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Audit is becoming an increasingly important tool for use in medical practice under the auspices of clinical governance, and the expectation for trainees to participate in audit is increasing. The Royal College of Paediatrics and Child Health recommends that specialist registrar trainees perform yearly audit during their training and audits performed during Higher Specialist Training form part of the competency framework for specialty training.
One of the required characteristics of applicants for specialist registrar positions in the West of Scotland is participation in audit, and one of the desirable characteristics is active involvement in audit. It is therefore important that trainees are aware of the requirement of audit and are given enough time and support in which to carry it out.
Questionnaires were sent to all experienced senior house officers and specialist registrars in the West of Scotland training programme to assess audit activity.
Response rate was 83% in the specialist registrar group and 59% in the experienced SHO group.
In the specialist registrar group, 93% of respondents had performed an audit during their training although only 48% had completed an audit in each year of their training. Fifty two per cent of audits led to a change in practise, with only 16% being re-audited and therefore completing the audit cycle. Fifty two per cent of respondents graded the level of support given by senior staff to be less than satisfactory.
In the experienced SHO group, 92% of respondents had completed an audit with 53% actively involved in audit at the time of questioning. Forty two per cent of audits undertaken had led to a change in practice, with only 17% being re-audited. The most common reasons cited for those who had not performed an audit were insufficient time (100%) and lack of knowledge of a topic to audit (83%). Seventy six per cent of respondents felt that being given an audit topic and brief outline of how to carry this out at the beginning of a post would increase likelihood of completing an audit. Thirty per cent graded the level of support given by senior staff to be less than satisfactory.
Although the incidence of performing audit was high in the population questioned (92%), the incidence of completing the audit cycle was low (16%). Factors identified which may increase audit activity include increased support from senior staff, more time available for audit, and being allocated an audit topic and outline of how to carry this out at the beginning of a post.