Impact of an educational intervention on ankle-brachial index performance among medical students and fidelity assessment at month-6

Loukman Omarjee (1, 2) , Céline Donnou (2, 3) , Ségolène Chaudru (1) , Clara Locher (1) , Eunice Paul (4) , Marie Charasson (4, 2) , Chadi Mauger (2) , Vincent Jaquinandi (1, 2) , Olivier Stivalet (1, 2, 3) , Guillaume Mahé (1, 2)

1 CIC - Centre d'Investigation Clinique [Rennes]
2 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
3 Département de médecine vasculaire [Centre Hospitalier de Saint-Malo]
4 Département de médecine vasculaire [Centre Hospitalier René Pleven]

Background - The resting ankle-brachial index (ABI) is a clinical test to diagnose peripheral artery disease. The Wyatt's score has been proposed to assess the students' performance on ABI measurement on a healthy volunteer (HV). No study has shown that this score is sensitive to different teaching methods. In this randomized controlled trial, we wanted to determine whether didactic learning alone or didactic learning combined with experiential learning improves proficiency in the ABI procedure assessed by the Wyatt's score. Methods - Medical students (n = 30) received a didactic learning, including (1) a presentation of the ABI guidelines and (2) a video demonstration. Each student was then randomized into 2 groups ("the no experiential learning group" and "the experiential learning group"). An initial evaluation was performed after the didactic learning and then the final evaluation at the end of the intervention. A student was considered to be proficient when he performed a correct ABI procedure on an HV. The correct procedure corresponds to the following: (1) correctly answered Wyatt's score and (2) a difference in the ABI measurement between a professor in vascular medicine and a student was ≤0.15. Results - No student was proficient at the initial evaluation. At the final evaluation, there was a significant difference between the number of proficient students for the Wyatt's score depending on their learning group [didactic alone (1/10) or didactic + experiential training (15/20)] and also for the ABI procedure [didactic alone (0/10) or didactic + experiential training (16/20)]. At 6 months, among the 12 students who passed the final evaluation, 4 students passed both the Wyatt's score and the ABI measurement. Conclusions - Our study demonstrates that the Wyatt's score was sensitive to an educational intervention and no improvement was found in the case of "no experiential learning." The Wyatt's score could be used to evaluate the student on ABI measurement after an educational intervention. Trial registration - A randomized controlled trial was conducted in the Vascular Medicine Department of Rennes University Hospital (France). This was approved by the ethics review board of our institution (no. 16.150).

Mots clés: medical students; peripheral artery disease; diagnosis; vascular medicine; teaching

Domaines: Cardiologie et système cardiovasculaire; Education

Loukman Omarjee, Céline Donnou, Ségolène Chaudru, Clara Locher, Eunice Paul, et al.. Impact of an educational intervention on ankle-brachial index performance among medical students and fidelity assessment at month-6. Annals of Vascular Surgery, 2019, 56, pp.246-253. ⟨10.1016/j.avsg.2018.07.044⟩. ⟨hal-01903061⟩