The impact of exposure to shift-based schedules on medical students

Figures & data

Table 1 Demographic data

	Exposed (n=36)	Not exposed (n=31)	p
Age mean (SD)	26.5 (2.3)	26.3 (2.5)	0.76
Gender: female, N (%)	19 (52.8)	12 (38.7)	0.25
March to June 2011, N (%)	13 (36.1)	21 (67.7)	0.01
March to June 2012, N (%)	23 (63.9)	10 (32.3)	0.01
Interest in career in internal medicine	27 (75.0)	17 (54.8)	0.08

Table 2 Complete survey results prior to logistic regression analysis^a

Category	Question	Overall (N=65)	Exposed (N=34)	Not exposed (N=31)	p
Teaching and supervision	Time to teach
Attendings	4 [4, 5]	4 [3, 4]	4 [4, 5]	0.11
	Residents	4 [3, 4]	4 [3, 4]	4 [3, 4]	0.89
	Interns	4 [2, 4]	4 [3, 4]	4 [2, 4]	0.77
	Able to observe at bedside
	Attendings	3 [2, 4]	3 [2, 3]	3 [2, 4]	0.13
	Residents	4 [3, 4]	4 [3, 4]	4 [3, 5]	1.0
	Interns^b	4 [3, 4]	4 [4, 5]	4 [2, 4]	0.04
	Effective teaching
	Attendings^b	4 [4, 5]	4 [4, 5]	5 [4, 5]	0.02
	Residents^b	4 [4, 5]	4 [4, 5]	4 [4, 5]	0.10
	Interns	4 [4, 5]	4 [4, 5]	4 [3, 5]	0.43
	Committed to teaching
	Attendings^b	N=64, 5 [4, 5]	4 [4, 5]	N=30, 5 [4, 5]	0.04
	Residents	5 [4, 5]	4.5 [4, 5]	5 [4, 5]	0.70
	Interns	4 [4, 5]	4 [4, 5]	4 [4, 5]	0.41
	Appropriately supervised
	Attendings	N=64, 4 [3, 4]	4 [3, 4]	N=30, 4 [3, 5]	0.15
	Residents	N=64, 4 [4, 5]	4 [4, 5]	N=30, 55 [4, 5]	0.38
	Interns	4 [4, 5]	4 [4, 5]	4 [4, 5]	0.82
	Rotation enabled me to learn internal medicine	5 [4, 5]	4 [4, 5]	5 [4, 5]	0.59
	I feel adequately prepared for my sub-I	N=62, 4 [4, 5]	N=33, 4 [4, 5]	N=29, 4 [4, 5]	0.52
	Overall satisfaction	5 [4, 5]	4 [4, 5]	5 [4, 5]	0.41
Assessment	Useful feedback
	Attendings	4 [4, 5]	4 [4, 4]	4 [4, 5]	0.11
	Residents	4 [4, 5]	4 [4, 5]	4 [4, 5]	0.58
	Interns	4 [4, 5]	4 [4, 5]	5 [4, 5]	0.61
	Had sufficient exposure to me to evaluate my performance
	Attendings^b	4 [3, 4]	4 [3, 4]	4 [3, 5]	0.06
	Residents	4 [4, 5]	4 [4, 5]	5 [4, 5]	0.30
	Interns	5 [4, 5]	4.5 [4, 5]	5 [4, 5]	0.49
Patient care	Satisfaction with care able to deliver	4 [4, 4]	4 [4, 4]	4 [4, 4]	0.37
	Able to follow a patient throughout their hospitalization	4 [4, 5]	4 [4, 5]	5 [4, 5]	0.30
	The care of patients on this service was fragmented^c	3 [2, 4]	3 [2, 4]	3 [2, 4]	0.38
	Residents appeared satisfied with the care they deliver	4 [3, 4]	4 [3, 4]	4 [3, 4]	0.93
Well-being	Established meaningful relationship with team members	4 [4, 5]	4 [4, 5]	5 [4, 5]	0.31
	Felt supported by my team^b	4 [4, 5]	4 [4, 5]	5 [4, 5]	0.08

Distribution of five-point Likert questions: 1=strongly disagree, 2=disagree, 3=neutral, 4=agree, 5=strongly agree.

^aThe values are reported as median [interquartile range].

^bIncluded in logistic regression model.

^cReverse coded: 1=strongly agree; 2=agree; 3=neutral, 4=disagree; 5=strongly disagree.

Table 3 Logistic regression model with statistically significant results

Question	OR^a	95% Confidence interval	p
Attendings committed to teaching	0.35	0.13–0.90	0.01
Interns observe at the bedside	1.89	1.08–3.13	0.02
Interns assess student performance	3.00	1.01–8.86	0.05
Residents assess student performance	0.29	0.09–0.91	0.03
Meaningful relationships	0.51	0.24–1.11	0.09

^aPositive odds ratio (OR) favors exposure.

Fig. 1.  Percent of patients admitted who were previously worked up.