Clinical audit; Who is auditing who?

Clinical audit is the principal means by which current clinical practice is improved. Doctors in training must gain positive experience of audit as ju niors, so as to establish the importance of audit for future practice. Good audit requires involvement of doctors in training, a high level of partici pation and a leading role to be taken by the professional bodies. To examin e the degree to which such criteria are met currently, the quality and prev alence of clinical audit, the participation of junior doctors in audit, and the preparedness of medical professional bodies' to guide audit were asses sed. One hundred and twenty-six junior and senior house officers in three E dinburgh hospitals were administered questionnaires in person, whilst eight Royal Colleges, the British Medical Association and the General Medical Co uncil were assessed by the quality of their written guidelines for audit. T he data showed that only thirteen out of twenty four specialties, which emp loyed half the juniors, utilised clinical audit. Half of these audit progra ms were structured to lead to improved patient care. Surprisingly, only thr ee out often professional bodies were able to provide good quality audit in formation. In conclusion, clinical audit is not universal practice and many existing audit programs are inappropriately structured. Commonly, doctors at all levels seemed unaware of the goals of clinical audit. In addition, t he majority of professional bodies provide poor information, thereby impedi ng successful audit by doctors in training. Clinical audit will not succeed until such deficiencies are rectified.