Amy L. Lawson, MD, Kathleen A. McGann, MD, Michael J. Potts, MD, and Angela M. Sharkey, MD St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, and University of Illinois-Chicago
While the on-call experience is part of almost all pediatric clerkships, it is one of the least structured in terms of teaching. Previous studies show that increased career interest in pediatrics is best correlated with positive experiences with residents and inpatients, suggesting that on-call teaching, if done well, promotes more interest in pediatrics.
Objective: To determine the educational value of various call night components during the third-year pediatric clerkship.
Methods: After IRB approval, students completed data sheets for overnight calls during their pediatric clerkship. Between 5 pm and 7 am, students recorded their activity in thirty-minute time increments including location, presence of residents, and a learning code (1 through 4) denoting educational value. Thirty-nine completed forms were analyzed.
Results: Students reported high codes throughout the night. Until 1 am, students rated the educational experience highly (codes 3 and 4). Although students continued seeing patients from 1 am to 6 am, the reported benefits of this experience decreased. Of the time increments coded at the highest learning level, 68% were spent seeing patients, 20% talking to faculty or residents, 10% in chart work, and 2% studying. Students spent 64% of total time on the floor and 30% of time in direct contact with residents. They averaged 4.4 hours of sleep per call.
Conclusions: Valuable educational experiences occur during overnight call. From the student perspective, the benefits of overnight call are amount of patient interaction and one-to-one resident contact, known to be important factors in student satisfaction and choice of future specialty.