Infection control competency in surgical settings among clinical medical students in Sudan: a cross sectional study

Abstract

Surgical site infections (SSIs) pose a major challenge to healthcare systems worldwide, with a disproportionately higher impact in low- and middle-income countries. Medical clinical students are actively involved in patient care and thus play a vital role in implementing infection prevention protocols. However, deficiencies in their knowledge, attitudes and practices (KAP) regarding infection control may undermine patient safety and surgical outcomes. This study aimed to assess the KAP of clinical medical students in Sudan concerning infection control measures in surgical settings and to explore perceived barriers and potential strategies for improvement. A cross-sectional study was conducted among 420 clinical medical students from 13 Sudanese universities between November 2024 and February 2025. Data were collected using a structured, self-administered online questionnaire covering demographic data, KAP components and contextual barriers. Scores were categorized into poor, moderate or good levels. Independent samples t-test and one-way ANOVA were used to assess the differences in KAP scores across demographic variables. Most students demonstrated moderate knowledge (73.8%) and practices (50.2%) regarding infection control while 43.8% exhibited a neutral attitude. Notably, Only 28.8% of participants had received formal infection control training. Significant knowledge gaps were observed in hand hygiene duration, personal protective equipment (PPE) sequencing and sterile field management. The most reported barriers were limited supplies (70%) and insufficient training (69.3%). Interestingly, students who had not completed a surgical rotation had significantly higher attitude scores toward infection control compared to those who had (p = 0.008). Sudanese medical students demonstrate moderate awareness and practice regarding infection control in surgical settings, with notable gaps in training and resource availability. Targeted educational interventions, enhanced supervision, and improved access to infection control supplies are critical to strengthening adherence and promoting safer clinical environments.