Training to measure ankle-brachial index at the undergraduate level: can it be successful?

We examined the effectiveness of teaching ankle-brachial index (ABI) measurement to medical students. ABI was estimated in 28 lower limbs by an experienced vascular surgeon. After a 2-week training course, 5 fourth-year students repeated the estimations and their results were compared with that of the trainer's. There was no difference in ABI values between trainees and trainer for subjects with mild-to-moderate peripheral arterial disease (PAD; 0.77 ± 0.22 vs 0.77 ± 0.19, respectively, P = .95). In the 4 normal limbs, ABI was 1.37 ± 0.12 and 1.16 ± 0.11, as measured by the trainer and the trainees, respectively (P < .00001). In subjects with severe PAD, trainees tended to overestimate ABI (P = .0002) in the beginning of the educational process, but this was no longer the case at a later stage of the training with no difference in ABI values between the 2 examiner groups (P = .09). In conclusion, training of medical students in ABI measurement can be helpful toward accurate estimation of PAD and merits further practice.