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



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).


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.


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).


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.

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

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