Download files
Abstract
Despite hand hygiene (HH) being considered the most cost-effective measure to control healthcare associated infections, healthcare workers (HCWs) are known to have poor HH compliance, especially doctors. One of the primary contributing factors is a failure of doctors to learn this behaviour as medical students. Previous studies have reported improvements in HCWs’ HH as a result of improvements in knowledge through increased education. However, there have been few studies that have focused on HH education of medical students, and even fewer that have reported long term retention of knowledge. We aimed to address this gap by developing and evaluating a teaching module for medical students. This thesis therefore aimed to explore the barriers and facilitators impacting on the teaching of HH to medical students. It also aimed to use that knowledge to develop a new teaching module to improve knowledge and attitudes of undergraduate medical students around HH. This thesis is the first of its kind to have evaluated a teaching module for undergraduate medical students and tested the retention of impact of the tool on knowledge and attitude over a period of time.
Four studies were conducted which employed both qualitative and quantitative approaches. In the first study, an Australian wide survey of Deans of Medical Education was undertaken to explore the different HH teaching approaches currently being utilised. The second study involved qualitative in-depth interviews of medical students and medical education and infection control experts and explored the barriers and facilitators around teaching HH to medical students. These studies found that scenario based learning activities were considered to be the best mode of teaching HH at the university level and that repetition of the teaching materials throughout the students medical training was considered very important. Based on these recommendations and a review of the literature and other available resources, a new teaching module was developed. Feedback on the developed module was sought in the third study using group interviews of medical students. The module was revised as per their feedback and the final study was then conducted to evaluate the impact of this module on student’s knowledge and attitudes as well as the retention over time. The results showed an overall and sustained improvement in HH knowledge of medical students and their attitudes towards HH.
These studies provide new knowledge around the factors that are currently impacting on the delivery of education around HH to undergraduate medical students. The four published studies presented in this thesis fill a gap in the around HH teaching for medical students in Australian literature.