Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-27T17:58:41.006Z Has data issue: false hasContentIssue false

Does Clinical Experience Affect Medical Students' Knowledge, Attitudes, and Compliance With Universal Precautions?

Published online by Cambridge University Press:  02 January 2015

Donna B. Jeffe*
Affiliation:
Washington University School of Medicine, St Louis, Missouri
Sunita Mutha
Affiliation:
Washington University School of Medicine, St Louis, Missouri
Lynn E. Kim
Affiliation:
Washington University School of Medicine, St Louis, Missouri
Bradley A. Evanoff
Affiliation:
Washington University School of Medicine, St Louis, Missouri
Paul B. L'Ecuyer
Affiliation:
Washington University School of Medicine, St Louis, Missouri
Victoria J. Fraser
Affiliation:
Washington University School of Medicine, St Louis, Missouri
*
Division of Health Behavior Research, 4444 Forest Park, Suite 6700, St Louis, MO 63108; e-mail, [email protected]

Abstract

Objective:

To investigate differences in second-, third-, and fourth-year medical students' knowledge of bloodborne pathogen exposure risks, as well as their attitudes toward, and intentions to comply with, Universal Precautions (UP).

Design:

Cross-sectional survey.

Participants And Setting:

Surveys about students' knowledge, attitudes, and intentions to comply with UP were completed by 111 second-year (preclinical), 80 third-year, and 60 fourth-year medical students at Washington University School of Medicine in the spring of 1996.

Results:

Preclinical students knew more than clinical students about the efficacy of hepatitis B vaccine, use of antiretroviral therapy after occupational exposure to human immunodeficiency virus, and nonvaccinated healthcare workers' risk of infection from needlestick injuries (P<.001). Students' perceived risk of occupational exposure to bloodborne pathogens and attitudes toward hepatitis B vaccine did not differ, but preclinical students agreed more strongly that they should double glove for all invasive procedures with sharps (P<.001). Clinical students agreed more strongly with reporting only high-risk needlestick injuries (P = .057) and with rationalizations against using UP (P = .008). Preclinical students more frequently reported contemplating or preparing to comply with double gloving, wearing protective eyewear, reporting all exposures, and safely disposing of sharps, whereas students with clinical experience were more likely to report compliance. Clinical students also were more likely to report having “no plans” to practice the first three of these precautions (P<.001).

Conclusions:

Differences in knowledge, attitudes, and intentions to comply with UP between students with and without clinical experience may have important implications for the timing and content of interventions designed to improve compliance with UP.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. O'Neill, TM, Abbott, AV, Redecki, SE. Risk of needlesticks and occupational exposures among residents and medical students. Arch Intern Med 1992;152:14511456.Google Scholar
2. Vergilio, JA, Roberts, RB, Davis, JM. The risk of exposure of third-year surgical clerks to human immunodeficiency virus in the operating room. Arch Surg 1993;128:3638.Google Scholar
3. Wurtz, R, Dolan, M, O'Neal, B, Azarcon, E. Infection control instruction and screening for students. Am J Infect Control 1994;22:322324.Google Scholar
4. Shalom, A, Ribak, J, Froom, P. Needlesticks in medical students in university hospitals. J Occup Environ Med 1995;37:845849.CrossRefGoogle ScholarPubMed
5. Sokas, RK, Simmens, S, Scott, J. A training program in Universal Precautions for second-year medical students. Acad Med 1993;68:374376.CrossRefGoogle ScholarPubMed
6. Elford, J, Cockcroft, A. Compulsory HIV antibody testing, Universal Precautions and the perceived risk of HIV: a survey among medical students and consultant staff at a London teaching hospital. AIDS Care 1991;3:151158.Google Scholar
7. Koenig, S, Chu, J. Senior medical students' knowledge of Universal Precautions. Acad Med 1993;68:372374.Google Scholar
8. Weyant, RJ, Bennett, ME, Simon, M, Palaisa, J. Desire to treat HIV-infect-ed patients: similarities and differences across health-care professions. AIDS 1994;8:117121.Google Scholar
9. Prochaska, JO, Redding, CA, Harlow, LL, Velicer, WF, Rossi, JS. The trans-theoretical model of change and HIV prevention: a review. Health Educ Q 1994;21:471486.CrossRefGoogle Scholar
10. Prochaska, JO, Velicer, WF, Rossi, JS, Goldstein, MG, Marcus, BH, Rakowski, W, et al. Stages of change and decisional balance for twelve problem behaviors. Health Psychol 1994;13:3946.Google Scholar
11. Bandura, A. Social Learning Theory Englewood Cliffs, NJ: Prentice-Hall, 1977.Google Scholar
12. Deci, EL, Ryan, RM. Intrinsic Motivation and Self-Determination in Human Behavior. New York City, NY: Plenum Press, 1985.Google Scholar
13. Deci, EL, Ryan, RM. Intrinsic motivation to teach: possibility and obstacles in our colleges and universities. In: Bess, J, ed. New Directions in Teaching and Learning. San Francisco, CA: Jossey-Bass, 1982.Google Scholar