Universal precautions training of preclinical students: impact on knowledge, attitudes, and compliance

Little information exists regarding the impact of universal precautions training programs on preclinical students' knowledge, attitudes, and behavior.

We developed, implemented, and assessed an educational program in universal precautions for 2nd-year medical and preclinical physician assistant students. Students (n = 170) completed pre- and post-training questionnaires to assess universal precautions knowledge and to evaluate attitudes about their perceived risk for bloodborne pathogen infection, the importance of universal precautions procedures, and their willingness to provide care for human immunodeficiency virus (HIV)-positive or acquired immune deficiency syndrome (AIDS) patients. Phlebotomy, intravenous catheter insertion, and arterial blood gas sampling techniques were demonstrated, practiced, and evaluated during practical training sessions. Outcome measures included changes in pre- and posttraining knowledge scores and attitudes, as well as observed compliance with universal precautions during practical training.

Universal precautions knowledge scores increased significantly after training (P < 0.0001). Personal assessments of the risk of developing HIV due to patient care significantly decreased (P < 0.0001) and willingness to provide care for AIDS patients increased (P = 0.004) following training. Importantly, students reported that high expected rates of contact with HIV-positive and other patient groups would not significantly affect their specialty choice. Observed compliance with universal precautions procedures during practical training ranged from 95 to 99% for glove use, 76 to 77% for direct sharps disposal without needle recapping, and 56 to 78% for handwashing after glove removal during phlebotomy and intravenous catheter insertion.

This program is effective in increasing students' knowledge of universal precautions. Training favorably affects students' willingness to care for HIV-positive patients and their assessed risk of developing occupational bloodborne infection.