Practice makes perfect! Patient safety starts in medical school: Do instructional videos improve clinical skills and hygiene procedures in undergraduate medical students?

In 2012 safety strategies were defined in five intervention areas to improve patient safety in Austria. Regarding policy development, patient safety should be mandatory part of education of all healthcare sectors, and measures to improve hygiene standards are to be included in organizational development. The aim of this project was to achieve sustained improvement in routine procedures and anchor patient safety in the undergraduate medical curriculum by making online instructional videos on clinical skills and hygiene procedures permanently available as preparation for the first clinical clerkship. Short films explaining how to insert urinary catheters in women and men were produced and provided online. These videos were shown to medical students shortly before the practical Objective Structured Clinical Examination (OSCE). After viewing the videos, all of the students were surveyed using an online questionnaire with 15 questions regarding quality and acceptance. The effect of the videos on learning success was determined by the assessment outcome through red cards in the practical exam. A red card for behavior endangering the doctor or others meant zero points and discontinuation of the assessment at that particular OSCE station. A total of 647 students viewed one of the two videos on urinary catheters, 623 responded to the online Moodle questionnaire completly. 551 (85.2%) reported being better able to recall individual steps and procedures, 626 students (96.7%) positively rated the fact that instructional videos were available on the Medical University of Vienna's website. More than half of the respondents (56.6%) were better able to remember critical hygiene practices. The comparison of the assessment outcomes on the OSCE for 2016 and 2013, a year in which the instructional videos were not yet available, shows no significant (chi=3.79; p>0.05) but a trend towards improvement. The chance of getting a red card in 2013 was 3.36 times higher than in 2016. Even if our study was unable to show significant improvements in the OSCE as a result of viewing the videos, it appears that clearly imparting medical skills and hygiene standards-including in visual form-is still important prior to the first clerkship to ensure the highest level of patient safety possible. The combination of teaching and learning formats, such as videos on online platforms with textbooks or lecture notes, is well suited to increase effectiveness and efficiency in learning. There is a need for further studies to investigate and analyze the effects of instructional videos in more detail.