The night float system: ensuring educational benefit

Lefrak, Shayna; Miller, Sheldon I.; Schirmer, Bruce D.; Sanfey, Hilary

doi:10.1016/j.amjsurg.2004.11.034

Cited by 39 publications

(34 citation statements)

References 5 publications

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“…35,36 Accordingly, others have raised concerns about the deleterious effects of night float systems on both resident education and patient safety. 37,38 Our study showed that residents who napped or slept for longer periods while on call perceived themselves as less sleepy. This was also confirmed in a study of emergency room doctors and nurses that demonstrated the effectiveness of planned naps to improve subsequent performance and alertness and decrease fatigue.…”

Section: Work Hour Limitations Should Differ By Specialty 55mentioning

confidence: 71%

Perceived sleepiness in Canadian anesthesia residents: a national survey

Hanlon

Hayter

Bould

et al. 2008

Can J Anesth/J Can Anesth

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Section: Work Hour Limitations Should Differ By Specialty 55mentioning

confidence: 71%

Perceived sleepiness in Canadian anesthesia residents: a national survey

Hanlon

Hayter

Bould

et al. 2008

Can J Anesth/J Can Anesth

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“…Similarly, in response to high levels of dissatisfaction of surgical night float residents, the University of Virginia surgical residency program implemented attending-driven daily morning reports as well as attending-run evening tutorials, both of which were timed to allow participation of overnight residents. 3 Given the lack of an on-site faculty presence at night, we designed a curriculum that harnessed the enthusiasm for teaching among residents by scripting structured presentations that promote stepwise progression through common clinical scenarios.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to night medicine, interns on night float rotations typically have little faculty interaction, leading to fewer opportunities for bedside teaching and observation of direct patient care. [2][3][4] Multiple studies have highlighted residents' perceptions of night float rotations as predominantly service-focused time with few formal educational opportunities. [4][5][6][7] While night float rotations have been valued for their experiential learning potential, they have historically lacked a formalized educational component.…”

Section: Introductionmentioning

confidence: 99%

“…9 Challenges inherent in night float rotations include cross-coverage responsibilities and resident fatigue, leading to decreased alertness. 10 Two studies 2,3 showed perceived improvements in the value of care delivered and in resident education with the presence of dedicated, on-site, attending physicians. Critics, however, argue that this structure has a negative effect on resident autonomy overnight, decreasing the experiential learning component of such rotations that is felt to be so valuable to the professional maturation of resident physicians.…”

mentioning

confidence: 99%

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Implementation of a Novel, Resident-Led, Nocturnal Curriculum

Golbus

Manly

Wonneberger

et al. 2015

Journal of Graduate Medical Education

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“…They found that night float residents had significantly decreased quality of life, as measured by the Short Form-36 (SF-36), compared with their colleagues doing standard 24-hour call. 4 Lefrak and colleagues 5 initially found that first-and third-year surgical residents engaging in a similar night float system had decreased exposure to educational opportunities, but were able to partially correct the disparity with alterations to their night float model. Cardiology fellows performing 2-week blocks of night float reported decreased fatigue and increased satisfaction, whereas internal medicine residents reported a greater emphasis on service and less emphasis on education while performing night float rotations than while on 24-hour call.…”

mentioning

confidence: 99%

Implementation of a novel night float call system: resident satisfaction and quality of life

2014

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Background: Compliance with Professional Association of Internes and Residents ofOntario duty hour guidelines has been problematic at our institution. To facilitate orthopedic residents' ability to go home postcall without significant disruption of ongoing clinical activities, a novel call system was adopted at our tertiary care centre. We sought to evaluate the satisfaction and quality of life of orthopaedic residents with that system. Methods:We administered questionnaires to on-service residents. These included the Short Form-36 questionnaire and others addressing topics including education, stress, work-related problems and miscellaneous concerns.Results: Seventeen residents were surveyed: 6 who had just completed a night float rotation, and 11 who were on a regular orthopedic service rotation while the night float system was in place. Quality of life was similar between residents on the night float block and those on the standard rotation; it was also similar to age-matched Canadian normative data. Eighty-nine percent of residents agreed that the presence of the night float rotation improved their quality of life on standard rotations, and 100% felt that their education was improved on standard rotations by having the night float system in place. Conclusion:This call system results in improved resident quality of life and widespread overall satisfaction, and may be considered as a viable alternative to traditional call formats. Follow-up data as more residents experience the night float block will be valuable.Contexte : La conformité aux lignes directrices de l'Association professionnelle des résidents et internes de l'Ontario en matière d'horaires de travail pose un problème dans notre établissement. Pour permettre aux résidents en orthopédie de retourner plus facilement à la maison après un appel, sans nuire significativement aux activités cliniques en cours, notre établissement de soins tertiaires s'est doté d'un nouveau système d'appel. Nous avons voulu mesurer la satisfaction des résidents en orthopédie à l'endroit de ce système et évaluer leur qualité de vie.Méthodes : Nous avons administré des questionnaires aux résidents de garde, incluant le questionnaire SF-36 (Short Form-36) et d'autres questionnaires sur la formation, le stress, les problèmes liés au travail et diverses autres questions.Résultats : Dix-sept résidents ont répondu aux questionnaires : 6 venaient de terminer leur garde dans une équipe de nuit et 11 travaillaient selon l'horaire régulier de l'orthopédie pendant que le système de garde de nuit était en place. La qualité de vie a été similaire entre les résidents de l'équipe de garde de nuit et ceux qui suivaient l'horaire régulier; elle s'est également révélée similaire en comparaison avec des données canadiennes assorties selon l'âge. Quatre-vingt-neuf pour cent des résidents se sont dits d'avis que la présence de l'équipe de nuit améliorait leur qualité de vie lors de leurs gardes régulières et 100 % ont estimé que leur formation se trouvait améliorée lors des gardes régulières du ...

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The night float system: ensuring educational benefit

Cited by 39 publications

References 5 publications

Perceived sleepiness in Canadian anesthesia residents: a national survey

Perceived sleepiness in Canadian anesthesia residents: a national survey

Implementation of a Novel, Resident-Led, Nocturnal Curriculum

Implementation of a novel night float call system: resident satisfaction and quality of life

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