SHM Converge Scientific Abstract ePoster Gallery-Pairing Medicine Subinterns With Nocturnists to Improve Nighttime Education Experience

Pdf Summary

This project describes a nighttime learning experience for internal medicine subinterns designed to address gaps in daytime training opportunities and better prepare students for internship. Because modern duty-hour restrictions and crowded daytime teams can limit chances for fourth-year students to do admissions, enter orders, and practice cross-cover, the program added one dedicated “night week” during a 4-week subinternship.<br /><br />During this week, students completed three night shifts. For the first half of each shift, they worked with nightfloat residents, receiving handoffs from day teams, participating in cross-coverage, and responding to rapid response teams and codes. For the second half, they paired with hospital medicine nocturnists and completed at least two admissions. A “Night Checklist” guided self-directed learning and highlighted night-specific educational opportunities. After the rotation, both students and nocturnists completed surveys to assess educational value, participation, workflow impact, and ideas for improvement.<br /><br />Feedback suggested the model was valuable. Students appreciated exposure to nighttime hospital flow, real clinical responsibilities, admissions, sign-out to day teams, and teaching from nocturnists. They felt the experience was helpful for preparing for intern year, especially for night shifts. However, students also reported some downtime, sleep disruption, and uncertainty about their role. Nocturnists viewed students as helpful with admissions, history-taking, and medication reconciliation, and valued the opportunity to give feedback, do brief teaching, and receive student evaluations that could support promotion. Challenges included integrating students into workflow and giving them enough attention on busy nights.<br /><br />Next steps include more pre-night orientation, required and gamified checklists, additional teaching on cross-cover and emergency response, possible ICU exposure with critical care fellows, follow-up surveys after students become interns, and continued faculty development to support student autonomy.

Asset Subtitle

Jennifer Valentine

Meta Tag

Author List Dianna Cheney-Peters, Jennifer Valentine, Paul Endres, Rebecca Vento

Category Innovations

Concept Sick Patient

Concept Escalation of Care

Concept Cross-Cover Care

Concept Hospital Admission

Concept Rapid Response Team

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College--Thomas Jefferson University Hospital

Presenting Author Jennifer Valentine

Track Education

Keywords

internal medicine

subinternship

night shift

nightfloat

hospital medicine

cross-coverage

admissions

duty-hour restrictions

handoff

internship preparation

Sick Patient

Escalation of Care

Cross-Cover Care

Hospital Admission

Rapid Response Team