Longitudinal Experience With a Transparent Weighted Lottery System to Incentivize Resident Scholarship

Background : Promoting resident scholarship is important to programs. Positive Peer-Pressured Productivity (P-QUAD) is a dual incentive model that combines increased transparency through awareness of peers' engagement in scholarship, with a weighted cash lottery where tickets are earned for various dimensions of academic success (ie, 1 point/ticket for an abstract submission up to 6 for manuscript acceptance). Objective : We explored whether a weighted lottery system contributes to sustained increases in academic productivity in a residency program. Methods : We implemented P-QUAD in 1 pediatrics residency program in July 2015. Residents reported their scholarship submissions/acceptances for the prior year, establishing a program baseline. During the 2-year intervention, residents logged their academic submissions/acceptances on a web interface where they could view real-time scores and the work of their peers. At the end of each academic year, we compared P-QUAD points for each category to baseline. Results : During the intervention, 31% of residents (68 of 218) reported engaging in scholarship. Using P-QUAD was acceptable to most residents. Engagement in scholarship across the program, as measured by total P-QUAD score, increased 53% from baseline (329 versus 504 points per year). Mean submission and acceptance rates for individual residents reporting research through P-QUAD increased across all categories, ranging from 19% for abstract submissions (1.62 to 1.93 per year) to 275% (0.24 to 0.90 per year) for accepted manuscripts. Conclusions : The residency program sustained gains in academic productivity at the program-wide and participating resident level in the 2 years since implementing P-QUAD.