 Past research has shown that 25 of diagnostic testing is duplicative or has limited value. Academic medical centers that employ physicians-in-training may find it particularly challenging to reduce low value testing due to a historical emphasis on extensive workups by trainees. Despite the increased emphasis on cost-consciousness in medical education, there is little existing research evaluating ways to optimize ordering behaviors of physicians-in-training. This study will evaluate a normative feedback intervention for internal medicine physicians-in-training to reduce overuse of routine laboratory tests for hospitalized patients. Physicians-in-training will be cluster-randomized into two arms: 1 those who receive report cards intervention group, 2 those who will not receive report cards control group. We will study the use of routine laboratory tests over a pre-intervention period of 1 week and a post-randomization period of 1 week. We will study physician attitudes about the real-time feedback dashboard with qualitative assessments in focus groups after the completion of the intervention. 