Abstract
BACKGROUND: Clinical audit (CA) is a quality improvement process aiming to systematically assess and improve patient care. It is among the seven pillars of clinical governance and an important tool for quality improvement in clinical practice. This study aimed to assess the perceptions and perspectives of pediatricians working in resource-limited settings toward clinical audit. METHODS: This cross-sectional facility-based survey included 141 pediatricians. The data were gathered using a questionnaire covering participants knowledge, attitudes, and practices about clinical audits. The questionnaire’s internal reliability was good (0.853). The chi-square test, correlation analysis, and multiple linear regressions were used to evaluate the factors associated with the research domains. RESULTS: Among participants, there is an overall knowledge gap (score of 62.2 ± 24.5), positive attitude (score of 75.4 ± 2), and insufficient practice (score of 40.7 ± 41.1) towards different CA aspects evaluated. Additionally, significant statistical differences were observed between the attitudes of the participants and their duration of experience (p = 0.024), seniority (p = 0.034), and knowledge (p = 0.043) levels, and between their practice and knowledge levels (p < 0.001). Furthermore, a strong positive correlation was found between knowledge level and attitude (r = 0.233, p = 0.005), practice (r = 0.328, p < 0.001), and seniority (r = 0.180, P = 0.033) levels. The participants duration of experience and knowledge levels were significant predictors of their attitude and practice levels (p = 0.045, p < 0.001), respectively. About 88 (62.4%) participants have a below than average competency in CA. In addition, 137 (97.2%) participants believed they required professional development activities. CONCLUSION: Although pediatricians have a positive attitude, their knowledge and practice levels seem insufficient. Additionally, participants knowledge levels about CA positively impact their attitudes and can predict their practice levels. Thus, future educational programs are required to guarantee that pediatricians are competent enough to participate in clinical audit projects. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13692-8.