The problem-based medical audit program: influence on family practice residents' knowledge and skills.

BACKGROUND AND OBJECTIVES: Family physicians need to possess the skills to conduct audits in their own clinical settings to ensure that their patients receive exemplary clinical care. Residency offers an important opportunity for physicians to develop these auditing skills. This study describes the introduction of a problem-based medical audit program at three teaching units in the Department of Family Medicine at McMaster University and the program's effect on learner knowledge, skills, and attitudes toward the practice audit. METHODS: A survey designed to assess residents' self-rated knowledge, skills, and attitudes toward practice audits was distributed before and after residents participated in the audit program. RESULTS: Forty-three residents were surveyed; 33 (76.7%) completed the initial questionnaire and follow-up questionnaire. Residents reported significant improvements in their understanding of the relevance of audits, ability to develop a practice audit question, skills in designing methodology, and skills needed to conduct an audit independently. Residents also reported a moderate increase in their knowledge of statistics needed to complete an audit. CONCLUSIONS: The practice audit program at McMaster University uses a problem-based model to introduce learners to the concept of the clinical audit. The practice audit program successfully improved the residents' self-reported ability to conduct an audit and heightened their understanding of the importance and relevance of the audit process.