reward vs punishment

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Jul 19, 2003
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I'm in a program where there is a lot of change going on. It's caused be to think a lot, especialy about the current system for evaluating and rewarding resident performance.

I think most of us are in a situation where we don't really get much feedback. We assume that if we aren't getting yelled at, we are doing OK. There are periodic evaluations, which you may or may not get to see. And sometimes an attending who didn't spend much time with you rates you poorly (eg I had one give me a low score for fund of knowlege, even though he interacted with me minimally on the rotation and never asked me any questions). Some programs also place more value on the ABSITE than others, and some may hold residents back a year for poor performace, either on the test or clincially.

But I've never heard of a program with rewards for good/excellent performance. Has anybody out there? Do you think that shifting from a punishment to a reward model would be good for surgical education? If so, what rewards would motivate you to work harder than you do now?