ArticlePloS one2020
Speaking up behavior and cognitive bias in hand hygiene: Competences of German-speaking medical students.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 26 citations in OpenAlex.
- Factors influencing hand hygiene speak-up as perceived by nursing students with clinical practice experience: an application of the theory of planned behavior.BMC nursing · 2026Article
- Self-assessment and learning motivation in emergency point-of-care ultrasound: an online pilot investigation in German physicians.BMC emergency medicine · 2024Article
- Interaction between overconfidence effects and training formats in nurses' education in hand hygiene.BMC nursing · 2024Article
- Hand hygiene in emergencies: Multiprofessional perceptions from a mixed methods based online survey in Germany.International journal of nursing studies advances · 2024Article
- Learning motivation and self-assessment in health economics: a survey on overconfidence in healthcare providers.BMJ open · 2024Article
- Infection prevention in medical education - results of a descriptive cross-sectional study in Germany.GMS journal for medical education · 2024Article
- Personal protective equipment and medical students in times of COVID-19: experiences and perspectives from the final clerkship year.BMC medical education · 2023Article
- Overconfidence effects and learning motivation refreshing BLS: An observational questionnaire study.Resuscitation plus · 2023Article
- Do task and item difficulty affect overestimation of one's hand hygiene compliance? A cross-sectional survey of physicians and nurses in surgical clinics of six hospitals in Germany.Antimicrobial resistance and infection control · 2022Article
- Self-Assessment and Learning Motivation in the Second Victim Phenomenon.International journal of environmental research and public health · 2022Article
- Correlation between Overconfidence and Learning Motivation in Postgraduate Infection Prevention and Control Training.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionInfection prevention and speaking up on errors are core qualities of health care providers. Heuristic effects (e.g. overconfidence) may impair behavior in daily routine, while speaking up can be inhibited by hierarchical barriers and medical team factors. Aim of this investigation was to determine, how medical students experience these difficulties for hand hygiene in daily routine.
methodsOn the base of prior investigations we developed a questionnaire with 5-point Likert ordinal scaled items and free text entries. This was tested for validity and reliability (Cronbach's Alpha 0.89). Accredited German, Swiss and Austrian universities were contacted and medical students asked to participated in the anonymous online survey. Quantitative statistics used parametric and non-parametric tests and effect size calculations according to Lakens. Qualitative data was coded according to Janesick.
results1042 undergraduates of 12 universities participated. All rated their capabilities in hand hygiene and feedback reception higher than those of fellow students, nurses and physicians (p<0.001). Half of the participants rating themselves to be best educated, realized that faulty hand hygiene can be of lethal effect. Findings were independent from age, sex, academic course and university. Speaking-up in case of omitted hand hygiene was rated to be done seldomly and most rare on persons of higher hierarchic levels. Qualitative results of 164 entries showed four main themes: 1) Education methods in hand hygiene are insufficient, 2) Hierarchy barriers impair constructive work place culture 3) Hygiene and feedback are linked to medical ethics and 4) There is no consequence for breaking hygiene rules. DISCUSSION: Although partially limited by the selection bias, this study confirms the overconfidence-effects demonstrated in post-graduates in other settings and different professions. The independence from study progress suggests, that the effect occurs before start of the academic course with need for educational intervention at the very beginning. Qualitative data showed that used methods are insufficient and contradictory work place behavior in hospitals are frustrating. Even 20 years after "To err is human", work place culture still is far away from the desirable.
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