Can incorporating inpatient overnight work hours into a pediatric clerkship improve the clerkship experience for students?
OBJECTIVE
After incorporating medical students into pediatric resident night-float teams, the authors studied the effects of the new schedule on (1) cognitive performance, (2) number of new admissions, (3) clerkship satisfaction, and (4) amount and quality of resident teaching.


METHODS
Part 1 was a retrospective historical controls study. The intervention was a schedule change that eliminated inpatient call. The historical control group had a four-week inpatient schedule of daytime hours plus five calls (DT+C). The comparison group had a schedule of three weeks of daytime hours plus five consecutive overnight shifts (DT+OS). National Board of Medical Examiners (NBME) Pediatrics Subject Exam scores, number of admission history and physicals (HPEs), and clerkship satisfaction data from both groups were compared. Part 2 was a two-item survey with open-ended comments that measured perceptions of resident teaching time and quality of resident teaching (QRT) from students on the DT+OS schedule.


RESULTS
DT+OS students had a significantly increased number of HPEs (t=2.17; P=.03) compared with the DT+C group (mean=7.49, standard deviation [SD]=3.34 in DT+OS versus mean=6.11, SD=2.95 in DT+C). The paired samples t test showed that students rated QRT significantly higher when on overnights than when they were on daytime hours (t=2.47; P=.02). There were no differences in satisfaction or NBME scores.


CONCLUSIONS
Overnight work hours for medical students increased clerkship capacity while maintaining student satisfaction and cognitive performance. Added benefits included increased clinical experience and improved QRT.
Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri 64111, USA. ntalib@cmh.edu
Nasreen
N
Talib
Serkan
S
Toy
Kristen
K
Moore
Jennifer
J
Quaintance
Jane
J
Knapp
Vidya
V
Sharma
D002982:Clinical Clerkship / Q000379:methods / Q000458:organization & administration*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D008297:Male; D008923:Missouri; D010372:Pediatrics / Q000193:education*; D010549:Personal Satisfaction; D010561:Personnel Staffing and Scheduling; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods / Q000592:standards