Clinical learning during night call versus day work: Perceptions of interns

Abstract

Introduction: Clinical learning during night call has been shown to be less efficient and effective than during the day among residents. Strategies are needed to address the gap between night-time and daytime learning. We conducted a survey study to examine perceptions of night-time compared with daytime learning among Internal Medicine interns, and asked for suggestions to address this gap. Method: This is a cross-sectional survey study conducted on a single class of 47 interns from Singapore General Hospital in December 2013. Interns anonymously completed a modified previously published 25-item survey. A total of 23 items asked for ratings of learning during the day versus the night using a 5-point Likert scale. The remaining two open-ended questions invited respondents to suggest improvements for teaching and learning. Analysis was done by descriptive statistics for the Likert-scale items, and thematic coding by two coders for narrative responses. Results: Response rate was 70% (33/47). Interns rated learning during the day more positively than during night call for 23 of 23 (100%) items, with 22 out of 23 items showing significant difference. Among the 33 respondents, 20 provided narrative responses. Three major themes emerged: increasing manpower, allowing patient follow-up after night call, and more time for bedside teaching in the daytime. Conclusion: Our study confirms that learning during night call is perceived as less effective than during the day. We further extended this finding to offer alternate strategies to enhance clinical learning among interns.