Is Night Float a Poison Apple to Shelf Exam Performance? Evaluating the Impact of Night Float During the Last Week of the Clerkship on Shelf Examination Score

Abstract

BACKGROUND: Obstetrics and Gynecology clerkships often incorporate a week of night float in which students work overnight and sleep during the day. Night float systems allow a team atmosphere for students and also portray practice trends within Ob/Gyn. However, sleep deprivation has been shown to negatively impact examination performance in many settings. We sought to determine whether students completing their clerkship on night float—culminating in their shelf examination at the end of that week—performed differently on the examination compared with students completing night float earlier in the clerkship. METHODS: We evaluated students completing the Ob/Gyn clerkship at our institution over the past 3 academic years. Student's t test was used to compare mean shelf exam scores between students who completed night float week on the last week of the Ob/Gyn clerkship and students not on night float during the last week. RESULTS: Thirty-four of 190 students completed night float during the last week of the clerkship (17.9%). Mean shelf exam score during the 3 academic years reviewed (2013–2016) was 77.6 (range 59–99, SD 7.9). Students on night float during the last week of the clerkship did not score differently from students not on nights during that final week (mean 76.6 versus 77.8, P=.42). DISCUSSION: Students completing a week of night float during the last week of the Ob/Gyn clerkship scored similarly to students completing night float earlier in the clerkship. Clerkship directors can comfortably schedule students for night float even during the last week of the clerkship, and can reassure students that having night float during the final week of the clerkship does not negatively impact shelf exam performance.