An Exploratory Study of Overnight Education in the Medical Intensive Care Unit

Background: Many hospitals in the United States employ overnight intensivist coverage for their medical intensive care units, but little is known about the effect of this staffing model on trainee education, and the learning that occurs overnight. This study examined the educational interactions occurring between residents and overnight intensivists in the context of the overnight multidisciplinary learning environment. Methods: We conducted an anonymous, cross-sectional survey of internal medicine residents and overnight intensivists at a single, tertiary academic teaching hospital regarding teaching impact, teaching frequency, educational needs and learning preferences when working overnight. Results: Of those surveyed, 61% (33/54) of residents and 56% (15/27) of intensivists responded. Residents identified overnight intensivists as having the highest teaching impact overnight, followed by co-residents, respiratory therapists, then nurses. Residents reported learning most about ventilator management (87%), procedures (70%), and vasopressors (67%) overnight. Overnight intensivists reported teaching most about ventilator management (100%), procedures (83%), and running a “code blue” (67%). Residents favored teaching that is procedural (78%), topic-specific (75%), and delivered in a one-on-one setting (63%). Conclusion: Residents identify the overnight intensivist as an impactful teacher. Other providers working in the intensive care unit overnight also contribute to resident education. Further study is needed on the educational roles of other multidisciplinary team members. There is opportunity to tailor overnight education both in content and style to suit learners’ needs.