title: Palpatory diagnosis training on the virtual haptic back: performance improvement and user evaluations.
abstract: BACKGROUND
  Learning palpatory diagnosis is a challenge for many osteopathic medical students. The Virtual Haptic Back (VHB) is an aid in teaching and learning these skills. The device simulates the contours and surface compliances of the human back and allows these to be felt through haptic interfaces. Regions of abnormal tissue texture are simulated by altered surface compliance.
  
  
  OBJECTIVE
  To examine the effectiveness of the VHB in training osteopathic medical students in palpatory diagnosis and to determine students' subjective impressions of the potential value of the VHB in learning palpatory diagnosis.
  
  
  METHODS
  Twenty-one first-year osteopathic medical students at the Ohio University College of Osteopathic Medicine in Athens took performance tests on the VHB before and after a series of eight 15-minute practice sessions, which occurred during multiple 2-week sessions between September 2005 and January 2006. The tests and practice sessions measured student accuracy and speed in locating regions of abnormal compliance in the haptic back, which varied randomly among 12 sites in the thoracic region. After completing the practice sessions and performance tests, students filled out a questionnaire regarding their impressions of the potential value of the VHB as a learning aid.
  
  
  RESULTS
  Students collectively improved in accuracy and speed following the practice sessions compared with the initial performance test. Subjects improved from being able to detect only a 40% difference in compliance to being able to detect an 11% difference (P<.05). The greatest improvements occurred at the difficulty levels near the apparent detection limit of compliance differences. Survey responses indicated that students thought the VHB experience was helpful in developing their palpatory skills.
  
  
  CONCLUSIONS
  The VHB has potential as an effective aid to osteopathic medical students in learning palpatory diagnosis.
authors.affiliation: Interdisciplinary Institute for Neuromusculoskeletal Research, Ohio University, Irvine Hall, Athens, OH 45701-2979, USA. howell@ohio.edu
authors.forename: John N
authors.initials: JN
authors.lastname: Howell
authors.forename: Robert R
authors.initials: RR
authors.lastname: Conatser
authors.forename: Robert L
authors.initials: RL
authors.lastname: Williams
authors.forename: Janet M
authors.initials: JM
authors.lastname: Burns
authors.forename: David C
authors.initials: DC
authors.lastname: Eland
mesh_terms: D001415:Back; D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis; D010021:Osteopathic Medicine / Q000193:education*; D010173:Palpation / Q000379:methods*; D013664:Teaching Materials; D014584:User-Computer Interface