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Physician Assistant Student Assessment of Body Mass Index in Children Aged 3 to 5 Years Using Visual Cues

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Physician Assistant Student Assessment of Body Mass Index in Children Aged 3 to 5 Years Using Visual Cues
Gina M. Berg, PhD, Paul Casper, PA-S, Evan Ohlman, PA-S, Justin Schulte, PA-S, Sue Nyberg, PA-C, Ashley M. Hervey, Med and Carolyn R. Ahlers-Schmidt, PhD, Wesley Medical Center - University of Kansas School of Medicine, Wichita KS

Objective: Introduction: Clinicians are not consistently assessing BMI in pediatric patients; often underestimating by utilizing visual cues. This study aimed to determine physician assistant (PA) students' and recent PA program graduates' ability to accurately assess BMI in pediatric patients based upon visual cues.
Methods: PA students and recent graduates completed an online survey to categorize BMI-for-age by visually assessing pictures of children (ages three to five years). Three pictures were shown to respondents first with only visual cues and then with height and weight provided. Survey questions regarding attitudes, confidence levels regarding BMI assessment, and demographics were also included.
Results: Ninety-eight PA students and recent graduates completed the survey. Half (50%) of respondents reported training to use the BMI-for-age growth charts; 26.5% reported being confident to accurately predict BMI-for-age via visual cues. Under half (39.8%) reported experience working with pediatric patients. Child 1 (obese 3 year old boy): no respondents accurately categorized with visual assessment alone; 10% categorized accurately with height and weight. Child 2 (healthy weight 4 year old girl): 81.6% accurately categorized with visual assessment alone; 54% categorized accurately with height and weight. Child 3 (overweight 4 year old girl): 6% categorized accurately with visual assessment alone; 15% categorized accurately with height and weight. Conclusion: PA's visual assessment of BMI-for-age is unreliable; more often underestimated. Respondents changed categorization when height and weight were provided and demonstrated improvement except in Child 2. Clinicians should consistently utilize height and weight measurements to document BMI, basing clinical decisions on objective measurements.
Objective: Learners will be able to discuss the unreliability of visual assessment of BMI in children aged three to five years.Objective Content: 1. Clinicians are not consistently assessing body mass index (BMI) in pediatric patients. Instead, clinicians often utilize visual cues, but have a tendency to underestimate weight when relying solely upon visual cues 2. Overall, according to the findings of this study, visual cues were not an accurate assessment of a child's BMI. Objective measurements of height and weight should be utilized to evaluate BMI in pediatric patients.


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