The observation of hand hygiene (HH) compliance is subject to the Hawthorne effect, particularly if the compliance monitors are easily recognizable.This recent study reports the use of medical students as covert observers of HH. Of note, the study summarizes the medical students' perceptions of their role as HH monitors. Generally, the findings are positive in so fas they gained considerable knowledge on HH compliance by nurses, physicians, and surgeons. In addition, the nine students studied were responsible for significant total of 17,742 HH opportunities during the study period.
The use of medical students as covert HH monitors may be feasible, however, this must be done cautiously. Students should volunteer and must be adequately trained. Also, because of a hierarchical asymmetry between student, nurse and physician, students should not be expected to intervene to correct deficiencies in HH. This would result in an uncomfortable situation.
