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1. Have you witnessed a colleague coming in late to work during a floor month?
 
Never
 
< 5 times per month
 
5-10 times per month
 
> 10 times per month
 
 
 
2. How often do you conduct surveys?
 
Never
 
< 5 times per call
 
5-10 times per call
 
> 10 times per call
 
 
 
3. Have you witnessed a colleague calling in At-Risk without a valid reason?
 
Never
 
1-2 times per year
 
3-5 times per year
 
> 5 times per year
 
 
 
4. Have you witnessed a colleague leave prior to 4 PM during ICU rotation?
 
Never
 
< 5 times per rotation
 
5-10 times per rotation
 
> 10 times per rotation
 
 
 
5. Have you witnessed a colleague skip morning report when they could attend?
 
Never
 
< 5 times per month
 
5-10 times per month
 
> 10 times per month
 
 
 
6. Have you witnessed a colleague skip didactics when they could attend?
 
Never
 
< 5 times per month
 
5-10 times per month
 
> 10 times per month
 
 
 
7. Have you witnessed your colleagues delay documentation beyond the calendar day?
 
Never
 
< 5 times per month
 
5-10 times per month
 
> 10 times per month
 
 
 
8. Have you witnessed a colleague behave inappropriately with a member of the hospital staff (nurses, PCA, PA)?
 
Never
 
< 5 times per month
 
5-10 times per month
 
> 10 times per month
 
 
 
9. Have you witnessed a colleague behave inappropriately with a member of their own team (students/interns/faculty)?
 
Never
 
< 5 times per month
 
5-10 times per month
 
> 10 times per month
 
 
 
10. Have you witnessed a colleague coming in late to work to clinic?
 
 
Never
 
< 5 times per month
 
5-10 times per month
 
> 10 times per month
 
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