A night float week in a surgical clerkship improves student team cohesion

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

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

A Nationwide Survey Study on Medical Student Experience in Acute Care Surgery

BACKGROUND

There is little known about medical student education in acute care surgery (ACS)-how much and what type of exposure students receive in the specialty. The aim of this study was to investigate the current status of ACS education provided to students in U.S. medical schools.

MATERIALS AND METHODS

We created an online survey tool covering the surgical clerkship and ACS curriculum and distributed this survey to the official email list of the Association for Surgical Education Committee on Clerkship Directors.

RESULTS

A total of 57 of 294 (19.4%) responses were received. All respondents reported that at least some of their major teaching hospitals are affiliated with an ACS service and have a level 1 or 2 trauma center. Although almost two-thirds (61.8%) of respondents believe that medical students should have formal ACS education in the form of a clinical rotation, an ACS rotation is mandatory at only 16.4% of programs and is optional at 69.1% of programs as part of the surgical clerkship curriculum. The duration of ACS rotations ranges from 1 to 6 wk, and half of programs require students to take overnight call (most often 1-2 nights/wk). The most common pathologies that students see on ACS include appendicitis, biliary disease and cholecystitis, intestinal obstruction, and trauma.

CONCLUSIONS

Medical students across the nation have varying exposure to ACS during their clinical training. With the continued growth of the ACS specialty, further study is warranted to examine the impact of undergraduate ACS education on student career planning.

Acute Care Surgery Education in US Medical Schools: A Systematic Review of the Current Literature and Report of a Medical Student Experience

OBJECTIVE

There is currently little known about acute care surgery (ACS) education in US medical schools. The purpose of this paper was to systematically review the state of the literature describing ACS training at the medical school level and introduce an ACS education model provided to medical students at our institution.

DESIGN

We conducted a comprehensive literature review using the PubMed database to identify all articles related to ACS (trauma surgery, emergency general surgery, and surgical critical care) and undergraduate medical education.

PARTICIPANTS

A total of 376 articles were captured with our search strategy. The articles were reviewed for eligibility by 2 separate reviewers.

RESULTS

We identified 3 relevant articles for our literature review. All studies were performed at level 1 trauma centers. The duration of ACS rotations ranges from 1 to 4 weeks with variable night call schedules. While several curricular changes have improved student perceptions on ACS education, none of the studies have thoroughly evaluated the impact on students' readiness or career choices for their postgraduate training.

CONCLUSIONS

The current lack of information on ACS education in medical school has left us with a need to better understand this area in order to improve students' experience and exposure to the specialty. Future efforts should be placed on addressing current issues in ACS education and evaluating its impact on career choice of medical students.