Resident Perceptions of the Educational Value of Night Float Rotations

Abstract

Background: Night float rotations are being increasingly used in the era of resident physician work-hour regulations, but their impact on resident education is not clear. Purpose: Our objective was to clarify resident perceptions of the educational aspects of night float rotations. Methods: An anonymous survey of internal medicine residents at a university-based residency program was completed. Results: Responses were received from 116 of 163 surveyed residents (71%). Residents attended less residents’ report (0.10 ± .43 vs. 2.70 + 0.93 sessions/week, p< .001) and fewer grand rounds sessions (0.14 ± 0.25 vs. 0.43 ± 0.28 sessions/week, p< .001) and spent less time reading, (2.63 ± 2.0 vs. 3.33 ± 1.6 hr/week, p< .001) interacting with attending physicians (0.57 ± 1.1 vs. 2.97 ± 1.5 hr/week, p< .001) and sleeping at home (6.3 ± 1.2 vs. 7.10 ± 0.9 hr/day, p< .001) on night float rotations than on non–night float rotations. Residents had strongly negative opinions about the educational value of night float, sleep cycle adjustment issues, and impact on their personal lives, which correlated with resident evaluations from the regular program evaluation process. In free responses, residents commented that they liked the autonomy and opportunity to improve triage skills on these rotations and confirmed their negative opinions about the sleep–wake cycle and interference with personal lives. Conclusions: Internal medicine residents at a university-based program have negative opinions regarding the educational value of night float rotations. Further work is necessary to determine whether problems exist across programs and specialties.

No funding sources were used for the completion of this project or the preparation of the article. All of the authors have had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. We thank David Frazer for assistance with production of the figures used in this article and the resident physicians in the University of Washington Internal Medicine Residency Training Program for their time and effort in completing the survey.