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.