The Golden Ticket Project for peer recognition.

Background: A supportive working environment can be protective against burnout in residency training. To help foster a positive culture, we developed the 'Golden Ticket Project' (GTP) and evaluated it as a tool for peer appreciation.

Methods: In October 2013-July 2014, all paediatric residents (n = 83) at a paediatric residency programme were invited to participate in the GTP. Through an electronic form, residents could award a co-resident with a 'Golden Ticket' for any behaviour that they were grateful for. Two authors manually coded and analysed the tickets using content analysis to identify recurring themes. We also distributed an anonymous survey to all residents to assess their attitudes toward the GTP.

Results: The majority (61%) of residents either gave or received 'Golden Tickets' (51/83). Reasons for receiving tickets fell into five categories: (i) teamwork; (ii) positive attitude; (iii) patient care; (iv) resident-resident support; and (v) supervisory skills. Across all three classes, teamwork was recognised most frequently, noted in 43% of all tickets. The recognition of other behaviours varied by class. Fifty-five percent (46/83) of residents completed the programme evaluation survey. Seventy-six percent (35/46) of respondents wanted the programme to continue; of those, 49% (17/35) 'agreed' or 'strongly agreed' that they were 'more aware of acts of kindness in the residency program because of the GTP'. A supportive working environment can be protective against burnout in residency training DISCUSSION: The GTP is a feasible and valued peer-support initiative for residents. The GTP characterised behaviours and attitudes that residents were grateful for in their peers. These behaviours could inform the development of wellness interventions for residents that focus on building supportive working environments.