Medical student reflections and learning from completing a clinical audit: Gains for the health system

Authors

  • Rochelle Hine Monash University, Australia
  • Bernadette Ward Monash University, Australia
  • Casey Stubbs Monash University, Australia
  • Jennifer Casey Monash University, Australia
  • Basia Diug Monash University, Australia
  • Megan Wallace Monash University, Australia

DOI:

https://doi.org/10.11157/fohpe-vol26iss2id869

Keywords:

evidence-based practice, quality improvement, workforce development, reflection, medical education

Abstract

Introduction: The exponential growth in healthcare knowledge, accreditation and professional development frameworks has increased an emphasis on quality assurance/improvement (QA/I). Today’s medical practitioners lead and engage in the design and implementation of healthcare monitoring and QA/I initiatives. For undergraduate medical students, QA/I scholarly placements may have dual benefits. While teaching scholarly skills in an applied context, they simultaneously support healthcare services to complete clinical audits, monitoring progress towards meeting health service quality and safety targets. This study examined the role of QA/I scholarly concentrations (SC) in developing medical students’ scholarly skills.

Methods: Data comprised written reflections focusing on students’ experiences and learning. Of the 405 SC projects conducted to meet the requirements of the Monash medical program, clinical audits that met the inclusion criteria were completed by 20 final-year medical students. Qualitative content analysis was used to examine student experiences, specifically how students’ knowledge, skills and attitudes towards scholarly work were influenced by undertaking a QA/I SC. A deliberate practice approach provided the theoretical framework for analysis.

Results: Six themes were identified: (1) appreciation for the role and significance of QA/I activities, (2) the multidisciplinary team context, (3) valuing documentation, (4) personal challenges and growth, (5) the role of literature reviews in evidence-based medicine and (6) student satisfaction. Students’ understanding of the importance of clinical audits was improved and technical skills were acquired through receiving timely feedback.

Conclusion: QA/I SCs may provide opportunities for developing scholarly skills while embedding evidence-based practice, multidisciplinary collaboration and critical thinking to build the capacity of the medical workforce and inform clinical policy, guidelines and practice.

References

Ahmed, F. A., Asif, F., Mubashir, A., Aboumatar, H. J., Hameed, M., Haider, A., & Latif, A. (2022). Incorporating patient safety and quality into the medical school curriculum: An assessment of student gains. Journal of Patient Safety, 18(6), 637–644. https://doi.org/10.1097/PTS.0000000000001010

Bierer, S. B., & Chen, H. C. (2010). How to measure success: The impact of scholarly concentrations on students: A literature review. Academic Medicine, 85(3), 438–452. https://doi.org/10.1097/ACM.0b013e3181cccbd4

Boyle, A., & Keep, J. (2018). Clinical audit does not work, is quality improvement any better? British Journal of Hospital Medicine, 79(9), 508–510. https://doi.org/10.12968/hmed.2018.79.9.508

Burr, V. (2024). Social constructionism (4th ed.) Routledge. https://doi.org/10.4324/9781003335016

Chapman, S. J., Glasbey, J. C., Khatri, C., Kelly, M., Nepogodiev, D., Bhangu, A., & Fitzgerald, J. E. F. (2015). Promoting research and audit at medical school: Evaluating the educational impact of participation in a student-led national collaborative study. BMC Medical Education, 15, Article 47. https://doi.org/10.1186/s12909-015-0326-1

Cornett, M., Palermo, C., Wallace, M. J., Diug, B., & Ward, B. (2021). A realist review of scholarly experiences in medical education. Medical Education, 55(2), 159–166. https://doi.org/10.1111/medu.14362

Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to clinical nursing practice. Journal of Clinical Nursing, 26(5–6), 862–872. https://doi.org/10.1111/jocn.13586

Davis, S., O'Ferrall, I., Hoare, S., Caroline, B., & Mak, D. B. (2017). Perceptions of medical graduates and their workplace supervisors towards a medical school clinical audit program. International Journal of Medical Education, 8, 244–251. https://doi.org/10.5116/ijme.592a.a936

Denniston, C. (2023). Sharpening reflexive practice in health professional education research. Focus on Health Professional Education, 24(1), 85–94. https://doi.org/10.11157/fohpe.v24i1.734

