Perceptions of Postgraduate Students Regarding Inclusion of Clinical Audit in Training Programme (original) (raw)
Related papers
Background: Clinical audit is based on the concept of quality assurance in health care. It is important for all health care providers especially specialists and consultants to be aware of the principles governing clinical audit in addition to the methods in conducting such an audit. Objectives: To assess the knowledge and attitude of medical postgraduate students on clinical audit. To evaluate the effectiveness of an interventional program conducted to educate the principles and methods of conducting clinical audit to medical postgraduates. Methods: The study was done in 92 postgraduate medical students in our institute using a pre-test and post-test questionnaire, evaluating their knowledge on different perspectives of medical audit and also assessing the change in their attitude towards audit after an educative interventional program. The questionnaire consisted of 13 knowledge questions and 3 attitude questions. Each question was scored and the overall maximum score was 35. Results: The mean post-test score (24.45 AE 3.21) was significantly higher than the mean pre-test score (16.18 AE 3.41) using paired t-test (p < 0.001) indicating that the educational intervention was effective in improving the understanding of the candidates on clinical audit. Conclusion: It is imperative for all medical postgraduates to realize the importance of clinical audit in addition to acquiring the skill of conducting a meaningful and successful clinical audit. Attainment of such a competency can be achieved through planned repeated interventions and help usher in an era of best quality of patient care.
Clinical Audits in a Postgraduate General Practice Training
2012
Background: Clinical audit can be of valuable assistance to any program which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at evaluating audits' effectiveness, valuable opportunities will be overlooked. Clinical audit projects are required as a part of the formative assessment of trainees in the Family Medicine Residency Program (FMRP) in Kuwait. This study was undertaken to draw a picture of trainees' understanding of the audit project with attention to the knowledge of audit theory and its educational significance and scrutinize the difficulties confronted during the experience. Methodology/Principal Findings: The materials included the records of 133 audits carried out by trainees and 165 post course questionnaires carried out between 2004 and 2011. They were reviewed and analyzed. The majority of audit projects were performed on diabetic (44.4%) and hypertensive (38.3%) care. Regarding audits done on diabetic care, they were carried out to assess doctors' awareness about screening for smoking status (8.6%), microalbuminuria (19.3%), hemoglobin A1c (15.5%), retinopathy (10.3%), dyslipidemia (15.8%), peripheral neuropathy (8.8%), and other problems (21.7%). As for audits concerning hypertensive care, they were carried out to assess doctors' awareness about screening for smoking status (38.0%), obesity (26.0%), dyslipidemia (12.0%), microalbuminuria (10.0%) and other problems (14.0%). More than half the participants (68.48%) who attended the audit course stated that they 'definitely agreed' about understanding the meaning of clinical audit. Most of them (75.8%) 'definitely agreed' about realizing the importance of clinical audit in improving patients' care. About half (49.7%) of them 'agreed' that they can distinguish between 'criteria' and 'standards'. Conclusion: The eight years of experience were beneficial. Trainees showed a good understanding of the idea behind auditing the services provided. They demonstrated their ability to improve the care given in health centers in which these projects were undertaken.
Educational aspects of medical audit
BMJ, 1990
Medical Audit: Working Paper 6' does not couch medical audit activities in an educational environment. The Royal College of Physicians and Royal College of Surgeons, however, have highlighted the educational aspects of medical audit, stating that "education is the most useful product of audit"2 and that audit "is an important educational process for both seniors and juniors."3 Kenneth Clarke in a speech on 10 July stated that in his view, "Medical audit is about quality assurance in clinical work. As it entails a measurement of performance it must be a key part of continuing professional education." This echoes the theme of the report of the Alment Committee: "In our view it is a necessary part of a doctor's professional responsibility to assess his work regularly in association with his colleagues,"4 although in medical audit such reviews are considered educational. The approach of peer review ofpractice creates a "sympathetic environment" for medical audit. This paper aims at highlighting the educational aspects of audit and the framework required to exploit them and at considering the nature of education and of audit.
PLoS ONE, 2012
Background: Clinical audit can be of valuable assistance to any program which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at evaluating audits' effectiveness, valuable opportunities will be overlooked. Clinical audit projects are required as a part of the formative assessment of trainees in the Family Medicine Residency Program (FMRP) in Kuwait. This study was undertaken to draw a picture of trainees' understanding of the audit project with attention to the knowledge of audit theory and its educational significance and scrutinize the difficulties confronted during the experience. Methodology/Principal Findings: The materials included the records of 133 audits carried out by trainees and 165 post course questionnaires carried out between 2004 and 2011. They were reviewed and analyzed. The majority of audit projects were performed on diabetic (44.4%) and hypertensive (38.3%) care. Regarding audits done on diabetic care, they were carried out to assess doctors' awareness about screening for smoking status (8.6%), microalbuminuria (19.3%), hemoglobin A1c (15.5%), retinopathy (10.3%), dyslipidemia (15.8%), peripheral neuropathy (8.8%), and other problems (21.7%). As for audits concerning hypertensive care, they were carried out to assess doctors' awareness about screening for smoking status (38.0%), obesity (26.0%), dyslipidemia (12.0%), microalbuminuria (10.0%) and other problems (14.0%). More than half the participants (68.48%) who attended the audit course stated that they 'definitely agreed' about understanding the meaning of clinical audit. Most of them (75.8%) 'definitely agreed' about realizing the importance of clinical audit in improving patients' care. About half (49.7%) of them 'agreed' that they can distinguish between 'criteria' and 'standards'. Conclusion: The eight years of experience were beneficial. Trainees showed a good understanding of the idea behind auditing the services provided. They demonstrated their ability to improve the care given in health centers in which these projects were undertaken.
