sleep quality, long term health and burnout or stress[3].

If you design your metrics properly, you can even see your numbers improve.  A few points on the positive side and you have now built a business case for a ROI that justifies all the hard work you put into your FRMS. For example, one study showed that introducing a sleep health training program and a sleep disorders screening opportunity netted 46% fewer disability days and 24% lower odds of filing an injury report in the training attendees versus non-attendees[4].

I still prefer attending and providing in-person training. But running your whole organization through a comprehensive fatigue training program that runs for a day or two can be logistically challenging. Thankfully, not everyone is “old-school” like me and this can provide you with a workforce that doesn’t absolutely need in-person training.  Training and education on fatigue and sleep can be provided through video conferencing tools, perpetual messaging through e-mail, workplace video monitors, apps and internal networks.  It can even be provided through on-line learning management systems.

online training


[1] See for example: Lerman, S., Eskin, E., Flower, D., George, E., Gerson, B., Hartenbaum, N., Hursh, S., Moore-Ede, M., (2012).  Fatigue risk management in the workplace.  Journal of Occupational and Environmental Medicine, 54(2), 231–258.

[2] Dinges, D., Maislin, G., Brewster, R., Krueger, G., & Carroll, R. (2005). Pilot testing of fatigue management technologies. Journal of the Transportation Research Board, 1922, 175-182.

[3] Barger, L., Runyon, M., Renn, M., Moore, C., Weiss, P., Condle, J., Flickinger, K., Divecha A., Coppler, P., Sequeira, D., Lang, E., Higgins, J., Patterson, P.  (2018). Effect of fatigue training on safety, fatigue, and sleep in emergency medical services personnel and other shift workers: A systematic review and meta-analysis. Prehospital Emergency Care, Feb. 15, 22(sup1), 58-68.

[4] Sullivan, J., O’Brien, C., Barger, L., Rajaratnam, S., Czeisler, C., Lockley, S. (2017). Randomized, prospective study of the impact of a sleep health program on firefighter injury and disability. Sleep, Jan 01, 40(1), zsw001.