# Gender influences resident physicians’ perception of an employee-to-employee recognition program: a mixed methods study

## TL;DR

This study finds that a recognition program for resident physicians is perceived differently by men and women, despite no difference in how many recognitions they receive.

## Contribution

The study reveals gender-based differences in the perception of an employee-to-employee recognition program among resident physicians.

## Key findings

- There was no significant difference in Hi-5 receipt between male and female residents.
- Female residents expressed concerns about gender-based expectations and fear of backlash.
- Residents found the program useful for feedback and reducing burnout.

## Abstract

Burnout is prevalent in medical training. While some institutions have implemented employee-to-employee recognition programs to promote wellness, it is not known how such programs are perceived by resident physicians, or if the experience differs among residents of different genders.

We used convergent mixed methods to characterize how residents in internal medicine (IM), pediatrics, and general surgery programs experience our employee-to-employee recognition ("Hi-5″) program. We collected Hi-5s received by residents in these programs from January 1, 2021–December 31, 2021 and coded them for recipient discipline, sex, and PGY level and sender discipline and professional role. We conducted virtual focus groups with residents in each training program.

We compared Hi-5 receipt between male and female residents; overall and from individual professions. We submitted focus group transcripts to content analysis with codes generated iteratively and emergent themes identified through consensus coding.

Over a 12-month period, residents received 382 Hi-5s. There was no significant difference in receipt of Hi-5s by male and female residents.

Five IM, 3 surgery, and 12 pediatric residents participated in focus groups. Residents felt Hi-5s were useful for interprofessional feedback and to mitigate burnout. Residents who identified as women shared concerns about differing expectations of professional behavior and communication based on gender, a fear of backlash when behavior does not align with gender stereotypes, and professional misidentification.

The “Hi-5” program is valuable for interprofessional feedback and promotion of well-being but is experienced differently by men and women residents. This limitation of employee-to-employee recognition should be considered when designing equitable programming to promote well-being and recognition.

The online version contains supplementary material available at 10.1186/s12909-024-05083-0.