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Night shifts for medical students


Students’ educational experiences and interaction with residents on night shifts.  Schiller J, Sokoloff M, Tendhar C, Schmidt J, Christner J. The Clinical Teacher 2016; 13: 1-5.  http://dx.doi.org/10.1111/tct.12561

Reviewed by Janet Meller

Tags: clerkship, pediatric, inpatient, learning environment, survey

What was the study question? 

What impacts, positive or negative, does a night float system have on medical students’ educational experiences?

How was the study done?

Beginning in 2011, 3rd year medical students rotating on an inpatient service were assigned 4 nights on night float.  Students completed two surveys: one in response to their experience on night shifts and one in response to their experience on  day shifts.  In addition, students participated in four focus groups to explore the students’ views. Consistent themes were identified using constant comparative thematic analyses methods. 25 students were retained in the study out of a group of 30.

What were the results?

While students reported less organized teaching during the night shifts,.there were increased patient-care related activities.  Students felt that the quality of teaching and their overall experience was better during the night shift. Four themes were identified during the focus groups:  education—more impromptu discussion and better feedback; glimpse of the future—students were able to learn more about residents’ night-time work;  team dynamics—students noted increased team cohesiveness; length of night shift—students were willing to increase the four nights to seven nights.

What are the implications?

Students feel that they learn better with experiential learning directed toward real-life problems and with automatic feedback.  In addition, night shift rotations allowed for increased socialization and understanding of resident work and hospital functioning.  The authors conclude that night shifts are a beneficial addition to students’ 3rd year pediatric clerkship experience and recommend that this system be adopted at other institutions.

Editor’s Note: I showed this article to a few students completing the pediatric clerkship at my institution where we instituted a night float week for clerkship students a few years ago. Students agreed with the study’s conclusions calling the night float week the most valuable for learning in the clerkship. (RR)

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