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

J Gen Intern Med. 2006 May;21(5):494-7. doi: 10.1111/j.1525-1497.2006.00434.x.


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

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

Design: A survey study.

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

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

Results: 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%).

Conclusions: 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Data Collection
  • Female
  • Humans
  • Internal Medicine / education
  • Internal Medicine / organization & administration
  • Internship and Residency*
  • Male
  • Medical Staff, Hospital / psychology*
  • Multivariate Analysis
  • New York
  • Nurses / psychology*
  • Patient Care / psychology
  • Personnel Staffing and Scheduling*
  • Work Schedule Tolerance
  • Workload