Innovation in patient care and medical resident education: Using blended instruction to transform nighttime patient care from a service model into an educational model

Medical resident education changed dramatically on July 1, 2011 with the institution of new duty-hour work restrictions. The move to shift scheduling changed the notion of nighttime work from a time of service to one of education. The National Pediatric Nighttime Education Steering Group responded to this paradigm shift by creating a national, peer-reviewed, Web- and case-based curriculum for nighttime learning in pediatrics. Field-test results from implementation in 89 programs revealed statistically significant improvements in knowledge and confidence, but a need for improvement in usability interface, instructional design, and dissemination. Finding support to improve upon the design of the curriculum and provide a robust platform for dissemination and use by residency programs presents a significant challenge, especially in light of severe threats to graduate medical education funding at the national level.