Simulation-Based Assessment of Blood Pressure by Certified Athletic Trainers

Authors

Michael W. Verde, University of South CarolinaFollow
Lindsey E. Eberman, Indiana State UniverstiyFollow
Dawn M. Emerson, University of South CarolinaFollow
Zoë J. Foster, University of South CarolinaFollow
Zachary K. Winkelmann, University of South CarolinaFollow

Abstract

Purpose: Blood pressure (BP) assessment is a key component of pre-participation examinations and can aid athletic trainers (ATs) in diagnosing hypertension. However, the current pedagogical technique, which involves practicing BP assessment on healthy individuals, may not adequately prepare healthcare providers to recognize Korotkoff sounds at abnormal pressures during clinical practice. Therefore, the purpose of this study was to examine AT's ability to and confidence in assessing and interpreting BP using a high-fidelity simulator.

Methods: We recruited ATs through conferences, in-services, and postprofessional athletic training programs. In total, 100 ATs from various job settings (age=31±11 years; men=37, women=63, clinical experience=8±10 years; self-identified hearing concerns=31; previous simulation experience=36) completed the cross-sectional study focused on descriptive quality assurance. First, participants verbally reported the professional guidelines they used in clinical practice to interpret findings. Second, ATs completed a practice trial BP assessment to familiarize themselves with the provided stethoscope, cuff, and high-fidelity manikin. Then, ATs completed 3 randomized BP assessment trials out of 11 pre-set BP cases. Participants reported the systolic and diastolic reading, interpretation (hypotension, hypertension, normal), and their confidence (0%=no confidence, 100%=complete confidence) in assessing the BP and the interpretation for that case. Assessment correctness scores were calculated by case, with each correct systolic or diastolic value within a ±5 mmHg range counting as 1 and each incorrect value as 0.

Results: Most participants (n=48) used the American Heart Association BP interpretation guidelines. Participants had a low overall assessment correctness score (42.67±20.88%) with only 50% of the systolic values (n=150; mean difference=-5.85±13.32) and 68.7% of the diastolic values (n=206; mean difference=-0.34±9.60) reported within ±5 mmHg. Participants were most accurate with Case 5 (normal) and least accurate with Case 2 (hypertensive). The participants correctly interpreted the BP by their reported guidelines in 56.3% of the trials (n=169). Despite the substandard performance, participants expressed high confidence in BP assessment (80±16%) and interpretation (87±16%).

Conclusions: We identified a confidence-to-practice gap using simulation-based assessment with ATs having low achievement in assessing and interpreting BP despite their high confidence levels.

Author Bio(s)

Michael W. Verde MS, LAT, ATC is an athletic trainer (Winthrop University) and recent graduate of the MS in Advanced Athletic Training program in the Department of Exercise Science at the University of South Carolina

Lindsey E. Eberman, PhD, LAT, ATC is a Profesor and Program Director in the Department of Applied Medicine and Rehabilitation at Indiana State University in Terre Haute, IN.

Dawn M. Emerson PhD, LAT, ATC is a Clinical Assistant Professor in the Department of Exercise Science at the University of South Carolina in Columbia, SC, USA.

Zoë J. Foster, MD, FAAFP is the Medical Director for the Department of Athletics at the University of South Carolina and Sports Medicine Fellowship Director in the Department of Family and Preventive Medicine at Prisma Health in Columbia, SC, USA.

Zachary K. Winkelmann, PhD, ATC, CHSE is a Clinical Assistant Professor and Director of Clinical Education for the Post-Professional Athletic Training Program at the University of South Carolina in Columbia, SC, USA.

Acknowledgements

This study was supported by a grant from the University of South Carolina Honors College. We want to acknowledge the research assistance provided by Nicholas Dell'Omo (University of South Carolina).

Recommended Citation

Verde MW, Eberman LE, Emerson DM, Foster ZJ, Winkelmann ZK. Simulation-Based Assessment of Blood Pressure by Certified Athletic Trainers. The Internet Journal of Allied Health Sciences and Practice. 2025 Apr 15;23(2), Article 24.