Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Center for Surgery and Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
J Surg Educ. 2024 Nov;81(11):1764-1771. doi: 10.1016/j.jsurg.2024.08.026. Epub 2024 Sep 20.
Night float rotations are associated with decreased feedback, educational conference attendance, and operative time. Interns are also more isolated and spend less time on teams. We therefore developed a novel post night shift initiative to address these shortcomings and examined its impact on the educational experience and sense of belonging among interns.
A program of weekly senior resident-led post night shift sessions was instituted at a university-based general surgery residency program for the first quarter of the academic year. Four interns and one senior resident participated in each session. Feedback surveys were administered. A previously validated Belonging in Surgery survey was also administered to all general surgery interns at the end of the quarter.
Eleven interns had night float rotations within the first 3 months of the academic year. The intern feedback survey response rate was 93% (10/11). All intern respondents attended at least 3 sessions. Interns felt that the sessions increased familiarity with each other (85%) and senior residents (92%), improved clinical decision making (77%), and provided a safe space for discussion (69%). The senior resident survey response rate was 86% (n = 14). All senior residents enjoyed teaching the sessions and felt that they improved their familiarity with interns. The intern belonging survey response rate was 84% (16/19). Categorical interns had significantly higher belonging scores than preliminary interns at the end of the first quarter (mean 48.1 vs 41.6, p = 0.009). There was a trend toward decreased belonging scores for interns who had night float rotations early in the year which did not meet statistical significance (42.9 vs 47.4, p = 0.059).
This novel program improved intern decision-making, familiarity with other residents, and comfort calling senior residents for assistance overnight. There was no statistically significant difference in belonging between interns who started residency on night float versus those who did not. Similar programs may help address concerns regarding missed learning opportunities and decreased sense of community during these rotations.
夜间轮班与反馈减少、教育会议出席率降低以及手术时间减少有关。实习医生也更加孤立，在团队中花费的时间更少。因此，我们开发了一项新的夜班后计划，以解决这些问题，并研究其对实习医生教育体验和归属感的影响。
在一所大学普外科住院医师培训计划中，第一学期开始实施每周由高级住院医师领导的夜班后课程。每次课程有四名实习医生和一名高级住院医师参加。进行了反馈调查。还在本季度末向所有普外科实习医生发放了一份先前经过验证的《外科归属感调查》。
在学术年的前 3 个月内，有 11 名实习医生进行了夜间轮班。实习医生反馈调查的回复率为 93%（10/11）。所有实习医生都至少参加了 3 次会议。实习医生认为，这些会议增加了他们彼此之间（85%）和高级住院医师之间的熟悉度（92%），提高了临床决策能力（77%），并为讨论提供了安全空间（69%）。高级住院医师调查的回复率为 86%（n=14）。所有高级住院医师都喜欢教授这些课程，并认为这提高了他们对实习医生的熟悉度。外科归属感调查的回复率为 84%（16/19）。在第一季度末，分类实习医生的归属感得分明显高于初步实习医生（平均 48.1 对 41.6，p=0.009）。但对于那些在年初进行夜间轮班的实习医生，归属感得分下降的趋势并不显著（42.9 对 47.4，p=0.059）。
这项新计划提高了实习医生的决策能力、对其他住院医生的熟悉程度以及夜间寻求高级住院医生帮助的舒适度。在夜间轮班开始与不开始的实习医生之间，归属感没有统计学上的显著差异。类似的计划可能有助于解决这些轮班期间错过学习机会和归属感降低的问题。
