title: Hand Hygiene: Knowledge and Attitudes of Fourth-Year Clerkship Medical Students at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.
abstract: BACKGROUND
  Little is known about the clerkship (clinical) medical students' knowledge of hand hygiene as the single most important precautionary measure to reduce nosocomial healthcare-associated infections. The aim of this study is to explore the knowledge of, and attitudes towards, hand hygiene practices among fourth-year clerkship medical students at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.
  
  
  METHODS
  A cross-sectional, paper-based, Yes/No formatted questionnaire was administered to explore the students' knowledge of, and attitudes towards, hand hygiene practices. Data were decoded in Microsoft Excel sheet and presented as numbers and percentages.
  
  
  RESULTS
  One hundred and eleven students (n=111/147) participated in the questionnaire (response rate: 76%). Although the majority of students had a fair knowledge of hand hygiene practices, a number of them had some misconceptions. Only 14% of students correctly agreed to the statement: "Traditional hand washing (water, plus regular soap) decreases the number of germs." Furthermore, only 32% of students correctly answered that "hand washing with a regular soap, instead of an antiseptic soap, is better in limiting the transmission of clostridium difficile infections". Almost all students (93%) agreed to the importance of hand hygiene education in medical curricula and its awareness in healthcare centers. Despite the importance of hand hygiene, only 13% of students reviewed the respective WHO and CDC guidelines before starting their clinical training in the teaching hospital.
  
  
  CONCLUSIONS
  The students' inadequate knowledge about hand hygiene needs to be enriched by well-structured curricular and extra-curricular programs as well as more positive attitudes by healthcare workers.
authors.affiliation: College of Medicine, Alfaisal University.
authors.forename: Reem
authors.initials: R
authors.lastname: Hamadah
authors.affiliation: College of Medicine, Alfaisal University.
authors.forename: Razan
authors.initials: R
authors.lastname: Kharraz
authors.affiliation: College of Medicine, Alfaisal University.
authors.forename: Airabab
authors.initials: A
authors.lastname: Alshanqity
authors.affiliation: College of Medicine, Alfaisal University.
authors.forename: Danah
authors.initials: D
authors.lastname: AlFawaz
authors.affiliation: College of Medicine, Alfaisal University.
authors.forename: Abdulaziz M
authors.initials: AM
authors.lastname: Eshaq
authors.affiliation: College of Medicine, Alfaisal University.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abu-Zaid
keywords: attitude; clerkship; curriculum; hand hygiene; healthcare; infection; knowledge; medical education; medical students; saudi arabia