Figure 1.

CONSORT diagram. Flow diagram identifying the participants whose survey responses were included in the analysis. Asterisk symbol indicates that trainees who participated in the cognitive interviews were not considered eligible and are not represented. Superscripted digit 1 indicates trainees who were not on an inpatient service at during study enrollment. Superscripted digit 2 indicates the rationale behind dropping observations related to zero response variance, which was  based on an item set with three or more items that includes at least one reverse item. Since reverse items should generate the opposite response  of the remaining items measuring the same dimension (e.g., those who selected “strongly agree” for items that measure autonomy, should not have selected the same for the reverse item, assuming that the item truly measures the dimension that it is intended to capture), those observations with zero variance were considered untruthful. Responses with a zero variance were, however, included in the analysis if the response to the reverse item (that required recoding) was “neither agree nor disagree.” RAFT, responsibility, accountability, and follow-through dimension.