Continuing medical education before audit.

Patient-care-assessment systems have failed to demonstrate efficiency in detecting continuing education needs or in influencing clinical practice. We believe that one of the weaknesses in retrospective audit systems is their tendency to result in the ratification of criteria which match past practices rather than criteria which incorporate new, science-based information. This is in spite of the fact that for many years guidelines for medical audit processes have encouraged physicians to develop science-based criteria. This study was undertaken to determine whether continuing education programs preceding patient care audits can induce physicians to choose criteria beyond their own experience. A highly significant difference was found between audit criteria developed after education programs and those which were developed without such programs. The results indicate that educational efforts can have a striking effect on the criteria ratified by audit committees.