Knowledge about ankle-brachial index procedure among residents: being experienced is beneficial but is not enough

Abstract

Summary:Background: Ankle-brachial index (ABI) at rest is the main clinical tool to diagnose the presence of lower extremity peripheral artery disease (PAD). The method for ABI procedure (i.e., measurement, calculation and interpretation) is standardised and guidelines were published in 2012. This study sought to: i) assess knowledge about the three major steps of the ABI procedure (i.e., measurement, calculation and interpretation) among residents from different medical schools, ii) compare the ABI knowledge of experienced residents (i.e., who have already performed ABI procedure more than 20 times) with the knowledge of inexperienced residents, and iii) describe the most common errors by residents. Methods: Residents from six medical schools were invited to complete a questionnaire about the ABI procedure. Results: Sixty-eight residents completed the questionnaire. None of them knew how to perform the entire ABI procedure. Overall, 22 %, 13 % and 41 % of residents correctly answered questions about ABI measurement, ABI calculation and ABI interpretation, respectively. Score comparisons underlined the fact that experienced residents (n = 26) answered ABI measurement questions to a signifi cantly better level and had a signifi cantly higher total score than inexperienced residents (n = 42) (P = 0.0485 and P = 0.0332, respectively). Errors were similar for most of the residents. Conclusions: Our study confi rms that experienced residents have signifi cantly better ABI procedure knowledge than inexperienced residents. However, none of them are able to perform the entire ABI procedure without any mistake with regard to current guidelines. It is important that training be given to residents in medical schools in order to improve their ABI procedure knowledge.

Impact of an Educational Intervention on Ankle–Brachial Index Performance Among Medical Students and Fidelity Assessment at Six Months

“…Teaching of the ABI procedure in major medical schools consists of only a didactic session, evaluated by questionnaire (9)(10)(11) , that is insufficient to ensure competence with the theoretical procedure. Our study supports dropping didactic learning alone or combining it with…”

Statement for Doppler waveforms analysis

“…A theoretical approach, as adopted by most French Medical Faculties to record the resting ABI, would probably be inappropriate [38]. Regarding ABI, a certain number of measurements must be recorded to build up competence [6,39,40]. Studies conducted by Scissons highlight a better system for classifying Doppler waveform morphologies with the person gaining experience with every waveform analysis [8,10].…”

Recommandations du Collège des enseignants de médecine vasculaire (CEMV) : analyse des flux artériels Doppler (classification de Saint-Bonnet simplifiée)

“…Cependant, dans certaines populations comme chez les diabétiques, les insuffisants rénaux, et les personnes âgées notamment, l'IPS de repos peut être faussement normal [5]. Dans ces cas et compte tenu des difficultés d'apprentissage, l'évaluation des flux Doppler peut apparaître comme intéressante [7][8][9][10]. Ainsi, l'artériopathie des membres inférieurs peut être définie au repos par [3,6,11]:…”