To Float or Not To Float, A Night time Solution: An Interrupted Time Series Comparing PGY-1 Residents

Abstract

Objective: With resident work hour restrictions, there is concern that training is compromised. Nearly all residencies have adopted a night float system, but the program at Banner University Medical Center-Phoenix started an innovative program for PGY-1 residents called Nighttime Alternative Program/Study (NAPS) to meet work hour requirements and enhance knowledge focusing on basic science material. Each PGY-1 resident rotates working 16 hours overnight followed by 32 hours for rest and study. A prepared curriculum for the NAPS rotation includes assigned reading, teaching sessions and exams with a focus on components of basic anatomy and physiology in Obstetrics, Gynecology, and Reproductive Endocrinology.Methods: CREOG scores and Accreditation Data System procedures from PGY-1 residents in 2010 and 2011 (n=16) were compared to those residents who participated in the NAPS program in 2012NAPS program in , 2013NAPS program in , 2014NAPS program in , 2015. Satisfaction was assessed by an online anonymous survey of the PGY-1 residents who participated in the NAPS curriculum.Results: CREOG scores were not statistically significant (P= .23), while Accreditation Data System procedures varied. In Obstetrics, spontaneous vaginal delivery was not significant (P=.147), while forceps, vacuum, and cesarean deliveries were decreased for NAPS interns (P=.041, 0.046 and <.01, respectively). Gynecology experience was similar between groups (P=.404 and 0.070). 100% of PGY-1 residents reported satisfaction with the NAPS program overall, while 97% reported they had an adequate clinical experience during NAPS. Conclusion:NAPS is an innovative schedule for PGY-1 residents and does not greatly affect the knowledge base or compromise technical experience at the PGY-1 level. Based upon residents' satisfaction, the program continues. This can serve as a model for other residency programs.