title: Residents' and attendings' perceptions of a night float system in an internal medicine program in Canada.
abstract: BACKGROUND
  The Night Float system (NFS) is often used in residency training programs to meet work hour regulations. The purpose of this study was to examine resident and attendings' perceptions of the NFS on issues of resident learning, well-being, work, non-educational activities and the health care system (patient safety and quality of care, inter-professional teams, workload on attendings and costs of on-call coverage).
  
  
  METHODS
  A survey questionnaire with closed and open-ended questions (26 residents and eight attendings in an Internal Medicine program), informal discussions with the program and moonlighting and financial data were collected.
  
  
  CONCLUSIONS
  The main findings included, (i) an overall congruency in opinions between resident and attendings across all mean comparisons, (ii) perceptions of improvement for most aspects of resident well-being (e.g. stress, fatigue) and work environment (e.g. supervision, support), (iii) a neutral effect on the resident learning environment, except resident opinions on an increase in opportunities for learning, (iv) perceptions of improved patient safety and quality of care despite worsened continuity of care, and (v) no increases in work-load on attendings or the health care system (cost-neutral call coverage). Patient safety, handovers and increased utilization of moonlighting opportunities need further exploration.
authors.affiliation: Department of Pathology; Dean's Office, Postgraduate Medical Education, Saskatoon, SK, Canada.
authors.forename: Anurag
authors.initials: A
authors.lastname: Saxena
authors.forename: Loni
authors.initials: L
authors.lastname: Desanghere
authors.forename: Robert P
authors.initials: RP
authors.lastname: Skomro
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Wilson
mesh_terms: D039602:After-Hours Care / Q000191:economics / Q000458:organization & administration / Q000592:standards; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000191:economics / Q000458:organization & administration*; D007858:Learning; D008297:Male; D008505:Medical Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D061214:Patient Safety; D010561:Personnel Staffing and Scheduling / Q000191:economics / Q000458:organization & administration / Q000592:standards; D011785:Quality Assurance, Health Care / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D012525:Saskatchewan; D012892:Sleep Deprivation / Q000150:complications* / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance / Q000502:physiology / Q000523:psychology