PS5-09: PROSPECTIVE COHORT STUDY: GAMIFICATION OF SURGICAL RESIDENCY
John C McAuliffe, MD, PhD, Mindy Statter, MD, W. Scott Melvin, MD; Montefiore Medical Center

Background: Team-based competition improves participation, engagement, and outcomes.  Comprehensive, longitudinal studies evaluating the efficacy of team-based competition in surgery have not been performed.  Resident teams may mitigate the perception of isolation particularly in large residencies, spread over multiple campuses.  Board pass rates and resident satisfaction may improve if surgical residents are involved in competition.

Objective: We sought to evaluate the efficacy of gamification of all activities in a surgical residency using a team-based competition.

Methods: We evaluated the need for a competition and teams by eliciting a survey of the categorical residents at Montefiore Medical Center (Bronx, New York) in 2017.  We separated the residents into teams during a draft at the beginning of the 2017-2018 academic year.  Each chief resident was the captain of their respective team and drafted residents onto their team.  Each resident’s academic, scholarly, and administrative performance as defined by the ACGME core competencies was assessed and converted into a point system. Each resident’s performance was combined into a composite team score.  The leaderboard was presented quarterly.  At the end of the academic year, awards for the top performing team and resident were given.  ABSITE, ACGME residency satisfaction, and ABS qualifying exam pass rates were compared before and after gamification. 

Results: Of the 47 categorical residents surveyed, 85% felt surgical residents work well in teams while 86% described themselves as competitive.  The ABSITE standard score improved from 487 to 511 (p = .034) with an improvement in average percentile score from 38.0 to 45.0.  Overall resident satisfaction decreased from 82% to 70%.  ABS qualifying exam pass rate improved from 73% to 89%.  Using a point system for all performance measures defined in the ACGME core competencies allowed for establishing “growth curves” for each post graduate year allowing for real-time objective feedback and assessment of residents.

Conclusions: Gamification of a large residency is feasible.  A comprehensive team-based competition seems to improve ABSITE scores and ABS pass rates.  Gamification can be a platform for comradery in a large surgical residency cultivating intrinsic motivation allowing for autonomy, purpose, and mastery in academic surgery.