"We are not stating what is unprofessional. We want to know what the hospitalists think is unprofessional," Arora says. "We used a range of behaviors from extremely egregious to not really an issue. Talking in the hallway is not the same as disparaging the patient or backdating a note. We wanted in the survey to provide heterogeneity of behaviors so people could decide what was grey and what was definitely black and white."
"The idea wasn't 'let's go find out what the bad things are in the workplace.' We wanted to develop some targeted educational interventions to improve the learning environment but before we did we wanted to know the behaviors to target," she says.
Nearly 80% of the hospitalists who took part in the study completed their residency after 2000, 57% were male and 61% had worked with their current hospital group for one to four years. They graded more than 30 unprofessional behaviors on a five-point scale commonly used to measure attitudes or opinions.
Arora noted an interesting correlation between job characteristics of hospitalists and reports of unprofessional behavior.
"Hospital-based physicians have very different types of jobs based on whether they teach, or do administrative work, or clinical or night work and we found that your job type predicted some of the behaviors you participated in," she says.