title: The sociocultural contribution to learning: why did my students fail to learn Aseptic Non-Touch Technique? Multidimensional factors involved in medical students' failure to learn this skill.
abstract: BACKGROUND
  Infection control in the hospital environment is a topical issue in the UK. Aseptic Non-Touch Technique (ANTT) has been recommended as an example of best practice for clinical skills requiring aseptic technique. ANTT is taught to clinical staff and to medical students at a West Midlands teaching hospital.
  
  
  OBJECTIVE
  To determine the effectiveness of ANTT training within an undergraduate population and to explore the factors involved in medical students' failure to learn this skill Method: 132 Students underwent training and assessment in ANTT. A sample of 42 students underwent re-testing in ANTT 7-10 weeks later. Student questionnaires and semi-structured interviews with students and trainers were undertaken to determine students' daily practice of ANTT, and practice observed in staff.
  
  
  RESULTS
  Student performance deteriorated significantly 10 weeks after initial ANTT training (p < 0.001). Qualitative data demonstrates an emphasis on assessment, poor observed practice in staff, and a lack of resources in the clinical setting. Further themes include acceptance of hierarchy, and a lack of belief in ANTT amongst students.
  
  
  CONCLUSIONS
  In order to bring about effective training in ANTT, we must look to the sociocultural contribution of the hospital environment alongside formal ANTT training.
authors.affiliation: Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, USA. dvjackson@doctors.org.uk
authors.forename: Dawn
authors.initials: D
authors.lastname: Jackson
authors.forename: David
authors.initials: D
authors.lastname: Wall
authors.forename: Julie
authors.initials: J
authors.lastname: Bedward
mesh_terms: D001207:Asepsis / Q000379:methods*; D002983:Clinical Competence / Q000592:standards*; D003428:Cross Infection / Q000517:prevention & control; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D006784:Hospitals, Teaching; D006801:Humans; D007858:Learning; D015279:Organizational Culture; D036301:Qualitative Research; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014110:Touch; D006113:United Kingdom