Do peer chart audits improve residents' performance in providing preventive care?

Acad Med. 2003 Oct;78(10 Suppl):S39-41. doi: 10.1097/00001888-200310001-00013.


Purpose: One recommended method to evaluate residents' competence in practice-based learning and improvement is chart audit. This study determined whether residents improved in providing preventive care after a peer chart audit program was initiated.

Method: Residents audited 1,005 charts and scored their peers on 12 clinical preventive services. The mean total chart audit scores were compared across five time blocks of the 45-month study.

Results: Residents' performance in providing preventive care initially improved significantly but declined in the last ten months. However, their performance remained significantly higher than at the beginning.

Conclusions: By auditing their peers' charts, residents improved their own performance in providing preventive care. The diffusion of innovations theory may explain the prolonged implementation phase and problems in maintaining a chart audit program.

MeSH terms

  • Analysis of Variance
  • Clinical Competence
  • Humans
  • Internship and Residency / statistics & numerical data
  • Medical Audit*
  • Peer Review, Health Care / methods*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Preventive Medicine / standards*
  • United States