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Our first instalment of CDTL Brief for 2011 is all about the various Teaching Tools our educators use to engage students and stimulate their interest in the subject. Whether commercially procured or developed by the educators themselves, these tools serve to enhance their students’ understanding of abstract concepts and ultimately enrich their learning experience. We are pleased to have colleagues from the medical, science, design and environment as well as engineering faculties share their teaching experiences in this area.

June 2011, Vol. 14 No. 1 Print Ready ArticlePrint-Ready
Using Routine Workplace Audits as Educational Tools: Teaching Hand Hygiene to Medical Students
Associate Professor Dale Fisher
Department of Medicine

As educators, we are increasingly aware of the benefits of practical simulation-based teaching over traditional didactic teaching. In medicine, “real patient learning” has shown how theory, when placed in context, is built upon and better appreciated. Medical students have strongly supported being placed in selected environments where perspective is given to classroom lessons.

Hand hygiene is key in the prevention of the spread of microorganisms responsible for potentially serious health care-associated infections (HAI). However, this is often not adequately recognised by doctors. Despite the well known importance and the ease with which hand hygiene can be undertaken, the average compliance by doctors (even straight after graduation) is poor. In short, as teachers we are failing!

The alcohol glycerol hand rub is effective in this respect and only requires 10 to 20 seconds to administer and can be used while simply walking from patient to patient. It should be undertaken according to the “5 moments of hand hygiene” (see Figure 1), the accepted international standard based on the World Health Organisation’s (WHO) guidelines on hand hygiene in healthcare. A hospital’s performance is assessed by hand hygiene auditors, usually nurses, who unobtrusively observe staff in their daily duties and record compliance.

Figure 1. The 5 moments of hand hygiene.

In the Department of Medicine, we have introduced a novel learning activity where final-year medical students are trained and undertake a hand hygiene audit themselves. We hypothesised that involving students in a ward-based routine audit would provide the opportunity for them to not only observe health workers’ practice in hand washing, but the exercise will also aid in their understanding of how hospital-acquired infection is linked to hand hygiene failure.

These students undertake (among other infectious disease learning modules) a standard hand hygiene auditor training program with a 30-minute tutorial by an infection control nurse trainer using a WHO audit package. The training describes the “5 moments of hand hygiene”, and includes a video demonstrating these moments. To complete the training, each student is assessed by watching three hand hygiene scenarios on video and recording their observations. They are subsequently assigned to 6 or 8 bedded surgical or medical wards for two 30-minute periods to unobtrusively observe hand hygiene opportunities and record their findings (Figure 2).


Figure 2. A student observes and records a hand hygiene scenario in the ward.

Student feedback has been overwhelmingly supportive towards our initiative. A survey suggested that while the students did not learn new facts particularly, what they did gain from this exercise was the opportunity of applying their knowledge into this real-world perspective. At least at this early stage, students report that they are more likely to appreciate and comply to these guidelines when they become full-fledged medical practitioners.

Audits are practised in all occupations to review performance and to maintain and improve standards. They are a largely untapped opportunity for teaching. University departments, even those outside of Medicine, could consider where similar learning opportunities exist for their students to obtain such perspectives for what they have learnt in the lecture theatre.

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Inside this issue
Using Routine Workplace Audits as Educational Tools: Teaching Hand Hygiene to Medical Students
The Use of Simulation in Paediatric Undergraduate Education
The Examination Library Folder (ELF): A Courseware to Manage Examination Questions
Personal Experiences in Teaching Chemical Engineering Thermodynamics
Using Full-sized Construction Models to Teach Construction Technology