Implementing and Maintaining an Increased Frequency of Nighttime Education Sessions.

Abstract

Conferences are an essential component to resident education. Work hour requirements have led to night rotations, causing residents to miss this important educational experience. To fill this void, many institutions have created night curricula, but few have studied how to implement and sustain it. Our aim was to increase formal nighttime teaching led by upper level residents from 0 to ≥3 times weekly by December of 2018. After a needs-assessment survey was completed by upper level residents, pediatric night education sessions were established. Upper level residents on wards were responsible for teaching and recording whether nighttime teaching occurred. Data were collected by using this form, and a run chart was used to analyze the data over time. A team of hospitalists, pediatric residency program leadership, and a second-year resident met throughout the project and used the model for improvement. Data were collected for 84 weeks. Introduction of the education sessions increased teaching occurrences from a baseline of 0 to a median of 1. After several plan, do, study, act cycles, most notably after implementing upper level feedback, special cause variation was achieved and median teaching occurrences increased to 3 times weekly. This was sustained for 32 weeks. Focused quality improvement methodologies can be used to improve new residency program education. These methods can inform other residency programs how to successfully weave a teaching expectation into their night shifts to provide more learning opportunities in the era of duty hour requirements.