1 Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan, 2 Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, 3 Nursing Department, National Cheng Kung University Hospital, Tainan, Taiwan Background: To promote the quality of hand hygiene skill, several innovative teaching programs has been initiated since 2012.