Night Float Teaching and Learning: Perceptions of Residents and Faculty

Abstract

Most internal medicine residency programs use a night float system to comply with resident duty hour limits. Night float assignments often comprise 7 to 10weeks of scheduled clinical time during training. Despite this substantial allotment of time to night float, few studies have assessed the adequacy of learning opportunities during these rotations. We designed an exploratory study to assess resident and faculty views about the educational aspects of a typical internal medicine night float system. Wright State University Boonshoft School of Medicine internal medicine residents and attending faculty were asked to complete a 25-item voluntary, anonymous survey. A 5-point Likert scale was used to assess perceptions of education during day and night rotations. The response rate was 52% (85 of 164). Residents rated teaching and learning on day rotations more positively than on night rotations for 17 of 25 (68%) items. Regarding night float, residents rated 14 of 25 items below 3.00; only one item was rated below 3.00 ("…H & P skills observed by attending") for day rotations. Attending physicians rated day rotations more highly for all 25 survey items. Faculty rated 13 of 25 items below 3.00 for night float and they rated no items below 3.00 for day rotations. Resident and faculty ratings differed significantly for 10 items, with 5 items receiving higher ratings by residents and 5 being rated more positively by faculty. Despite a substantial allotment of time to night rotations, there appear to be lost teaching and learning opportunities in the current night float system. Modification of the existing format may improve its educational value.