Medical Student Engagement to promote Standard Precaution


  • Harutaya Kasyanan
  • Naritchaya Phattana
  • Orawan Chaiyamahapurk


8JJ Patient safety


Buddhachinaraj Medical Education Center


Medical students have been the largest group of bloodborne pathogen exposure in Buddhachinaraj hospital, Thailand, and the incidences are increasing continually.

Non-compliance to standard precaution is the main cause despite the pre-practice education program.


Figure 1 The incidence of blood borne pathogen exposure from October 2010 to September 2013 

Summary of Results
  • We had 924 stars on the behavior star chart, the increase in the number of stars in each month showed increasing observations and feedback. 

Figure 4 Number of stars on star chart during 3-month observation period


  • The gold stars of good compliance continually increased in 3 months and the black stars of non-complianceshowed a minimal decrease in the third month.
  • Sharp injury among medical students occured only once in October, three times in November and twice in December 2013.
  • These results showed that behavior star chart may have some effects on students' compliance.

  • Students from group discussion reflected that

1) Lack of concentration and awareness were still the main causes of all workplace accident. 

2) Narrating the procedure to patients could increase physicians' concentration.

3) The role models for procedure learning of junior students were their seniors, not medical staff.

Our activities created an environment of participation among health care workers, strengthening relationship as well as teamwork. Medical students realized their importance in fostering safety in the workplace and also became more responsible of their own actions. Students appreciated that their voices were heard and acted upon.

Summary of Work

Standard precaution promoting program was conducted through 2 activities;

  • First, Behavior star chart were used to encourage ward nurses to provide immediate, direct but friendly feedback to the students in a three-month observation period (October to December 2013). 
  • Second, students who experienced bloodborne pathogen exposure were asked to join a Focus group discussion for their views on how to improve compliance.

Figure 2 The research timeline during 3-month period










Figure 3 Star chart implementation and ward nurse participation


Figure 4 Star chart and medical student compliances



Whilst a pre-practice education program is important, medical student engagement is necessary to improve standard precautions more effectively.

Take-home Messages

In achieving objectives that involve students, it is important to engage them to the process. 

Summary of Results
Summary of Work
Take-home Messages
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