Development and appraisal of a hand hygiene teaching approach for medical students: a qualitative study

Abstract

Background: Poor hand hygiene (HH) practices among medical students have previously been attributed to students not being exposed to sufficient teaching materials during their training. Aim:To develop and evaluate a teaching module directed at improving the knowledge and attitudes of undergraduate medical students towards HH. Methods:The HH teaching module was designed based on educational materials used by the World Health Organization and other patient safety organisations. The development was also informed by the findings from two previous studies including qualitative interviews with staff and students and a survey of Australian medical schools. In-depth group interviews were undertaken with 24 undergraduate medical students.Results: Favourable feedback was received from the interviewed medical students towards the developed scenariobased learning activity; however, the group interview activity was not received well by students. They suggested that the HH teaching activities should be compulsory and not optional for medical students. In order to reinforce good HH practices and to improve knowledge around HH and healthcare-associated infections, they felt that the activities should be repeated during each phase of their degree. Conclusions:There is a need to change the approach to training in education, particularly to engage students in topics such as HH which are often seen as unimportant.

Current hand hygiene education is suboptimal

“…Trainees and educators want improved HH education beginning at the student level and continuing into the clinical arena; however, the most effective HH training programmes have yet to be determined. Until medical students understand that HH is the most effective method to prevent HAI, current approaches will remain inadequate.…”

“…Although it has been established that health care workers’ hands are the most common vehicle for the transmission of pathogens, nearly 75 000 patients died from HAI during hospitalisation . A critical first step to building ingrained hand hygiene compliance (HHC) is to reinforce HH training throughout medical education …”

“…Although there is limited research related to medical students’ and residents’ HH practices, the training years represent a critical opportunity to develop good HH behaviours . Even when educational interventions are introduced and students learn the WHO Five Moments, compliance remains low .…”

“…Medical students self‐report higher HHC than is actually observed,4 and have expressed dissatisfaction with HH training. This may be an unwanted consequence of how undergraduate curricula are structured; however, medical students report that they need further in‐depth training on hygiene‐related guidelines . Role models are essential to improving HHC, as trainees showed improved HHC when attending physicians demonstrated proper techniques .…”

“…3 A critical first step to building ingrained hand hygiene compliance (HHC) is to reinforce HH training throughout medical education. 4 Although there is limited research related to medical students' and residents' HH practices, the training years represent a critical opportunity to develop good HH behaviours. 4 Even when educational interventions are introduced and students learn the WHO Five Moments, compliance remains low.…”