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Original Investigation |

Effects of a Reward System on Resident Research Productivity

C. W. David Chang, MD1; Jonathan C. Mills, MD1,2
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, University of Missouri, Columbia
2currently in private practice, Castle Rock, Colorado
JAMA Otolaryngol Head Neck Surg. 2013;139(12):1285-1290. doi:10.1001/jamaoto.2013.5303.
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Importance  With the changing academic medical environment, nontraditional methods may need to be considered to foster research and scholarly activity during the otolaryngology residency experience.

Objective  To evaluate the results of a reward system on resident research activity.

Design, Setting, and Participants  Retrospective review of publications and approved institutional review board (IRB) projects between July 1, 1997, and June 30, 2011, among otolaryngology residents at a single otolaryngology residency program at the University of Missouri.

Intervention  A resident reward system, which awards points for research efforts for each progressive step along the research path from project design to acceptance for publication, was implemented on July 1, 2004. Residents can convert points to a monetary amount to be used for academic enrichment.

Main Outcomes and Measures  Publication rate and IRB approval rate were compared before and after institution of the reward system. Study design types that were published and study design types that received IRB approval were evaluated as well. We hypothesized that the reward system would increase research quantity and quality.

Results  The mean publication output per resident per year increased from 0.13 (95% CI, 0.03-0.23) before commencement of the reward system to 0.43 (95% CI, 0.26-0.60) after implementation of the reward system (P = .004). Significantly more case reports were published compared with other study design types. The number of approved IRB projects before institution of the reward system was 0.47 (95% CI, 0.18-0.75) per resident per year. After instituting the reward system, this increased significantly to 1.29 (95% CI, 0.96-1.63) per resident per year (P = .007). Significant increases in IRB-approved case reports and retrospective clinical studies were noted.

Conclusions and Relevance  After implementation of a point-based reward system, resident research activity increased. The data suggest that this system may encourage resident research, although further refinement may be required to promote higher-quality research endeavors.

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Figure 1.
Number of Publications and Approved Institutional Review Board (IRB) Projects per Academic Year

The IRB data for academic year 1998 were unavailable.

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Figure 2.
Types of Studies and Approved Institutional Review Board (IRB) Projects per Resident per Year Before and After Implementation of the Reward System

Basic science indicates basic science projects; prospective, prospective clinical studies; and retrospective, retrospective clinical studies. Error bars represent the SE of the mean.

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Resident, research, and rewards. JAMA Otolaryngol Head Neck Surg 2014;140(5):479.
Resident, research, and rewards--reply. JAMA Otolaryngol Head Neck Surg 2014;140(5):479-80.
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