Transitioning to Night Float: A Year-long Prospective Crossover Trial Evaluating the Impact on Measures of Urology...

To compare professional quality of life, sleep-related impairment, sleep disturbance, depression, anxiety, and stress among junior urology residents during a transition from a traditional home call to night float (NF) call system within a consistent cohort followed throughout an entire academic year.

Four validated instruments were administered weekly for 52 weeks to five junior residents undergoing an intra-year transition to the NF model during the 2024-2025 academic year. Instruments measured professional quality of life (ProQOL: compassion, burnout, and secondary traumatic stress); sleep (PROMIS Sleep Disturbance and Sleep-Related Impairment); and mental health (Depression Anxiety Stress Scale-21). Weeks 1-9 corresponded to home call, and weeks 10-52 to NF. Random intercept and intercept-slope models assessed differences with P <.05 considered significant.

Residents completed 260 surveys (1040 questionnaires with 100% response rate). Depression, anxiety, and stress scores decreased significantly after NF transition for both NF and non-NF residents (P <.001). Sleep disturbance was unchanged for NF residents (P = .946) but decreased for non-NF residents compared with home call (P = .003). Sleep impairment improved for both NF and non-NF residents (P <.001). Burnout and secondary traumatic stress increased following NF transition (P <.001), while compassion scores were unchanged.

Transitioning to NF improved mental health and reduced sleep-related impairment but was associated with higher burnout and secondary traumatic stress. While the NF model may mitigate sleep deprivation, it may introduce new challenges to long-term professional well-being.