Article Text

Hand hygiene of medical students and resident physicians: predictors of attitudes and behaviour
  1. Violeta Barroso1,
  2. Wendy Caceres2,
  3. Pooja Loftus2,
  4. Kambria H Evans2,
  5. Lisa Shieh2
  1. 1Department of Family Medicine, Kaiser, Vallejo Medical Center, Vallejo, California, USA
  2. 2Department of Medicine, Stanford University, Stanford, California, USA
  1. Correspondence to Kambria H Evans, Department of Medicine, Stanford School of Medicine, 1265 Welch Road, X2C06, Stanford, CA 94305, USA; khevans{at}


Objectives We measured medical students’ and resident trainees’ hand hygiene behaviour, knowledge and attitudes in order to identify important predictors of hand hygiene behaviour in this population.

Methods An anonymous, web-based questionnaire was distributed to medical students and residents at Stanford University School of Medicine in August of 2012. The questionnaire included questions regarding participants’ behaviour, knowledge, attitude and experiences about hand hygiene. Behaviour, knowledge and attitude indices were scaled from 0 to 1, with 1 representing superior responses. Using multivariate regression, we identified positive and negative predictors of superior hand hygiene behaviour. We investigated effectiveness of interventions, barriers and comfort reminding others.

Results 280 participants (111 students and 169 residents) completed the questionnaire (response rate 27.8%). Residents and medical students reported hand hygiene behaviour compliance of 0.45 and 0.55, respectively (p=0.02). Resident and medical student knowledge was 0.80 and 0.73, respectively (p=0.001). The attitude index for residents was 0.56 and 0.55 for medical students. Regression analysis identified experiences as predictors of hand hygiene behaviour (both positive and negative influence). Knowledge was not a significant predictor of behaviour, but a working gel dispenser and observing attending physicians with good hand hygiene practices were reported by both groups as the most effective strategy in influencing trainees.

Conclusions Medical students and residents have similar attitudes about hand hygiene, but differ in their level of knowledge and compliance. Concerns about hierarchy may have a significant negative impact on hand hygiene advocacy.

  • EDUCATION & TRAINING (see Medical Education & Training)

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.