DOES CLINICAL-EXPERIENCE AFFECT MEDICAL, STUDENTS KNOWLEDGE, ATTITUDES, AND COMPLIANCE WITH UNIVERSAL PRECAUTIONS

OBJECTIVE: To investigate differences in second-, third-, and fourth-y ear medical students' knowledge of bloodborne pathogen exposure risks, as well as their attitudes toward, and intentions to comply with, Uni versal Precautions (UP).DESIGN: Cross-sectional survey. PARTICIPANTS A ND SETTING: Surveys about students' knowledge, attitudes, and intentio ns to comply with UP were completed by 111 second-year (preclinical), 80 third-year, and 60 fourth-year medical students at Washington Unive rsity School of Medicine in the spring of 1996. RESULTS: Preclinical s tudents knew more than clinical students about the efficacy of hepatit is B vaccine, use of antiretroviral therapy after occupational exposur e to human immunodeficiency virus, and nonvaccinated healthcare worker s' risk of infection from needlestick injuries (P<.001). Students' per ceived risk of occupational exposure to bloodborne pathogens and attit udes toward hepatitis B vaccine did not differ, but preclinical studen ts agreed more strongly that they should double glove for all invasive procedures with sharps (P<.001). Clinical students agreed more strong ly with reporting only high-risk needlestick injuries (P=.057) and wit h rationalizations against using UP (P=.008). Preclinical students mor e frequently reported contemplating or preparing to comply with double gloving, wearing protective eyewear, reporting all exposures, and saf ely disposing of sharps, whereas students with clinical experience wer e more likely to report compliance. Clinical students also were more l ikely to report having ''no plans'' to practice the first three of the se precautions (P<.001). CONCLUSIONS: Differences in knowledge, attitu des, and intentions to comply with UP between students with and withou t clinical experience may have important implications for the timing a nd content of interventions designed to improve compliance with UP (In fect Control Hosp Epidemiol 1998;19:767-771).