Assessment of blood pressure measurement skills in second-year medical students after ongoing simulation-based education and practice.

BACKGROUND: Simulation-Based Education (SBE) simulates specific physiological characteristics of a patient, allowing student practice in developing clinical skills and assessment of skill competency. Literature is limited regarding SBE's effectiveness in curriculum enrichment. This study investigated Blood Pressure (BP) measuring proficiency of second-year medical students with first-year SBE training and a second-year review, by comparing data from Simulation-Based assessments in 2017 and 2019. METHODS: Second-year medical students measured BP on three manikin arms, associated with distinct clinical contexts (healthy young male, young female experiencing hypotension, and older male suffering hypertension and diabetes). All manikins' BP settings were independent of clinical context. In January 2019, 108 second-year medical students who received traditional training, as well as SBE in 2017 and Simulation-Based practice in 2018, were divided into four groups (n = 32, 24, 24, and 28), with two groups each assessed on consecutive days. The proportions of correct BP values in each of three contexts were compared between experiments in 2017 and 2019. Additionally, systolic (SBP) and diastolic (DBP) blood pressure results were stratified into three groups: lower than setting value, correct, and higher than setting vgalue, with proportions for each group compared for the 2017 and 2019 studies using Fisher's Exact Tests. RESULTS: In Case Two and Three, the proportion of correct BP values significantly increased from 2017 (Case Two: 51%; Case Three: 55%) to 2019 (Case Two: 73%; Case Three: 75%). Additionally, proportions of students who reported lower SBP values than setting values were significantly decreased in Case One and Two, with five failing all contexts. CONCLUSIONS: Second-year student BP measurement skills were improved, not only due to repeated Simulation-Based practice but advancing basic science knowledge and mastery experience in ongoing curriculum. Simulation-Based assessment provided an effective tool for evaluating skill retention and proficiency in medical training.

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

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.