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Our laboratory is active in the study of human performance of medical personnel. We are actively involved in teaching health care personnel the techniques of crisis resource management (CRM) using realistic simulation. My research centers on the effects of sleepiness and fatigue in medical personnel. Data from our studies reveal resident physicians to be pathologically sleepy (as tested in the sleep laboratory) during normal working conditions as well as in the post on-call condition. If the same subjects are allowed to extend night time sleep by two hours for four consecutive days they return to normal states of alertness. We have evaluated the effects of sleep deprivation on clinical performance using a realistic simulator. We are currently measuring the sleep propensity and performance of health care personnel (nurses, residents and staff physicians).