Initiation of a Night Float System in an Otolaryngology Residency: Resident Perception and Impact on Operative Volume

2021 ◽  
Author(s):  
Chelsea S. Hamill ◽  
Claudia I Cabrera ◽  
Henna Murthy ◽  
Sarah Mowry ◽  
Nicole Maronian ◽  
...  
Keyword(s):  
Night Float ◽  
Resident Perception

Resident-faculty overnight discrepancy rates as a function of number of consecutive nights during a week of night float

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Christine Peterson ◽  
Michael Moore ◽  
Nabeel Sarwani ◽  
Eric Gagnon ◽  
Michael A. Bruno ◽  
...  
Keyword(s):  
Progressive Increase ◽  
Recent Change ◽  
Final Report ◽  
Quality Performance ◽  
Resident Performance ◽  
Night Float ◽  
Perceived Workload ◽  
Report Accuracy ◽  
Shift Length ◽  
The Voice

AbstractObjectivesIn 2018, the ACGME (Accreditation Council for Graduate Medical Education) made a change to the maximum permissible number of consecutive nights a resident trainee can be on “night float,” from six to seven nights. To our knowledge, although investigators have studied overall discrepancy rates and discrepancy rates as a function of shift length or perceived workload of a particular shift, no study has been performed to evaluate resident-faculty discrepancy rates as a quality/performance proxy, to see whether resident performance declines as a function of the number of consecutive nights. Our hypothesis is that we would observe a progressive increase in significant overnight resident – attending discrepancies over the 7 days’ time.MethodsA total of 8,488 reports were extracted between 4/26/2019 to 8/22/2019 retrospectively. Data was obtained from the voice dictation system report server. Exported query was saved as a .csv file format and analyzed using Python packages. A “discrepancy checker” was created to search all finalized reports for the departmental standard heading of “Final Attending Report,” used to specify any significant changes from the preliminary interpretation.ResultsModel estimates varied on different days however there were no trends or patterns to indicate a deterioration in resident performance throughout the week. There were comparable probabilities throughout the week, with 2.17% on Monday, 2.35% on Thursday and 2.05% on Friday.ConclusionsOur results reveal no convincing trend in terms of overnight report discrepancies between the preliminary report generated by the night float resident and the final report issued by a faculty the following morning. These results are in support of the ACGME’s recent change in the permissible number of consecutive nights on night float. We did not prove our hypothesis that resident performance on-call in the domain of report accuracy would diminish over seven consecutive nights while on the night float rotation. Our results found that performance remained fairly uniform over the course of the week.

110 Resident Perception of Educational Value in the Clinical Arena: How Important Is Contact Time?

2011 ◽  
Vol 58 (4) ◽  
pp. S214-S215
Author(s):  
N. Trueger ◽  
R. Levene ◽  
T. Allison ◽  
D. Cherkas
Keyword(s):  
Contact Time ◽  
Educational Value ◽  
Resident Perception

What is the Resident Perception of Physician Assistants in an Oral and Maxillofacial Training Program?

2021 ◽  
Author(s):  
Vickas Agarwal ◽  
Joshua Hockaday ◽  
Kari Teigen ◽  
John P. Stella ◽  
Thomas Schlieve ◽  
...  
Keyword(s):  
Training Program ◽  
Physician Assistants ◽  
Resident Perception

Keeping Residents in the Dark: Do Night-Float Rotations Provide a Valuable Educational Experience?

2017 ◽  
Vol 74 (6) ◽  
pp. e67-e73 ◽  
Author(s):  
Alessandra Landmann ◽  
Heidi Mahnken ◽  
Mara B. Antonoff ◽  
SuAnn White ◽  
Arpit Patel ◽  
...  
Keyword(s):  
Educational Experience ◽  
Night Float

scholarly journals Nighthawk: Making Night Float Education and Patient Safety Soar

2017 ◽  
Vol 9 (6) ◽  
pp. 755-758 ◽  
Author(s):  
Brett W. Sadowski ◽  
Hector A. Medina ◽  
Joshua D. Hartzell ◽  
William T. Shimeall
Keyword(s):  
Patient Safety ◽  
Online Education ◽  
Senior Resident ◽  
Resident Satisfaction ◽  
Educational Materials ◽  
Team Members ◽  
Safety Issues ◽  
Night Float ◽  
Satisfaction With Supervision ◽  
The Impact

