At UC Davis, diversity drives better BP measurement training

Timothy M. Smith , Contributing News Writer

Being able to accurately measure blood pressure is a keystone in patient work-up, but medical education has long taken this skill for granted. Fortunately, health care’s renewed push for equity has brought this shortcoming to light and given medical schools new opportunities—and even new funding—to give training in this fundamental skill additional time and space in their curricula.

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A grant program put forward by the AMA Improving Health Outcomes unit is funding projects at medical schools across the U.S. that expand and standardize blood pressure measurement training. The centerpiece of each is use of a new online training module developed by the AMA, “BP Measurement Essentials: Student Edition,” which is designed to support existing efforts within medical schools to ensure students are learning the latest evidence-based techniques.

One of those schools, the University of California (UC), Davis, School of Medicine, is using a train-the-trainer approach, wherein medical students who volunteer at the student-run clinics are trained using the blood-pressure measurement student module. They then train the undergraduate volunteers who take vital signs in one of the school’s student-run clinics that serves primarily monolingual Spanish-speaking patients.

“The area around UC Davis has one of the most diverse patient populations in the nation, and that diversity is reflected in our medical students, who have a lot of passion for serving the underserved,” said Alicia Gonzalez-Flores, MD, associate clinical professor in the Department of Internal Medicine. “We saw the need for more standardized training for medical students who volunteer at the student-run clinics, and we wanted to make sure they had the best training they could get.”

Here is why UC Davis used the student module to improve blood pressure measurement.

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UC Davis’ 11 student-run clinics were prime candidates for the project because they serve so many patients at risk of hypertension, and these patients are often either uninsured or underinsured. One of the sites, Clínica Tepati, a nearly 50-year-old student-run clinic in downtown Sacramento, primarily serves Latino patients who are known to experience greater inequities in hypertension control compared with patients from racial and ethnic groups.

Previously, medical students there were ill-equipped to measure blood pressure, as their training was only a5 blip in their curriculum.

“It was just one brief session in the beginning of the first year,” said Jennifer Chen, MD, assistant clinical professor in the Department of Internal Medicine. “Often, these students entered their second and third years without any reinforcement of that training, and by the time they began clinical rotations, they may never have had the opportunity to take blood pressures more than once or twice.”

In addition, training during the clinical years may not be done by physicians, Dr. Chen noted.

“Thus, the repeat training for blood pressure measurement may not be standardized,” she said. “Knowing that hypertension is associated with many co-morbidities, it is extremely important that medical students receive appropriate training so they can take accurate measurements, as these values are then used to guide patient treatment.”

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Ideally, student training should continue long-term, Dr. Chen said, noting that in the future it should also incorporate the AMA’s “BP Measurement Refresher: Student Edition."

“We know you have to keep practicing to get it right,” she said. “We hope that students will not only be able to take better measurements in clinic, but also teach patients how to accurately measure their blood pressure at home,” Dr. Chen added.

The modules, all of which are designated for AMA PRA Category 1 Credit™, are part of the AMA Ed Hub, an online platform with high-quality CME and education that supports the professional development needs of physicians and other health professionals. With topics relevant to you, it also offers an easy, streamlined way to find, take, track and report educational activities.

Learn more about AMA CME accreditation. Learn more about UC Davis’ experience adopting the student BP module July 27 at 2 p.m. CT in a special two-part webinar.