ObjectiveThis investigation was performed to determine how students in a health sciences
program utilize and explain techniques within blood pressure measurement using
a novel assessment, and changes associated with greater curricular exposure. MethodsAn exploratory,
qualitative and quantitative study was conducted using a ‘Think Aloud’ design
with protocol analysis. Following familiarization, participants performed the
task of measuring blood pressure on a reference subject while stating their
thought processes. A trained practitioner recorded each participant’s
procedural proficiency using a standardized rubric. There were 112 participants
in the study with varying levels of curricular exposure to blood pressure
measurement.
ResultsFour
trends are noted. Specifically, a trend was observed wherein a marked increase
in procedural proficiency with a plateau occurred (e.g. released cuff pressure
2-4 mmHg, 10%, 60%, 83%, 82%). Secondly, a trend was observed with improvement
across groups (e.g. cuff placed snugly/smoothly on upper arm, 20%, 60%, 81%, and
91%). Other trends included a marked improvement with subsequent decrease, and
an improvement without achieving proficiency (e.g. palpation of the brachial
pulse, 5%, 90%, 81%, 68%, appropriate size cuff, 17%, 40%, 33%, 41%,
respectively). Qualitatively, transcript interpretation resulted in a need for
clarification in the way blood pressure procedure is instructed in the curriculum.
ConclusionsThe
current investigation provides a snapshot of proficiency in blood pressure
assessment across a curriculum and highlights considerations for best
instructional practices, including the use of Think Aloud. Consequently,
medical educators should use qualitative and quantitative assessments
concurrently to determine achievement of blood pressure skill proficiency.