Relation of clinical context to accuracy of simulator-based blood pressure measurement by first-year medical students

Yuka Yamazaki, Iku Hiyamizu, Kyoko Joyner, Yukie Abe, Yuka Yamazaki, Iku Hiyamizu, Kyoko Joyner, Yukie Abe

Abstract

Objectives: To explore the association between clinical contexts and accuracy of manikin blood pressure readings by first-year medical students after first Simulation-Based-Education training.

Methods: This cross-sectional study, in controlled simulation settings, was comprised of 121 first-year medical student participants after their first Simulation-Based-Education training. Divided into three groups (n = 39, 42 and 40), participants measured blood pressure on three simulator arms assigned different clinical contexts: healthy young male, young female with hypotension, and elderly male with hypertension and diabetes. Each group performed the same protocol on three different days. A Chi-squared test was performed for between-day and between-case differences of correct answers, and one-way ANOVA with Bonferroni post-hoc comparisons was performed for manikin-settings deviation (reported Systolic Blood Pressure (SBP) - set SBP) among cases.

Results: The proportion of correct answers of on Day Two was significantly lower than on the other two days (χ2(2, N = 285) = 0.34, p = .84), but roughly comparable among cases (χ2(2, N = 285) = 24.07, p < .001). The mean of the differences of (SBPreported - SBPset) of Case Two (M = -6.68, SD = 8.91) was significantly lower than Case One (M = -3.07, SD = 9.11) and Three (M = -1.63, SD = 7.76) (F (2, 274) = 8.68, p < .001).

Conclusions: Although no statistical associations were found between clinical contexts and student performance in blood pressure measurement, student familiarity with diseases may be associated with performance in taking blood pressure. Day Two performance underscores the need to promote student confidence in diagnostic skills.

Keywords: assessment; blood pressure; clinical skills; medical students; simulation.

References

    1. Stoklosa H, Lyman M, Bohnert C, Mittel O. Medical education and human trafficking: using simulation. Med Educ Online. 2017;22:1412746. doi: 10.1080/10872981.2017.1412746.
    1. Barry Issenberg S, Mcgaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2009;27:10–28. doi: 10.1080/01421590500046924.
    1. Ballard G, Piper S, Stokes P. Effect of simulated learning on blood pressure measurement skills. Nurs Stand. 2012;27:43–47. doi: 10.7748/ns.27.8.43.s57.
    1. Obara H. Status quo of simulation education in anesthesia by using high-fidelity mannequins. The Journal of Japan Society for Clinical Anesthesia. 2011;31:762–770. doi: 10.2199/jjsca.31.762.
    1. Abe Y, Kawahara C, Yamashina A, Tsuboi R. Repeated scenario simulation to improve competency in critical care: a new approach for nursing education. Am J Crit Care. 2013;22:33–40. doi: 10.4037/ajcc2013229.
    1. Lineberry M, Walwanis M, Reni J. Comparative research on training simulators in emergency medicine: a methodological review. Simul Healthc. 2013;8:253–261. doi: 10.1097/SIH.0b013e31828715b1.
    1. Wakasugi M, Okudera H. Simulation Medicine and Education. In: Okamoto K, Yokota H, editors. The Review of Emergency and Intensive Care Medicine. Tokyo: Sougou Igakusya ; 2014.
    1. WHO. A global brief on hypertension - silent killer, global public health crisis Geneva 2013 [cited 15 July 2018]; Available from: .
    1. WHO. Community-based efforts to reduce blood pressure and stroke in Japan Geneva 2013 [cited 15 July 2018]; Available from: .
    1. Gazibara T, Rancic B, Maric G, Radovanovic S, Kisic-Tepavcevic D, Pekmezovic T. Medical students, do you know how to measure blood pressure correctly? Blood Press Monit. 2015;20:27–31. doi: 10.1097/MBP.0000000000000085.
    1. Gordon CJ, Frotjold A, Fethney J, Green J, Hardy J, Maw M, Buckley T. The effectiveness of simulation-based blood pressure training in preregistration nursing students. Simul Healthc. 2013;8:335–340. doi: 10.1097/SIH.0b013e3182a15fa7.
    1. Lee JJ, Sobieraj DM, Kuti EL. Student measurement of blood pressure using a simulator arm compared with a live subject's arm. Am J Pharm Educ. 2010;74
    1. Harden RM, Gleeson FA. Assessment of clinical competence using an objective structured clinical examination (OSCE). Med Educ. 1979;13:41–54. doi: 10.1111/medu.12801.
    1. González-López JJ, Gómez-Arnau Ramírez J, Torremocha García R, Albelda Esteban S, Alió del Barrio J, Rodríguez-Artalejo F. Knowledge of correct blood pressure measurement procedures among medical and nursing students. Rev Esp Cardiol. 2009;62:568–571.
    1. Leung GKK, Nicholls JM. Effect of clinical context on simulator-based assessment of blood pressure taking - A pilot randomized study. Medical Teacher. 2014;36:177–179. doi: 10.3109/0142159X.2013.849328.
    1. Yamazaki Y, Uka T, Shimizu H, Miyahira A, Sakai T, Marui E. Characteristics of physicians engaged in basic science: a questionnaire survey of physicians in basic science departments of a medical school in Japan. Tohoku J Exp Med. 2012;228:75–82.
    1. Bottenberg MM, Bryant GA, Haack SL, North AM. Assessing Pharmacy Students' ability to accurately measure blood pressure using a blood pressure simulator arm. Am J Pharm Educ. 2013;77:98. doi: 10.5688/ajpe77598.
    1. Thabane L, Mbuagbaw L, Zhang S, Samaan Z, Marcucci M, Ye C, Thabane M, Giangregorio L, Dennis B, Kosa D, Borg Debono V, Dillenburg R, Fruci V, Bawor M, Lee J, Wells G, Goldsmith CH. A tutorial on sensitivity analyses in clinical trials: the what, why, when and how. BMC Med Res Methodol. 2013;13:92. doi: 10.1186/1471-2288-13-92.
    1. Ip EJ, Nguyen K, Shah BM, Doroudgar S, Bidwal MK. Motivations and predictors of cheating in pharmacy school. Am J Pharm Educ. 2016;80:133. doi: 10.5688/ajpe808133.
    1. Muhney KA, Gutmann ME, Schneiderman E, DeWald JP, McCann A, Campbell PR. The prevalence of academic dishonesty in Texas dental hygiene programs. J Dent Educ. 2008;72:1247–1260.
    1. Sun RC, Shek DT. Student classroom misbehavior: an exploratory study based on teachers' perceptions. ScientificWorldJournal. 2012;2012:208907. doi: 10.1100/2012/208907.
    1. . Past weather in Tokyo, Japan - September 2017 [cited 15 July 2018]; Available from: .
    1. Li Ka Shing Faculty of Medicine, The University of Hong Kong. Under-graduates studies Hong Kong 2018 [cited 15 July 2018]; Available from: .
    1. Tadros GM, Oren JW, Costello JM. Syncope in young patients I: an approach to the patient with syncope. Hospital Physicians. 2002:47-54.
    1. Kim JW, Lee JH, Lee KR, Hong DY, Baek KJ, Park SO. Improvement in Trainees' Attitude and Resuscitation Quality With Repeated Cardiopulmonary Resuscitation Training: Cross-Sectional Simulation Study. Simul Healthc. 2016;11:250–256. doi: 10.1097/SIH.0000000000000151.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj