Registrars' and senior registrars' perceptions of their audit activities

To ascertain the level and quality of audit activity among junior doctors, their attitudes to audit, and their views on its educational value.

Postal questionnaire survey in April 1991.

Yorkshire region.

All 610 registrars and senior registrars recorded as employed in the region.

Grade, current specialty, details of last audit participated in and its educational usefulness, and attitude to audit.

255 (41.8%) completed questionnaires were returned, 148 from registrars and 101 from senior registrars; grade was not indicated in six. 27 respondents were in general medicine, 26 in general surgery, 30 in anaesthetics, and 36 in psychiatry; other specialties had fewer than 20 respondents. About a fifth (54) of respondents, most in psychiatry (19/36, 53%), had not participated in audit. Among the 201 who had participated, the audit topics covered most components of care (access to services (47, 23%), communication (51, 25%), and appropriateness (158, 79%) and effectiveness (157, 78%) of treatment); only 84 (41%) audits set standards, and in only half of them had the doctors been involved in doing so. Doctors responsible for gathering data and those responsible for collating and reporting data found their experience significantly less useful than those who were not. 172 (86%) respondents considered that audit had helped patient care. Suggested improvements to the educational value of audit were mostly for better methods but included requests for less "witch hunting," better feedback, more training, more time, and more participation by consultants.

The educational value of audit to junior doctors could be improved by better audit methods, guidance, and feedback.