Implementation of a Night-Float Curriculum: Impact on Intern Confidence over Time

Area of Science:

• Medical Education
• Internal Medicine Residency Training

Background:

• Internal medicine residency programs increasingly use night-float rotations (NFRs), necessitating formal education.
• The effectiveness of NFR curricula and their impact on trainee confidence over an academic year remain largely unexamined.

Purpose of the Study:

• To evaluate the impact of a 12-module, self-paced NFR curriculum on postgraduate year-1 residents' clinical confidence.
• To assess the longitudinal efficacy of the NFR curriculum throughout an academic year.

Main Methods:

• A 12-module, self-paced NFR curriculum was implemented for 76 postgraduate year-1 residents.
• Pre- and post-rotation surveys using Likert scales assessed clinical confidence in 12 specific topics.
• Data were collected over 32 week-long NFR cycles from June 2020 to March 2021.

Main Results:

• Residents' confidence significantly improved for all 12 NFR curriculum topics post-rotation.
• The curriculum demonstrated the most significant confidence improvement during the initial 4 months of the academic year (11/12 topics statistically significant).
• Modules on altered mental status, hypotension, narrow-complex tachyarrhythmias, new fever, and sepsis/antibiotic escalation showed sustained efficacy.

Conclusions:

• Emphasizing NFR curriculum content at the beginning of the academic year is crucial.
• Residency programs should consider topic rotation, potentially replacing some modules with more advanced content as the year progresses to maintain efficacy.