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Unprotected medical students

Do medical students receive training in correct use of personal protective equipment? John A, Tomas ME, Hari A, Wilson BM, Donsky CJMedical Education Online 2017, 22(1)

Reviewed by Ginny Randall

Tags: Medical students, competency, survey


What was the study question?

Do medical students receive the correct training for donning and doffing personal protective equipment (PPE)?

How was the study done?

Medical students on clinical rotations at two teaching hospitals were surveyed to determine the type of training received in PPE technique. Students performed simulations of contaminated PPE removal with fluorescent lotion on gloves and were assessed for correct PPE technique and skin and/or clothing contamination. To obtain additional information on PPE training during medical education, residents, fellows, and attending physicians completed written questionnaires on PPE training received during medical school and on knowledge of PPE protocols recommended by the Centers for Disease Control

What were the results?

Of 27 medical students surveyed, only 11 (41%) reported receiving PPE training, and none had received training requiring demonstration of proficiency. During simulations, 25 of 27 (92.5%) students had one or more lapses in technique and 12 (44%) contaminated their skin with fluorescent lotion. For 100 residents, fellows and attending physicians representing 67 different medical schools, only 53% reported receiving training in use of PPE and only 39% selected correct donning and doffing sequence. The PPE training that was provided most often focused on selection of appropriate PPE rather than on using it correctly.

What are the implications?

The implications of this study are horrendous.  Healthcare providers, medical students, and patients are at risk of contamination when PPE is not used correctly. The proficiency study with fluorescent lotion (in which 92.5% of students made errors) was carried about with 27 medical students in 3 medical schools. In the setting of multi drug resistant MRSA, C. difficile, and emerging tropical diseases, proper use of PPE should be emphasized on every clinical rotation.  Modeling correct donning and doffing by preceptors is vital.

Editor’s note: I always tell the third year clerkship students that it is an unfortunate rite of passage that students typically get sick during their pediatric rotations. Now I know why (at least one of the reasons). Most physicians surveyed had never been trained in the correct donning and doffing sequence for PPE and yet medical students often reported that the most common way they had learned the technique was by observing those same more senior physicians. (RR)

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