A Multicenter UK Study on Trainee Involvement in Clinical Audit: Is it an Effective Contribution to Service Quality Improvement or a Portfolio Generating Activity?

Abstract

Aims: The primary purpose of audit is to improve quality of care, but it is also considered educationally valuable. Audits are often sought in job applications and also form annual review targets. The study aimed to examine audit activity across hospital trainees.
Methods: 100 doctors, ranging from F1 to Specialty Training year 5 (ST5) level across 10 UK hospitals were invited to complete a printed or online questionnaire about audit involvement.
Results: Seventy five (75%) participated, including 1 F1 (1.3%), 34 F2s (45%), 6 ST1s (8%), 14 ST2s (19%), and 20 ST3-5s and post-basic training fellows (26%). Their Specialities included: Medicine 33(44%), Surgery 29(38%), General Practice (GP) 6(8%), Anaesthesia 4(5.3%), Accident and Emergency (A&E) 2(2.6%) and Ophthalmology 1(1.3%). Seventy (93%) claimed audit involvement in the last year. Most (54, 72%) worked by themselves, with over a quarterled by others (28%). None received audit training. Most (86%) completed within 6 months.  Audits focused chiefly on local practice (96%), with only 3 regional or national audits (4%). Only five were re-audits (6.7%), and just four were submitted for publication (5.3%). Most (60, 80%) were formally presented: 46 at local meetings (61%), 10 reaching regional (13%) and 4 international (5.3%) conferences.
Conclusion: The positive response rate indicates that audit is a frequent trainee activity, but the results suggest that it is mainly a self-directed portfolio fulfilling exercise. Improved training and supervision may be needed to achieve the primary aim of audit, which is improved clinical practice, whilst the educational value is unproven.