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Can incorporating inpatient overnight work hours into a pediatric clerkship improve the clerkship experience for students? Talib N et al. Academic Medicine 2013;88:376-381.
Reviewed by Srividya Nagapathan


What was the study question?
Does incorporating medical students into pediatric resident night float teams affect 1) students' NBME scores, 2) number of admissions performed by the student, 3) students' overall satisfaction with the clerkship, and 4) students' perception on resident teaching?

How was the study done?
Researchers at the University of Missouri-Kansas City School of Medicine studied 2 groups of students: a retrospective control group that had four weeks of inpatient work that included daytime hours plus evening call five times a month, and a comparison group that had three weeks of daytime shifts and one week of five consecutive overnight shifts. Data collected included pediatric NBME scores, number of history and physical exams (HPEs) performed by the student, overall student satisfaction and students' perception of quantity and quality of resident teaching.

What were the results?
There was no statistical significance in the NBME scores or the overall satisfaction in the two groups. The students in the comparison group had an increase in the number of HPEs which was statistically significant (p=0.03) in contrast to the control group (7.5 vs 6.1). There was no significant difference in the amount of time residents spent teaching the students in the two groups but the perception of quality of resident teaching was significantly higher (p=0.02) in the comparison group.

What are the implications of these findings?
With increases in medical school enrollment, innovative methods are necessary to accommodate the increased capacity while preserving quality of education. Restructuring the pediatric clerkship to include one week of night float may be a solution to address this issue without negatively impacting NBME scores and overall clerkship satisfaction. (The institution was able to include 24 more students per year to its inpatient teams by adopting a week of night-call.)

Editor's note: At the University of Calgary, we have had included a week of night call in our three-week inpatient experience for years - our data echoes this study: clerks love the chance to work with the night-float team, they conduct lots of histories and physicals and very much value the teaching they receive (SLB).

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