ABSTRACT Background  Some residency programs responded to duty hour restrictions by implementing night rotations. Night supervision models can vary, resulting in potential patient safety issues and educational voids for residents. Objective  We evaluated the impact of multiple evidence-based interventions on resident satisfaction with supervision, perception of the education value of night rotations, and residents' use of online educational materials. Methods  The night team was augmented with an intern to assist with admissions and a senior resident (the “nighthawk”) to supervise inpatient care and deliver a night medicine curriculum. We instituted a “must-call” list, with specific clinical events requiring mandatory attending notification, and reduced conflict in the role of the night float team. We studied patient contact, online curriculum use, residents' perceptions of nighthawk involvement, exposure to educational materials, and satisfaction with supervision. Results  During the first half of academic year 2016–2017, 51% (64 of 126) of trainees were on the night medicine rotation. The nighthawk reviewed 1007 intern plans (15 per night; range, 6–36) and supervised 215 hands-on evaluations, including codes and rapid responses (3 per night; range, 0–12). The number of users of the online education materials increased by 85% (13 to 24), and instances of use increased 35% (85 to 115). The majority of residents (79%, 27 of 34) favored the new system. Conclusions  A nighthawk rotation, a must-call list, and reducing conflict in night team members' roles improved resident satisfaction with supervision and the night medicine rotation, resulting in increased communication.

scholarly journals An ACGME Duty Hour Compliant 3-Person Night Float System for Neurological Surgery Residency Programs

2014 ◽  
Vol 6 (2) ◽  
pp. 315-319 ◽  
Author(s):  
Brian T. Ragel ◽  
Mark Piedra ◽  
Paul Klimo ◽  
Kim J. Burchiel ◽  
Heidi Waldo ◽  
...  
Keyword(s):  
Work Schedule ◽  
Meaningful Difference ◽  
Residency Programs ◽  
Night Float ◽  
System A ◽  
Oregon Health ◽  
Before And After ◽  
Work Hour ◽  
Operative Experience ◽  
Neurological Surgery

Abstract Background In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted the 24+6-hour work schedule and 80-hour workweek, and in 2011, it enhanced work hour and supervision standards. Innovation In response, Oregon Health & Science University's (OHSU) neurological surgery residency instituted a 3-person night float system. Methods We analyzed work hour records and operative experience for 1 year before and after night float implementation in a model that shortened a combined introductory research and basic clinical neurosciences rotation from 12 to 6 months. We analyzed residents' perception of the system using a confidential survey. The ACGME 2011 work hour standards were applied to both time periods. Results After night float implementation, the number of duty hour violations was reduced: 28-hour shift (11 versus 235), 8 hours off between shifts (2 versus 20), 80 hours per week (0 versus 17), and total violations (23 versus 275). Violations increased only for the less than 4 days off per 4-week interval rule (10 versus 3). No meaningful difference was seen in the number of operative cases performed per year at any postgraduate year (PGY) training level: PGY-2 (336 versus 351), PGY-3 (394 versus 354), PGY-4 (803 versus 802), PGY-5 (1075 versus 1040), PGY-7 (947 versus 913), and total (3555 versus 3460). Residents rated the new system favorably. Conclusions To meet 2011 ACGME duty hour standards, the OHSU neurological surgery residency instituted a 3-person night float system. A nearly complete elimination of work hour violations did not affect overall resident operative experience.

scholarly journals Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format

2015 ◽  
Vol 7 (2) ◽  
pp. 220-224 ◽  
Author(s):  
Steven Angus ◽  
John Moriarty ◽  
Robert J. Nardino ◽  
Amy Chmielewski ◽  
Michael J. Rosenblum
Keyword(s):  
Internal Medicine ◽  
Professional Development ◽  
Developmental Trajectory ◽  
Specific Knowledge ◽  
Survey Questions ◽  
Internal Medicine Residents ◽  
Resident Perception ◽  
And Behaviors ◽  
Appropriate Education

Abstract Background In contrast to historical feedback, which was vague or provided residents' numerical scores without clear meaning, milestone-based feedback is focused on specific knowledge, skills, and behaviors that define developmental trajectory. It was anticipated that residents would welcome the more specific and actionable feedback provided by the milestone framework, but this has not been studied. Objective We assessed internal medicine (IM) residents' perceptions of receiving feedback in the milestone framework, particularly assessing perception of the utility of milestone-based feedback compared to non–milestone-based feedback. Methods We surveyed a total of 510 IM residents from 7 institutions. Survey questions assessed resident perception of milestone feedback in identifying strengths, weaknesses, and trajectory of professional development. Postgraduate years 2 and 3 (PGY-2 and PGY-3) residents were asked to compare milestones with prior methods of feedback. Results Of 510 residents, 356 (69.8%) responded. Slightly less than half of the residents found milestone-based feedback “extremely useful” or “very useful” in identifying strengths (44%), weaknesses (43%), specific areas for improvement (45%), and appropriate education progress (48%). Few residents found such feedback “not very useful” or “not at all useful” in these domains. A total of 51% of PGY-2 and PGY-3 residents agreed that receiving milestone-based feedback was more helpful than previous forms of feedback. Conclusions IM residents are aware of the concepts of milestones, and half of the residents surveyed found milestone feedback more helpful than previous forms of feedback. More work needs to be done to understand how milestone-based feedback could be delivered more effectively to enhance resident development.

The graveyard shift: experience with a night float system

2002 ◽  
Vol 9 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Douglas W. Reader ◽  
Dimitrios G. Spigos ◽  
William F. Bennett ◽  
Charles F. Mueller ◽  
Kuldeep K. Vaswani
Keyword(s):  
Night Float
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