McKay J, Lough J R, Murray T S
Department of Postgraduate Medical Education, University of Glasgow.
Br J Gen Pract. 1995 Jun;45(395):301-3.
Departments of general practice increasingly provide formal teaching in audit. However, little is known about audit projects carried out by trainees in general practice.
A study was undertaken to ascertain general practitioner trainees' experience of undertaking an audit project in the trainee year, with reference to their understanding of audit theory, perceived usefulness of the project in enhancing clinical knowledge, time taken to do the audit and practice team involvement in the project.
All 104 trainees in the west of Scotland region completing their trainee year on 31 July 1993 were sent a postal questionnaire that month. The replies to the questionnaire were analysed and compared with the audit project that each trainee had submitted in June 1993 as part of a pilot project for summative assessment.
Responses were received from 103 trainees (99%). Seventy trainees (68%) felt strongly that their audit project was relevant to patient care but only 31 (30%) felt strongly that the project was a useful way of enhancing clinical knowledge of the disease process. Data collection was the most time consuming aspect of the audit project, 23% of trainees reporting taking a day or more to complete this stage. Trainees who chose their own audit project were more likely to complete two sets of data collection than those who had not chosen their own project. Seventy nine trainees (77%) indicated that trainers had been involved in their project and 51 trainees indicated that one of the other practice partners had been involved in their project.
Performing an audit as a trainee is feasible in the time limit of the one year in general practice. The educational benefit appears to be limited to the knowledge of audit process, rather than to clinical knowledge. Audit projects of relevant size and complexity, involving appropriate members of the practice team, are to be encouraged, as is the development of an instrument for assessing trainee audit.
普通科越来越多地提供正式的审计教学。然而,对于普通科实习医生开展的审计项目却知之甚少。
开展一项研究,以确定普通科实习医生在实习年度开展审计项目的经历,涉及他们对审计理论的理解、该项目在增强临床知识方面的感知有用性、完成审计所需时间以及实践团队对项目的参与情况。
1993年7月31日在苏格兰西部地区完成实习年度的所有104名实习医生于当月收到一份邮寄问卷。对问卷回复进行分析,并与每位实习医生在1993年6月作为总结性评估试点项目提交的审计项目进行比较。
收到了103名实习医生(99%)的回复。70名实习医生(68%)强烈认为他们的审计项目与患者护理相关,但只有31名(30%)强烈认为该项目是增强对疾病过程临床知识的有用方式。数据收集是审计项目中最耗时的方面,23%的实习医生报告完成这一阶段需要一天或更长时间。选择自己审计项目的实习医生比未选择自己项目的实习医生更有可能完成两组数据收集。79名实习医生(77%)表示培训师参与了他们的项目,51名实习医生表示其他一名实践伙伴参与了他们的项目。
在普通科一年的时间限制内,作为实习医生进行审计是可行的。教育收益似乎仅限于审计过程的知识,而非临床知识。应鼓励开展涉及实践团队适当成员的规模和复杂性合适的审计项目,以及开发评估实习医生审计的工具。