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Brief report: Internal medicine residents’, attendings’, and nurses’ perceptions of the night float system

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Abstract

BACKGROUND: Residency training programs use the night float system increasingly to meet the new resident work hour regulations.

OBJECTIVE: To assess and compare residents’, attendings’, and nurses’ perceptions of the night float system.

DESIGN: A survey study.

PARTICIPANTS: One hundred and seven residents, 48 attendings, and 69 nurses in a university-based multicenter internal medicine residency program.

MEASUREMENTS: Perceived impact on patient care, resident training, and resident performance.

RESULTS: The overall response rate was 75%. In general, more residents than both attendings and nurses had positive opinions regarding the night float system, particularly in relation to patient care. Only a small proportion of residents and attendings thought positively about the night float’s impact on training quality (29.9%; 18.2%), daily feedback (23.0%; 9.1%), and end of rotation evaluation (21.8%; 6.1%). Less than half of the nurses had positive perceptions of the night residents’ performance in terms of promptness (40.9%), physical availability (38.6%), familiarity with the patients’ cases, and management plans (15.9%), communication of management plans to nurses (36.4%), professional respect and trust (43.2%), and teamwork (45.5%).

CONCLUSIONS: Residents had more positive perceptions than attendings and nurses. Nurses, in particular, had negative perceptions of resident performance in the setting of the night float system.

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Author information

Authors and Affiliations

  1. Department of Social & Preventive Medicine, University at Buffalo, Buffalo, NY, USA

    Elie A. Akl MD, MPH, Brydon J. B. Grant MD & Holger J. Schünemann MD, PhD

  2. Department of Medicine, VAMC, Buffalo, NY, USA

    Brydon J. B. Grant MD

  3. Department of Biostatistics, University at Buffalo, Buffalo, NY, USA

    Brydon J. B. Grant MD

  4. Department of Physiology and Biophysics, University at Buffalo, Buffalo, NY, USA

    Brydon J. B. Grant MD

  5. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

    Holger J. Schünemann MD, PhD

  6. INFORMA/Department of Epidemiology, Istituto Regina Elena/Italian National Cancer Institute, Rome, Italy

    Holger J. Schünemann MD, PhD

  7. Department of Medicine, University at Buffalo, ECMC-CC 142, 462 Grider St., 14215, Buffalo, NY

    Elie A. Akl MD, MPH, Anshu Bais MD, Ellen Rich MD, Joseph Izzo MD, Brydon J. B. Grant MD & Holger J. Schünemann MD, PhD

Authors
  1. Elie A. Akl MD, MPH
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  2. Anshu Bais MD
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  3. Ellen Rich MD
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  4. Joseph Izzo MD
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  5. Brydon J. B. Grant MD
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  6. Holger J. Schünemann MD, PhD
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Corresponding author

Correspondence to Elie A. Akl MD, MPH.

Additional information

Conflict of Interest: None to declare.

The Research for Health in Erie County Inc., the Graduate Medical Education of the University at Buffalo, and the Italian National Cancer Institute in Rome, Italy, funded this study. The funding source was not involved in the design of the study; in the collection, analysis, or interpretation of data; or in the decision to submit the manuscript for publication. Investigators received salary support from institutional sources.

Author contributions: Conception and design: E.A.A., H.J.S, J.I.; analysis and interpretation of data: E.A.A., H.J.S.; drafting of the article: E.A.A., H.J.S.; critical revision of the article for important intellectual content: E.A.A., A.B., E.R., J.I., B.G., H.J.S.; final approval of the article: E.A.A, A.B., E.R., J.I., B.G., H.J.S.; provision of study materials or patients: E.A.A., A.B., E.R., J.I., B.G., H.J.S.; statistical expertise: H.J.S., E.A.; obtaining of funding: E.A., H.J.S, A.B.; administrative, technical, or logistic support: Linda Sachs; collection and assembly of data: E.A., A.B., H.J.S.

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Akl, E.A., Bais, A., Rich, E. et al. Brief report: Internal medicine residents’, attendings’, and nurses’ perceptions of the night float system. J GEN INTERN MED 21, 494–497 (2006). https://doi.org/10.1111/j.1525-1497.2006.00434.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00434.x

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