The night float system: ensuring educational benefit

Background The ACGME mandated a change in resident work hours effective July 2003. We postulated that taking a block of night call would provide an opportunity for residents to improve clinical decision-making without detracting from operative experience. Methods The educational benefit of the Night Float model was evaluated weekly by anonymous questionnaires that assessed resident conference attendance, operative experience, attending teaching interactions, and consultations for the previous seven days. Results Preliminary results demonstrated that a higher percentage of Night Float residents reported less exposure to each educational opportunity than their colleagues. These data prompted several remedial interventions that resulted in significant improvement. Compliance with the 80-hour workweek was equal for both groups. Conclusions The Night Float model has the advantage of fulfilling ACGME requirements, but it also has the potential to limit educational experience. Continued monitoring and faculty intervention are critical if we are to succeed in our goal to provide our residents with the best possible training.