Audit as a learning tool in postgraduate emergency medicine training

Objective: Educational activities for emergency medicine trainees need to be clinically focused, relevant, and ideally have the capacity to change practice and patient outcomes. It is proposed that the use of audit methods in educational sessions may address these learning needs. The aims of this project were to involve emergency medicine trainees in undertaking audits of ED patient care, and to evaluate the use of this technique in fulfilling training needs. Methods: Trainees were given clinical topics on which to develop a presentation at weekly education sessions within the ED. This presentation included a brief clinical audit concerning an aspect of the same topic. The audit question addressed one of the issues identified as standard of care in the trainee presentation and investigated our department's level of compliance with that standard. At the end of a 6-month period, a questionnaire was given to all trainees involved, either as presenters or attendees at an audit presentation. Results: Trainees performing audits reported that this method was most useful for demonstrating the limitations of coding, giving a greater appreciation of poor documentation in medical records, and improving their presentation skills. Most trainees attending audit based presentations reported that this educational method gave them a greater appreciation of systems based practice, actually changed their clinical practice, and was more useful than traditional lectures. Conclusions: Audit should be a key component of emergency medicine education. Trainees perceive the technique as useful addressing a number of training needs in a clinical context.