Night-float In The OB/GYN Clerkship: As The Sun Sets, A Resilient Resident Rises
Date
2025
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Abstract
Introduction
While virtually all residency programs require some form of night call, a minority of medical students have overnight experiences. At the John A. Burns School of Medicine, although many clerkships have “late-call” experiences, OB/GYN is the only rotation with an overnight component in the form of night float. Previous studies have described students’ night float experiences in clerkships other than OB/GYN. Some studies have found more opportunities for admission history and physicals during the nighttime with varied impacts on the quality of teaching overnight, and most studies demonstrated either better performance or no impact on NBME scores (1,2,3). Few studies have surveyed students directly, and no studies have been conducted on this topic in the OB/GYN clerkship.
Objectives
The purpose of this study was to characterize third-year medical students’ perceptions and experiences during a four-consecutive night float shift on Labor and Delivery.
Methods
Medical students who completed the OB/GYN clerkship during the 2023-2024 academic year answered unlinked, pre- and post-clerkship surveys. Students responded to statements of their experiences using a 5-point Likert scale and reported the number of patient interviews and
deliveries they participated in. Statistical significance was tested with Chi-square.
Results
Among 75 students, there was an increase in the percentage of students (pre-8% vs. post-31%) who “strongly disagreed” / “disagreed” that students should experience a night float rotation during medical school (p<0.001). Students reported more patient interviews (4 or more) during the day (59%) versus night shift (36%; p<0.001), but the same number of deliveries (7 or more) (day-55% vs. night-63%; p>0.05). The majority of students agreed/strongly agreed that night float allowed them to experience a resident schedule (73%) and taught them how to function when tired (57%).
Discussion
Overall, medical students seemed to have a negative perception of night float with similar numbers of patient care experiences as the day shift. However, night float provided students with a taste of a residency schedule and taught them resilience. Having exposure to their first night shift during medical school may provide comfort to incoming residents as they are bombarded with new challenges and experiences to overcome during their intern year.
References
1. Talib N, Toy S, Moore K, Quaintance J, Knapp J, Sharma V. Can incorporating inpatient overnight work hours into a pediatric clerkship improve the clerkship experience for students? Acad Med. 2013 Mar;88(3):376-81. doi: 10.1097/ACM.0b013e318280d271. PMID: 23348086.
2. Tran JH, Fine ME, Holzer H. Student and Educator Perceptions of Night Float in the Internal Medicine Inpatient Clerkship. J Gen Intern Med. 2023 Apr;38(5):1319-1321. doi: 10.1007/s11606-022-07956-w. Epub 2022 Dec 1. PMID: 36456845; PMCID: PMC10110800.
3. Connelly CR, Kemp Bohan PM, Cook MR, Moren AM, Schreiber MA, Kiraly LN. A night float week in a surgical clerkship improves student team cohesion. Am J Surg. 2016 May;211(5):913-8. doi:10.1016/j.amjsurg.2016.01.011. Epub 2016 Feb 23. PMID: 26988619.
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