Abstract
Introduction: Restrictions on resident work hours and increased requirements for resident supervision have led to night float rotations overseen by overnight hospitalists (nocturnists). The educational value of night float rotations for residents has traditionally been low and studies have yet to elucidate the optimal role of nocturnists in resident education.Methods: We performed a cross-sectional survey of all residents within our training program and attending hospitalists in the department of medicine at our three teaching medical centers. Questions sought to investigate the current state of overnight education within an internal medicine residency program, understand barriers to overnight education, and define best practices for nighttime teaching.Results: Both attending and resident physicians reported low satisfaction with the current state of overnight education, while simultaneously expressing high levels of interest in performing and receiving dedicated nighttime teaching. Attending and resident physicians identified similar barriers to overnight teaching (clinical work, time coordination, provider fatigue) and agreed on the ideal format for overnight didactics (case-based, chalk-talk, 20-minute duration between 10 pm to 2 am).Conclusion: Our study identifies a desire by both faculty and trainees for increased overnight teaching and offers a simple initial framework for programs to improve overnight housestaff education utilizing nocturnist providers.
Highlights
Restrictions on resident work hours and increased requirements for resident supervision have led to night float rotations overseen by overnight hospitalists
Our study identifies a desire by both faculty and trainees for increased overnight teaching and offers a simple initial framework for programs to improve overnight housestaff education utilizing nocturnist providers
Recent investigation into improving overnight trainee education has focused on formalizing residentled curricula [7,8], without considering the role nocturnists can play in enhancing nighttime learning
Summary
Restrictions on resident work hours and increased requirements for resident supervision have led to night float rotations overseen by overnight hospitalists (nocturnists). Increasing resident supervision mandates and work hour restrictions, enacted in response to the 2011 Accreditation Council for Graduate Medical Education (ACGME) regulations [1], have led to the prevalence of overnight hospitalists (nocturnists) in training environments [2]. Recent investigation into improving overnight trainee education has focused on formalizing residentled curricula [7,8], without considering the role nocturnists can play in enhancing nighttime learning. This is despite evidence that residents find increased educational value to nighttime rotations when working alongside overnight faculty [9,10].
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