Devi, V., Ramnarayan, K., Abraham, R. R., Pallath, V., Kamath, A., & Kodidela, S. (2015). Short-term outcomes of a program developed to inculcate research essentials in undergraduate medical students. Journal of Postgraduate Medicine, 61(3), 163–168. https://doi.org/10.4103/0022-3859.159315

Gould, B. E., Grey, M. R., Huntington, C. G., Gruman, C., Rosen, J. H., Storey, E., Abrahamson, L., Conaty, A. M., Curry, L., Ferreira, M., Harrington, K. L., Paturzo, D., & Van Hoof, T. J. (2002). Improving patient care outcomes by teaching quality improvement to medical students in community-based practices. Academic Medicine, 77(10), 1011–1018.

https://journals.lww.com/academicmedicine/abstract/2002/10000/improving_patient_care_outcomes_by_teaching.14.aspx

Greenwood, J. (1993). Reflective practice: A critique of the work of Argyris and Schön. Journal of Advanced Nursing, 18(8), 1183–1187. https://doi.org/10.1046/j.1365-2648.1993.18081183.x

Jones, A. C., Shipman, S. A., & Ogrinc, G. (2015). Republished: Key characteristics of successful quality improvement curricula in physician education: A realist review. Postgraduate Medical Journal, 91(1072), 102–113. https://doi.org/10.1136/postgradmedj-2014-002846rep

Kaid, L. L., & Wadsworth, A. J. (1989). Content analysis. In P. Emmert & L. L. Barker (Eds.), Measurement of communication behaviour (pp. 197–217). Longman.

Kinsella, E. A. (2010). The art of reflective practice in health and social care: Reflections on the legacy of Donald Schön. Reflective Practice, 11(4), 565–575. https://doi.org/10.1080/14623943.2010.506260

Laidlaw, A., Aiton, J., Struthers, J., & Guild, S. (2012). Developing research skills in medical students: AMEE Guide No. 69. Medical Teacher, 34(9), 754–771. https://doi.org/10.3109/0142159X.2012.704438

Mak, D. B., & Miflin, B. (2012). Clinical audit in the final year of undergraduate medical education: Towards better care of future generations. Medical Teacher, 34(4), e251–e257. https://doi.org/10.3109/0142159X.2012.660216

Mullan, J. R., Weston, K. M., Rich, W. C., & McLennan, P. L. (2014). Investigating the impact of a research-based integrated curriculum on self-perceived research experiences of medical students in community placements: A pre-and post-test analysis of three student cohorts. BMC Medical Education, 14, Article 161. https://www.biomedcentral.com/1472-6920/14/161

National Health and Medical Research Council (NHMRC). (2014). Ethical considerations in quality assurance and evaluation activities. https://www.nhmrc.gov.au/about-us/resources/ethical-considerations-quality-assurance-and-evaluation-activities

Ng, S. L., Kinsella, E. A., Friesen, F., & Hodges, B. (2015). Reclaiming a theoretical orientation to reflection in medical education research: A critical narrative review. Medical Education, 49(5), 461–475. https://doi.org/10.1111/medu.12680

Royal Australian College of General Practitioners (RACGP). (2023). Clinical audit. Retrieved November 8, 2024, from https://www.racgp.org.au/education/registrars/fellowship-pathways/policy-framework/program-handbooks-and-guidance-documents/progressive-assessment-and-wba/wba-tools/clinical-audit

Schön, D. A. (2017). The reflective practitioner: How professionals think in action. Routledge. https://doi.org/10.4324/9781315237473

Ward, B., & Harvey, P. (2023). Equity and access: A spotlight on rural health. In L. Reynolds, D. Debono, & J. Travaglia (Eds.), Understanding the Australian health care system (pp. 100–113). Elsevier.

Downloads

Published

2025-06-27

Issue

Section

Articles

How to Cite

Medical student reflections and learning from completing a clinical audit: Gains for the health system. (2025). Focus on Health Professional Education: A Multi-Professional Journal, 26(2), 33-43. https://doi.org/10.11157/fohpe-vol26iss2id869