Background: With the advent of resident duty hour restrictions, many programs now utilize nightfloat rotations in place of resident overnight call, with emphasis on admissions and crosscover of medical patients. While these rotations foster resident development through enhanced autonomy, they often lack structured didactics or formalized learning experiences, in stark contrast with rigorous structures of daytime rotations. It has been previously demonstrated that night attendings increase the clinical value of night float rotations. However, few residency programs have incorporated formalized night-float curricula. The majority of patient admissions in our institution occur during evening hours and this represents a missed opportunity for education and feedback. To address this issue, our academic institution has developed and implemented a novel, sustainable and structured night float curriculum enhancing our residents’ educational experiences.
Purpose: To develop and implement an innovative, sustainable, structured and high yield educational experience for internal medicine interns and residents on their nightfloat rotation.
Description: We implemented case-based educational sessions led by the night attending akin to a resident morning report. Internal medicine interns and residents attended a 1-hour teaching session at 3 am in which a patient admitted overnight was discussed. The attending led teaching focused on presentation skills among learners of varying levels and the clinical reasoning surrounding building a differential diagnosis and the initial diagnostic evaluation and/or management of the patient. Teaching attendings were expected to perform real time radiology review and incorporate evidence-based practice as part of the discussion.
Conclusions: We successfully implemented an attending led resident night report from August 2017 – June 2018. There were twice as many resident evaluations with positive comments about the night teaching sessions. Constructive comments were primarily focused on time constraints rather than content or quality. Similar to daytime rotations, designing a nighttime curriculum requires a balance of education and service. Case-based educational sessions on patients admitted overnight are an innovative approach to providing structured and high yield learning to the night float rotation.