DEPARTMENTAL CLINICAL AUDIT, AUDIT PRINCIPLES AND THE PRESENT STATUS IN PAKISTAN
Clinical audit has been defined in a variety of ways. Perhaps one of the simplest definitions is that it is a clinically led initiative which seeks to improve the quality and outcome of patient care whereby clinicians examine their practices and results against agreed standards and modify their practice where indicated. In brief the clinical audit provides a method for systematically reflecting on and reviewing practice. It is a means to ensure professional accountability.
What influences postgraduate psychiatric trainees’ attitudes to clinical audit?
Irish Journal of Psychological Medicine, 2017
Introduction Clinical audit is an important component of safe and ethical practice but many clinicians cite barriers to engagement in audit. Methodology A total of 81 basic specialist trainees in psychiatry were surveyed in terms of their basic demographic details and their knowledge, direct experience and attitudes in relation to clinical audit. Results Among the 49 (60.5%) who responded, 57.1% had received formal training in audit, but only 20.4% had received more than four hours of training in their whole career. The median positivity score was 30 out of a possible 54 (range 12–40), suggesting that participating trainees were barely more than ‘undecided’ overall when it comes to positive attitudes to clinical audit. Age, nationality and specific training did not predict attitudes to clinical audit. Gender, years of clinical experience and direct experience of clinical audit did not significantly predict attitudes to clinical audit, but these findings are at odds with some previou...
Audit in general practice: educating medical students
1997
This paper describes the third stage in the evolution of methods of teaching on audit in general practice at the Department of General Practice, University of Glasgow. The authors asked the final year students to develop, carry out and submit a written report on an audit project devised by themselves, after briefing and with continued support. Every student asked was successful in producing a report and the standard was generally very high, although only two students completed the audit cycle in the 4 week'period: More than half the students (51.7%) found the project valuable or very valuable. As many as 90.6% understood audit better or much better after doing the project and 83.4% thought that the project should continue to be part of the GP attachment. Seventy-eight per cent of the GP tutors thought that teaching audit to undergraduates in general practice was valuable or very valuable, 64.4% reported that the audit had been of benefit to their practice, and 89.9% thought that audit should continue to be part of the GI? attachment. This method of teaching students about audit was the most successful of three methods tried. It has produced benefits both for students and for the general practices to which they were attached, ultimately producing benefits for patients.
Audits in general practice by medical students
The Medical journal of Malaysia, 2004
This paper reports the implementation, findings and feedback of the audit project of the general practice (GP) module carried out in the fifth year of the MBChB (Sheffield) twinning programme with the Perak College of Medicine. After training, each student with his/her GP tutor planned and conducted the audit. All 28 students (year 2002) satisfactorily completed their audit projects. Fifty percent did an audit of hypertension, 36% on diabetes, 7% on asthma and one each (3.5%) on upper respiratory tract infection and client satisfaction. It was the GP tutors first experience at audit in their clinics. The majority of indicators of care audited did not meet the set target standards.
Clinical audit and quality improvement - time for a rethink?
Journal of Evaluation in Clinical Practice, 2012
Evidence of the benefits of clinical audit to patient care is limited, despite its longevity. Additionally, numerous attitudinal, professional and organizational barriers impede its effectiveness. Yet, audit remains a favoured quality improvement (QI) policy lever. Growing interest in QI techniques suggest it is timely to re-examine audit. Clinical audit advisors assist health care teams, so hold unique cross-cutting perspectives on the strategic and practical application of audit in NHS organizations. We aimed to explore their views and experiences of their role in supporting health care teams in the audit process. Method Qualitative study using semi-structured and focus group interviews. Participants were purposively sampled (n = 21) across health sectors in two large Scottish NHS Boards. Interviews were audio-taped, transcribed and a thematic analysis performed. Results Work pressure and lack of protected time were cited as audit barriers, but these hide other reasons for non-engagement. Different professions experience varying opportunities to participate. Doctors have more opportunities and may dominate or frustrate the process. Audit is perceived as a time-consuming, additional chore and a managerially driven exercise with no associated professional rewards. Management failure to support and resource changes fuels low motivation and disillusionment. Audit is regarded as a 'political' tool stifled by inter-professional differences and contextual constraints. Conclusions The findings echo previous studies. We found limited evidence that audit as presently defined and used is meeting policy makers' aspirations. The quality and safety improvement focus is shifting towards 'alternative' systems-based QI methods, but research to suggest that these will be any more impactful is also lacking. Additionally, identified professional, educational and organizational barriers still need to be overcome. A debate on how best to overcome the limitations of audit and its place alongside other approaches to QI is necessary.