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Changes in Perception of and Participation in Unprofessional Behaviors During Internship

Background Do perceptions of and participation in unprofessional behaviors change during internship? Method Interns at three Chicago medicine residencies anonymously reported participation in unprofessional behaviors before and after internship. On the basis of a prior survey, interns rated 28 unprofessional behaviors from 1 (unprofessional) to 5 (professional). Site-adjusted regression examined changes in participation rates and perception scores. Results Response rates were 93% (105) before and 88% (99) after internship. Participation in on-call unprofessional behaviors increased (“blocking” admissions [12% versus 41%, P < .001], disparaging the ER [27% versus 45%, P = .005], misrepresenting tests as urgent to expedite care [40% versus 60%; P = .003], and signing out by phone [20% versus 42%, P < .001]). Participation in egregious behaviors (fraud, disrespect, misrepresentation) and perceptions of most behaviors remained unchanged. Conclusions Although participation in egregious unprofessional behavior remained unchanged during internship, participation in on-call unprofessional behaviors increased.