Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge

Abstract

Blood pressure (BP) measurement is the most common procedure performed in clinical practice. Accurate BP measurement is critical if patient care is to be delivered with the highest quality, as stressed in published guidelines. Physician training in BP measurement is often limited to a brief demonstration during medical school without retraining in residency, fellowship, or clinical practice to maintain skills. One hundred fifty‐nine students from medical schools in 37 states attending the American Medical Association's House of Delegates Meeting in June 2015 were assessed on an 11‐element skillset on BP measurement. Only one student demonstrated proficiency on all 11 skills. The mean number of elements performed properly was 4.1. The findings suggest that changes in medical school curriculum emphasizing BP measurement are needed for medical students to become, and remain, proficient in BP measurement. Measuring BP correctly should be taught and reinforced throughout medical school, residency, and the entire career of clinicians.

The ongoing saga of poor blood pressure measurement: Past, present, and future perspectives

“…Although first‐year students made up the majority of the study sample and would have been closest to the teaching of this skill, it was the 2nd‐ to 4th‐year students who scored higher than the first‐year students, which suggests that some reinforcement or further knowledge consolidation is occurring. Still, in highest‐scoring group, a mean of only 4.9 of 11 skills were performed correctly …”

“…This issue of inaccurate measurement is underrecognized and pervasive. In the current issue of the Journal of Clinical Hypertension , the excellent study by Rakotz and colleagues refocuses attention on the poor state of BP measurement among medical students. The authors studied a convenience sample of medical students attending the American Medical Association's House of Delegates Annual Meeting.…”

“…The 11 skills evaluated in the study by Rakotz and colleagues were all procedure‐related skills. Having the patient sit prior to starting the BP measurement was the skill the medical students missed most often.…”

Medical students’ proficiency in performance of the resting ankle‐brachial index is not sustained at 6 months

“…1 BP measurement is also a basis of the ankle-brachial index (ABI) at rest that is the first-line test to diagnose peripheral artery disease (PAD), a disease affecting over 200 million individuals worldwide. 2 ABI proposed by Winsor is defined as the ratio of the highest systolic BP measured at the ankle to that measured at the brachial artery.…”

“…Furthermore, this study strengthens the ideas that the current medical school curriculum needs to be redesigned as already suggested. 1 Didactic learning alone should be stopped or reinforced with experiential learning and competency testing should be carried out regularly to check retention.…”