Re-thinking microbiology/infection control education to enhance the practice-readiness of health professional students: More than just a curriculum issue

Jennifer L Cox, Maree Donna Simpson, Will Letts, Heather MA Cavanagh


Undergraduate education in the health professions is intended to produce competent health professional graduates. Infection prevention and control (IPC) is a necessary element of daily practice in many health professions, to safeguard patients and staff, however previous research has established poor knowledge and implementation of IPC precautions despite escalating rates of potentially lethal healthcare-associated infections (HAIs) across the globe. This paper will discuss three key areas of influence for graduates’ IPC knowledge, intentions and practice: perceptions of science, health behaviour beliefs (perceived risk and self-efficacy) and applied knowledge (microbiology). To date, each of these areas have been researched individually however there is an urgent need for improved synthesis and integration of these factors in curriculum planning and design, both inside and outside the classroom, to enhance the development of competent, work-ready graduates.


curriculum integration; misperceptions; microbiology; infection control; health

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Allegranzi, B., & Pittet, D. (2009). Role of hand hygiene in healthcare-associated infection prevention. Journal of Hospital Infection, 73(4), 305-315.

Bednash, G. (2006). Scientific underpinnings for professional nursing practice. Focus on Microbiology Education, 12(2), 5-6.

Brinsley, K. J., Sinkowitz-Cochran, R. L., Cardo, D. M., & The C. D. C. Campaign to Prevent Antimicrobial Resistance Team. (2005). Assessing motivation for physicians to prevent antimicrobial resistance in hospitalized children using the Health Belief Model as a framework. American Journal of Infection Control, 33(3), 175-181. doi:

Burke, J. P. (2003). Infection Control - A Problem for Patient Safety. N Engl J Med, 348(7), 651-656.

Caon, M., & Treagust, D. (1993). Why do some nursing students find the science courses difficult? J Nurs Educ, 32(6), 255-259.

Cate, O. T., & Scheele, F. (2007). Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Academic Medicine, 82, 542-547.

Clark, T., & Holmes, S. (2007). Fit for practice? An exploration of the development of newly qualified nurses using focus groups. International Journal of Nursing Studies, 44(7), 1210-1220. doi:

Clements, A., Halton, K., Graves, N., Pettitt, A., Morton, A., Looke, D., & Whitby, M. (2008). Overcrowding and understaffing in modern health-care systems: key determinants in methicillin-resistant Staphylococcus aureus transmission. Lancet Infectious Diseases, 8(7), 427-434.

Collignon, P., Wilkinson, I., Gilbert, G., Grayson, M. L., & Whitby, R. M. (2006). Health-care associated Staphylococcus aureus bloodstream infections: a clinical quality indicator for all hospitals. Medical Journal of Australia, 184, 404-406.

Committee on Undergraduate Science Education. (1997). Science teaching reconsidered : a handbook Washington, DC: National Academy Press.

Cooper, T. (2001). Educational theory into practice: development of an infection control link nurse programme. Nurse Education in Practice, 1(1), 35-41.

Courtenay, M. (1991). A study of the teaching and learning of the biological sciences in nurse education. Journal of Advanced Nursing, 16(9), 1110-1116. doi: 10.1111/j.1365-2648.1991.tb03372.x

Cox, J. L., Simpson, M. D., Letts, W., & Cavanagh, H. M. A. (2014). Putting it into practice: Infection Control Professionals’ perspectives on early career nursing graduates’ microbiology and infection control knowledge and practice. Contemporary Nurse, 49(1-2).

Cruickshank, M., & Ferguson, J. (2008). Reducing Harm to Patients from Health Care Associated Infection: The Role of Surveillance: Australian Commission on Safety and Quality in Health Care.

Dannenfeldt, G., Stewart, J., McHaffie, J., Gibson-van Marrewijk, K., Stewart, K., & Hipkins, R. (2009). Addressing obstacles to success: implementing change in science delivery. Focus on Health Professional Education, 11(1), 41-48.

Davis, G. M. (2010). What is provided and what the registered nurse needs -- bioscience learning through the pre-registration curriculum. Nurse Education Today, 30(8), 707-712.

DeJoy, D. M., Gershon, R. R. M., & Schaffer, B. S. (2004). Safety Climate. Professional Safety, 49(7), 50-57.

Duit, R., & Treagust, D. (2003). Conceptual change: a powerful framework for improving science teaching and learning. International Journal of Science Education, 25(6), 671-688.

Frank, J. R., Snell, L. S., Cate, O. T., Holmboe, E. S., Carraccio, C., Swing, S. R., . . . Harris, K. A. (2010). Competency-based medical education: theory to practice. Medical Teacher, 32(8), 638-645. doi: 10.3109/0142159X.2010.501190

Gammon, J., & Gould, D. (2005). Universal precautions. A review of knowledge, compliance and strategies to improve practice. Journal of Research in Nursing, 10(5), 529-547.

Gould, D. (1995). Infection control: a survey to determine knowledge of nurses in a clinical setting. Nurs Stand, 9(36), 35-38.

Gould, D. J., Drey, N. S., Moralejo, D., Grimshaw, J., & Chudleigh, J. (2008). Interventions to improve hand hygiene compliance in patient care. Journal of Hospital Infection, 68(3), 193-202. doi:

Grace, S., & O'Neil, R. (2014). Better prepared, better placement: An online resource for health students. Asia-Pacific Journal of Cooperative Education, 15(4), 291-304.

