From theory to practice in learning about healthcare associated infections: reliable assessment of final year medical students' ability to reflect

Background: Healthcare associated infection affects 9% of patients admitted to hospital. One of the greatest challenges in addressing this problem is transferring theory to practice in relation to hand hygiene. Developing the ability to reflect can promote this transfer. This study illustrates how an instrument to assess the reflective ability of final year medical students was applied to the context of hand hygiene within the infection control cleanliness champion programme (CCP) and demonstrated inter-rater reliability at all three levels of reflection. The results suggest behaviour change in relation to practice.

Methods: One hundred and thirty two reflective accounts were used for this study, provided by 44 5th year medical students. Each student had written three reflective accounts for each part of the hand hygiene unit. Results show that the inter-rater agreement was consistently high for all three levels of reflection. However, the least consistent was at reflective level three.

Conclusions: These results suggest that the students were able to link theory to practice following the completion of the CCP. It could also indicate that assessors might require more skills and knowledge to enable effective and consistent examination of all areas of reflection.