title: Knowledge about ankle-brachial index procedure among residents: being experienced is beneficial but is not enough.
abstract: BACKGROUND
  Ankle-brachial index (ABI) at rest is the main clinical tool to diagnose the presence of lower extremity peripheral artery disease (PAD). The method for ABI procedure (i.e., measurement, calculation and interpretation) is standardised and guidelines were published in 2012. This study sought to: i) assess knowledge about the three major steps of the ABI procedure (i.e., measurement, calculation and interpretation) among residents from different medical schools, ii) compare the ABI knowledge of experienced residents (i.e., who have already performed ABI procedure more than 20 times) with the knowledge of inexperienced residents, and iii) describe the most common errors by residents.
  
  
  METHODS
  Residents from six medical schools were invited to complete a questionnaire about the ABI procedure.
  
  
  RESULTS
  Sixty-eight residents completed the questionnaire. None of them knew how to perform the entire ABI procedure. Overall, 22%, 13% and 41% of residents correctly answered questions about ABI measurement, ABI calculation and ABI interpretation, respectively. Score comparisons underlined the fact that experienced residents (n = 26) answered ABI measurement questions to a significantly better level and had a significantly higher total score than inexperienced residents (n = 42) (P = 0.0485 and P = 0.0332, respectively). Errors were similar for most of the residents.
  
  
  CONCLUSIONS
  Our study confirms that experienced residents have significantly better ABI procedure knowledge than inexperienced residents. However, none of them are able to perform the entire ABI procedure without any mistake with regard to current guidelines. It is important that training be given to residents in medical schools in order to improve their ABI procedure knowledge.
authors.affiliation: 1 Inserm, Centre d'Investigation Clinique 1414, Rennes, France.
authors.forename: Ségolène
authors.initials: S
authors.lastname: Chaudru
authors.affiliation: 2 Movement, Sport and Health Laboratory, University of Rennes 2, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: de Müllenheim
authors.affiliation: 1 Inserm, Centre d'Investigation Clinique 1414, Rennes, France.|2 Movement, Sport and Health Laboratory, University of Rennes 2, France.|3 Department of sport sciences and physical education, ENS Rennes, Campus de Ker Lann, Rennes, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Le Faucheur
authors.affiliation: 4 Cabinet d'Angiologie, University of Rennes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jaquinandi
authors.affiliation: 4 Cabinet d'Angiologie, University of Rennes, France.|5 Inserm U1099, Signal and Image Processing Laboratory, University of Rennes.
authors.forename: Adrien
authors.initials: A
authors.lastname: Kaladji
authors.affiliation: 1 Inserm, Centre d'Investigation Clinique 1414, Rennes, France.|4 Cabinet d'Angiologie, University of Rennes, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mahe
mesh_terms: D055109:Ankle Brachial Index; D002309:Cardiology / Q000193:education*; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000503:physiopathology; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires
keywords: Peripheral artery disease; competency; diagnosis; teaching; vascular medicine