A competency-based framework for preventing blood-borne pathogen occupational exposures in medical students: literature review and Delphi study

Abstract Background Blood-borne pathogen occupational exposures pose significant hazard to medical students during clinical internships, with needlestick injuries being the primary transmission vector for blood-borne pathogens (hepatitis B virus, hepatitis C virus, human immunodeficiency virus). Cur...

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Bibliographic Details
Main Authors: Pingping Wang, Minhong Cai, Yu Lv, Qian Xiang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Education
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Online Access:https://doi.org/10.1186/s12909-025-07620-x
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Summary:Abstract Background Blood-borne pathogen occupational exposures pose significant hazard to medical students during clinical internships, with needlestick injuries being the primary transmission vector for blood-borne pathogens (hepatitis B virus, hepatitis C virus, human immunodeficiency virus). Current prevention guidelines lack tailored frameworks for this vulnerable population. Methods A two-phase method was conducted: literature review and Delphi method. Phase one conducted a literature review across PubMed, Web of Science, Embase, and Cochrane Library (2000–2024). Data were extracted to form an initial framework. During phase two, a modified Delphi method was employed with a multidisciplinary expert panel across two rounds to refine the initial framework developed from the literature review. Consensus thresholds required ≥ 70% agreement on 5-point Likert scale. Results The literature review initially identified 1,477 records, with 200 articles retained after search and selection process. During the modified Delphi process, a multidisciplinary panel of 25 experts (71.4% initial response rate; 65.7% retention) iteratively refined prevention strategies. The finalized framework comprises 13 actionable elements, stratified across prevention tiers: primary prevention (7 items), secondary prevention (4 items), and tertiary prevention (2 items). Conclusion This study provides the first competency-based framework for medical students to prevent blood-borne pathogen occupational exposures during clinical internships. The framework, informed by evidence-based strategies in conjunction with expert consensus, is a significant step forward in ensuring the occupational safety of medical students.
ISSN:1472-6920