ReviewJournal of general internal medicine2025
Acute Medical Care by Nocturnists: A Narrative Review.
Review in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nocturnists are the principal means by which hospital medicine groups currently ensure continuous overnight coverage of hospitalized patients within academic medical centers and community hospitals. Yet despite their involvement in most aspects of overnight care, a comprehensive review of the impact of nocturnists in the hospital is absent. Here we examine the physiologic effects of overnight work on clinicians, the quality of medical care delivered by nocturnists in floor and intensive care units, the impact of nocturnist presence on trainee supervision and graduated autonomy in academic settings, and prevalent staffing models. Nocturnists serve diverse roles across institutions, including performing overnight admissions and consultations, managing patients, supervising trainees, and participating in rapid response activations. Physiologically, nocturnists may experience circadian misalignment and sleep deprivation, which can impact cognitive function and results in potential long-term health risks to those working overnight. Studies show mixed results of nocturnist impact on patient outcomes, with comparative observational analyses revealing no significant differences in mortality, readmissions, or length of stay, despite perceived benefits. Nocturnist presence has been shown to enhance resident supervision and educational value of overnight rotations without compromising decision-making autonomy, though trainees' fear of revealing knowledge gaps persists. Overnight staffing models vary, with some institutions employing dedicated nocturnists and others using hybrid models; the heterogeneity of nocturnist responsibilities across institutions makes determining ideal models difficult. Compensation is typically greater for nocturnists, but the role's sustainability and impact on overall group retention remain unknown. Nocturnist programs are essential to provide continuous care of hospitalized patients and meet trainee supervision mandates, yet their full impact on patient and educational outcomes requires further investigation. Future research should aim to optimize staffing models to enhance patient care, trainee education, and clinician well-being.
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