Impact of a Pediatric Night Float on Medical Students' Education: Clerkship Student Perspectives

A night float, in which learners work successive overnight shifts, is increasingly used in undergraduate medical education, yet few studies have examined its impact on students. The study objective was to explore third-year medical students' perspectives on the impact on learning of a pediatric night float.

Informed by situated learning theory, we performed a qualitative study using grounded theory methodology to interview 19 third-year medical students who completed a pediatric night float between June 2019 and April 2021. Four coders analyzed data with the constant comparative method. Codes were built using an iterative approach and organized into themes. Discrepancies were resolved by consensus.

Analysis yielded 4 themes: professional identity formation, learning activities, clinical experiences, and work-life balance. Students described positive and negative educational experiences, which were influenced by how well students integrated into the team. For some students, the night float provided opportunities to admit patients, increase confidence, and build camaraderie, which helped form professional identity. Students felt the night float was key residency preparation. Educational activities included experiential learning, teaching, and receiving feedback. Students admitted more patients and were exposed to a greater diversity of illnesses at night compared with day shifts. Fatigue was common and sending students home before morning handoff impeded their integration into the team.

Students described varied impact of the night float on their education. A night float experience was felt to be key residency preparation. For students who felt included in the team a night float may promote professional identity formation.