Last night I finished a book that, from beginning to end, filled its pages with confusing pronouns. This book was written in third-person, but it followed four or five different characters, most of them male.
In the course of the narrative, the author constantly spoke of one character by name (usually a male), and then referred to another character as "he" in the next paragraph. Here's an example (not taken from the book). This is Third-Person close. I'm following Tom, and Tom is interacting with Sam.
Tom walked into the cafeteria and set his tray down next to Sam's. "How's it going?" he asked.
"Not bad," Sam replied. "I aced all of my midterms. How 'bout you?"
"Cs and Bs," he replied, taking a seat and digging into his lunch. "I know I would have done a better job if I could have studied during my grandpa's funeral."...
Confusing, right? Believe me, the book itself was worse. It felt as if the author completely ignored the beta readers and the copy editor when they pointed out this problem. On the other hand, it shouldn't necessarily take a copy editor or a beta reader to prevent pronoun confusion.
Here's a tip: if you have two or more characters of the same gender interacting with each other, make sure that you refer to each of them by name any time their actions follow the action of the other character, especially if you begin a new paragraph. Does that make sense? Every time Sam performs an action that follows one of Tom's, my job as the writer is to make sure that I implicitly inform the reader that Sam is indeed the one who is acting.
Now I know readers are smart and capable of figuring out who's who, but when I read through the book that prompted this post, I found myself skipping ahead and backwards to figure out who the author was talking about. In fact the only reason I fought through this book, as bad as it is, was because I wanted to see how the story ended. If anyone ever asked me if the author is worth reading, though, I will give them an emphatic, "NO!"