Gruppen, L., Mangrulkar, R., & Kolars, J. (2012). The promise of competency-based education in the health professions for improving global health. Human Resources for Health, 10(43). doi:10.1186/1478-4491-10-43

Handwerker, S. (2012). Transforming Nursing Education: A Review of Current Curricular Practices in Relation to Benner's Latest Work. International Journal of Nursing Education Scholarship, 9(1).

Harbarth, S., Sax, H., & Gastmeier, P. (2003). The preventable proportion of nosocomial infections: an overview of published reports. Journal of Hospital Infection, 54, 258-266.

Huggonet, S., & Pittet, D. (2000). Hand hygiene - beliefs or science? Clinical Microbiology and Infection, 6(7), 348-354.

Johnson, P., Fogarty, L., Fullerton, J., Bluestone, J., & Drake, M. (2013). An integrative review and evidence-based conceptual model of the essential components of pre-service education. Human Resources for Health, 11(42). doi:10.1186/1478-4491-11-42

Jordan, S., Davies, S., & Green, B. (1999). The biosciences in the pre-registration nursing curriculum: staff and students' perceptions of difficulties and relevance. Nurse Education Today, 19(3), 215-226. doi: 10.1016/s0260-6917(99)80007-0

Kretzer, E. K., & Larson, E. L. (1998). Behavioral interventions to improve infection control practices. American Journal of Infection Control, 26(3), 245-253. doi:

Levett-Jones, T., & Lathlean, J. (2009). `Don't rock the boat': Nursing students' experiences of conformity and compliance. Nurse Education Today, 29(3), 342-349.

Limper, H. M., Barton, G., McGinty, M., Landon, E., O’Boyle, C., Reddy, S., & Weber, S. G. (2013). Behavioral Intention of Physician Trainees and Medical Students to Practice Hand Hygiene. Infection Control and Hospital Epidemiology, 34(10), 1102-1105. doi: 10.1086/673146

Liu, L.-M., Curtis, J., & Crookes, P. A. (2014). Identifying essential infection control competencies for newly graduated nurses: a three-phase study in Australia and Taiwan. Journal of Hospital Infection, 86, 100-109.

Lumpkin Allen, D. M. A. (1997). The effects of computer-based multimedia lecture presentations on community college microbiology students' achievement, attitudes and retention. (9824854 Ph.D.), The University of Texas at Austin, Ann Arbor. Retrieved from ProQuest Dissertations & Theses Global database.

Miller, G. E. (1990). The assessment of clinical skills/competence/performance. Academic Medicine, 65, S63-S67.

Minasian-Batmanian, L. C., Lingard, J., & Prosser, M. (2005). Differences in students’ perceptions of learning compulsory foundation biochemistry in the health sciences professions. Advances in Health Science Education, 28(10), 279-290. doi: 10.1007/s10459-005-1404-7

Mutha, S., Jeffe, D. B., Kim, L. E., L' Ecuyer, P. B., Evanoff, B. A., & Fraser, V. J. (1999). Healthcare Workers' Perceptions of Occupational Exposure Infection Control and Hospital Epidemiology, 20(9), 592-593.

Nursing and Midwifery Board of Australia. (2006). National Competency Standards for the Registered Nurse.

O'Brien, D., Richards, J., Walton, K. E., Phillips, M. G. A., & Humphreys, H. (2009). Survey of teaching/learning of healthcare-associated infections in UK and Irish medical schools. Journal of Hospital Infection, 73(2), 171-175.

Pittet, D. (2004). The Lowbury lecture: behaviour in infection control. Journal of Hospital Infection, 58(1), 1-13. doi:

Prieto, J., & Clark, J. M. (2005). Contact precautions for Clostridium difficile and Methicillin-resistant Staphylococcus aureus (MRSA). Journal of Research in Nursing, 10(5), 511-526. doi: 10.1177/136140960501000508

Roark, J. (2005). Microbiology 101 for the ICP. Infection Control Today.

Scott, R. D. (2009). The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention: Centers for Disease Control and Prevention.

Sherwood, G. (2011). Integrating quality and safety science in nursing education and practice. Journal of Research in Nursing, 16(3), 226-240. doi: 10.1177/1744987111400960

Stein, A. D., Makarawo, T. P., & Ahmad, M. F. R. (2003). A survey of doctors' and nurses' knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals. Journal of Hospital Infection, 54(1), 68-73.

Thornton, T. (1997). Attitudes towards the relevance of biological, behavioural and social sciences in nursing education. J Adv Nurs, 26(1), 180-186.

Ward, D. J. (2013). The application of the theory of planned behaviour to infection control research with nursing and midwifery students. Journal of Clinical Nursing, 22(1-2), 296-298. doi: 10.1111/j.1365-2702.2012.04327.x

Whitby, M., McLaws, M., & Ross, M. (2006). Why healthcare workers don't wash their hands: A behavioural explanation. Infection Control and Hospital Epidemiology, 27(5), 484-492.

Wilkes, L., & Batts, J. (1998). Nurses' understanding of physical science in nursing practice. Nurse Education Today, 18, 125-132.

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