Brief report: Internal medicine residents', attendings', and nurses' perceptions of the night float system

Residency training programs use the night float system increasingly to meet the new resident work hour regulations.

To assess and compare residents', attendings', and nurses' perceptions of the night float system.

A survey study.

One hundred and seven residents, 48 attendings, and 69 nurses in a university-based multicenter internal medicine residency program.

Perceived impact on patient care, resident training, and resident performance.

The overall response rate was 75%. In general, more residents than both attendings and nurses had positive opinions regarding the night float system, particularly in relation to patient care. Only a small proportion of residents and attendings thought positively about the night float's impact on training quality (29.9%; 18.2%), daily feedback (23.0%; 9.1%), and end of rotation evaluation (21.8%; 6.1%). Less than half of the nurses had positive perceptions of the night residents' performance in terms of promptness (40.9%), physical availability (38.6%), familiarity with the patients' cases, and management plans (15.9%), communication of management plans to nurses (36.4%), professional respect and trust (43.2%), and teamwork (45.5%).

Residents had more positive perceptions than attendings and nurses. Nurses, in particular, had negative perceptions of resident performance in the setting of the night float system.