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

BACKGROUND: The resting ankle-brachial index (ABI) is a clinical test to diagnose peripheral artery disease (PAD). 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 improve proficiency in the ABI procedure assessed by the Wyatt's score.

METHODS: Medical students (n = 30) received a didactic learning, including i) a presentation of the ABI guidelines and ii) a video demonstration. Each student, was then randomized into two 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 a HV. The correct procedure corresponds to: i) correctly answered Wyatt's score and ii) a difference of an ABI measurement between a professor in vascular medicine and a student ≤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 month-6, among the twelve students who passed the final evaluation, four 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 student on ABI measurement after an educational intervention.

TRIAL REGISTRATION: A randomized controlled trial (RCT) was conducted in the vascular medicine department of Rennes University Hospital (France). This was approved by the ethics review board of our institution (n° 16.150).