Advances in Health Sciences Education 4: 175–186, 1999. © 1999 Kluwer Academic Publishers. Printed in the Netherlands. 175 Pre-service Nurses’ Understanding of Blood Pressure and the use of the Sphygmomanometer C. E. GREIVE 1 , K. C. DE BERG 1 and D. F. TREAGUST 2 1 Avondale College, P.O. Box 19, Cooranbong, NSW, Australia. E-mail: kdeberg@avondale.edu.au; 2 Curtin University of Technology, P.O. Box 1987, Perth, Western Australia Abstract. Undergraduate nurses from the last four semesters of their course were interviewed about their understanding of the nature of pressure in relation to the use of some nursing devices, blood circulation and the measurement of pressure using a sphygmomanometer. The interview protocol was designed to be investigative during the first portion of the interview and to become instructive toward the latter portion of the interview. The study found that pre-service nurses significantly abbreviated the process of auscultatory blood pressure measurement as recommended in the nursing literature and that a number of them rounded-off manometer readings to the nearest ten millimetres of mercury. An analysis of interview transcripts revealed an array of differing concepts of pressure some of which impinged on the students’ understanding of arterial blood pressure and the function of the sphygmomanometer. Despite the fact that many of the respondents did not understand the fluctuating nature of arterial blood pressure and the relationship between cuff air pressure and blood pressure in a functioning sphygmomanometer, most recognized blood pressure readings that were above the normal range and a number spontaneously gave advice regarding the blood pressure that they found. The implications for nurse education are discussed. Key words: blood pressure, nurse education, nurses’ understanding of pressure, sphygmomanometer Introduction The concept of pressure is central to an understanding of fluid flow and the operation of devices such as syringes, siphons, drainage bottles, and sphygmo- manometers. However, fluid flow studies with first semester nurses (Greive and De Berg, 1994) who had already completed a semester’s study of physical science revealed fragmentary and contradictory concepts of pressure. Pressure was often associated only with moving air or the presence of a vacuum and although most students could recall that fluids flowed from high to low pressure, they consistently invoked suction in their explanations of fluid flow rather than the high to low pressure model. With respect to the specific case of blood pressure most studies have concentrated on student performance of blood pressure measurements rather than on an understanding of the nature of the pressure changes occurring during blood flow and its measurement.