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Journal of General Internal Medicine

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01-09-2015 | Original Research

Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey

Authors: Eric N. Goren, MD, Debra S. Leizman, MD, Jeffrey La Rochelle, MD, MPH, Jennifer R. Kogan, MD

Published in: Journal of General Internal Medicine | Issue 9/2015

ABSTRACT

BACKGROUND

Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24–30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described.

OBJECTIVE

We aimed to determine the current status of medical students’ overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators’ perceptions of the importance of overnight work during internal medicine rotations.

DESIGN AND PARTICIPANTS

In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1–5 Likert scale, 1 = very unimportant and 5 = very important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively.

KEY RESULTS

The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p < 0.001. Admitting new patients, following their course and responding to emergencies were rated as important overnight tasks for both clerkship and sub-internship students.

CONCLUSIONS

Overnight experiences offer students additional educational opportunities. Clerkship directors felt that the overnight experience for the sub-intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

Available only for authorised users

Ludmerer KM. Let me heal: the opportunity to preserve excellence in American medicine. Oxford: Oxford University Press; 2015.

Alexander D, Bushell IW. Coping with night call: part 1: understanding the benefits and challenges of traditional call. Hosp Physician. 1999;53–69.

Petersdorf RG, Bentley J. Residents’ hours and supervision. Acad Med. 1989;64(4):175–81.CrossRefPubMed

Resident Duty Hours in the Learning and Working Environment Comparison of 2003 and 2011 Standards. Available at https://www.acgme.org/acgmeweb/Portals/0/PDFs/dh-ComparisonTable2003v2011.pdf Accessed May 7, 2015.

Philibert I, Taradejna C. Chapter 2: a brief history of duty hours and resident education in the ACGME 2011 duty hour standards: enhancing quality of care, supervision, and resident professional development. 2011. Chicago. pp 5–12.

Barzanasky B, Etzel SI. Educational programs in US medical schools, 2004–2005. JAMA. 2005;294:1068–74.CrossRef

Oshimura JM, Sperring J, Bauer BD, Carroll AE, Rauch DA. Changes in inpatient staffing following implementation of new residency work hours. 2014 Oct;9(10)640–645.

Wallach SL, Khursheed A, Diaz N, Shine D. How do internal medicine residency programs evaluate their resident float experiences? South Med J. 2006;99(9):9190923.CrossRef

Lang VJ, Mooney CJ, O’Connor AB, Bordley DR, Lurie SJ. Association between hand-off patients and subject exam performance in medicine clerkship students. J Gen Intern Med. 2009;24(9):1018–22.PubMedCentralCrossRefPubMed

10.

Bump GM, Zimmer SM, McNeil MA, Elnicki DM. Hold-over admissions: are they educational for residents? J Gen Intern Med. 2013. doi:10.1007/s11606-013-2667-y.PubMedCentralPubMed

11.

Corriere MD, Hanson JL, Hemmer PA, Denton GD. Overnight call: a survey of medical student experiences, attitudes, and skills. Teach Learn Med. 2013;25(1):64–70.CrossRefPubMed

12.

Hiraoka M, Sung S, Davis J, Kim D. Faculty and resident perceptions regarding overnight student call during third year Ob/Gyn clerkship. Hawaii Med J. 2011;70:189–192.PubMedCentralPubMed

13.

Barzansky B, Etzel S. Medical schools in the United States, 2009–2010. JAMA. 2010;304:1247–54.CrossRefPubMed

14.

Brasher AE, Chowdhry S, HAuge LS, Prinz RA. Medical students’ perceptions of resident teaching: have duty hours regulations had an impact? Ann Surg. 2005;242(4):548–53.PubMedCentralPubMed

15.

Christopher M. A eulogy to the traditional overnight call. J Gen Intern Med. 2011;27(3):387–8.

16.

Nixon LJ, Benson BJ, Rogers TB, Sick BT, Miller WJ. Effects of Accreditation Council for Graduate Medical Education work hour restrictions on medical student experience. J Gen Intern Med. 2007;22(7):937–41.PubMedCentralCrossRefPubMed

17.

Reed DA, Fletcher KE, Arora VM. Systematic review: association of shift length, protected sleep time, and night float with patient care, residents’ health, and education. Ann Intern Med. 2010;153(12):829–42.CrossRefPubMed

18.

Prince K, Van de Weil M, Vad der Vleuten C, Boshuizen H, Scherpbier A. Junior doctors’opinions about the transition from medical school to clinical practice: a change of environment. Educ Health (Abingdon). 2004;17(3):323–31.CrossRef

19.

Zahn CM, Dunlow SG, Alvero R, Parker JD, Nace C, Armstrong AY. Too little time to teach? Medical student education and the resident work-hour restriction. Mil Med. 2007;172(10):1053–7.CrossRefPubMed

20.

Alliance for Academic Internal Medicine. CDIM Survey guideline available at http://www.im.org/p/cm/ld/fid=758. Accessed May 7, 2015.

21.

Englander R, Aschenbrener CA, Call SA, et al. Core entrustable professional activities for entering residency. MedEdPortal–AAMC. Online. https://www.mededportal.org/icollaborative/resource/887. Accessed May 5, 2015.

22.

Brennan N, Corrigan O, Allard J, Archer J, Barnes R, Bleakley A, Collett T, de Bere SR. The transition from medical student to junior doctor: today’s experiences of Tomorrow’s Doctors. Med Educ. 2010;44(5):449–58.CrossRefPubMed

23.

Center for Disease Control. National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary. 2008. Retrieved from: http://www.cdc.gov/nchs/data/nhsr/nhsr007.pdf.

24.

Cohee BM, Hartzell JD, Shimeall WT. Achieving balance on the inpatient internal medicine wards: a performance improvement project to restructure resident work hours at a tertiary care center. Acad Med. 2014;89(5):740–429.CrossRefPubMed

25.

ACGME rules: Common Program Requirements. Available at: https://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf Accessed May 5, 2015.

Title: Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey
Authors: Eric N. Goren, MD
Debra S. Leizman, MD
Jeffrey La Rochelle, MD, MPH
Jennifer R. Kogan, MD
Publication date: 01-09-2015
Publisher: Springer US
Published in: Journal of General Internal Medicine / Issue 9/2015
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-015-3405-4

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ABSTRACT

BACKGROUND

OBJECTIVE

DESIGN AND PARTICIPANTS

KEY RESULTS

CONCLUSIONS

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