An intervention with third-year medical students to encourage the reporting and management of occupational exposures

Medical students are particularly vulnerable to occupational exposures to blood-borne pathogens because of their inexperience. Although exposure rates for medical students remain high, they often do not report such incidents or seek the proper medical care. The authors describe and evaluate an intervention at the Yale University School of Medicine to prevent and manage occupational exposures among medical students.

Since 2001, students have met with key faculty during orientation and again before clinical clerkships to discuss the circumstances under which most exposures occur, examine the equipment used to draw blood and start IVs, and review instructions about postexposure management. They are also given a laminated card summarizing this information. In 2010 and 2011, the authors surveyed graduating students about their experiences.

Two hundred twenty-five of 245 (92%) students responded to the survey, and 82 (36%) had experienced 103 exposures. Forty-seven of those 82 (57%) students reported their exposure, 52 (56%) had the laminated card on them at the time of the incident, and 15 (18%) started postexposure prophylaxis. The most common reasons students cited for not reporting an incident were a low-risk exposure, a sense of embarrassment, or perceived difficulties in getting care.

The authors recommend continuing to educate medical students about the importance of reporting exposures and seeking the proper care. They also recommend educating physicians and residents in an attempt to change the environment around exposures so that medical students no longer feel discouraged from reporting incidents.