title: Learning spinal manipulation: a comparison of two teaching models.
abstract: OBJECTIVE
  The goal of the present study was to quantify the high-velocity, low-amplitude spinal manipulation biomechanical parameters in two cohorts of students from different teaching institutions. The first cohort of students was taught chiropractic techniques in a patient-doctor positioning practice setting, while the second cohort of students was taught in a "complete practice" manipulation setting, thus performing spinal manipulation skills on fellow student colleagues. It was hypothesized that the students exposed to complete practice would perform the standardized spinal manipulation with better biomechanical parameters.
  
  
  METHODS
  Participants (n = 88) were students enrolled in two distinct chiropractic programs. Thoracic spine manipulation skills were assessed using an instrumented manikin, which allowed the measurement of applied force. Dependent variables included peak force, time to peak force, rate of force production, peak force variability, and global coordination.
  
  
  RESULTS
  The results revealed that students exposed to complete practice demonstrated lower time to peak force values, higher peak force, and a steeper rate of force production compared with students in the patient-doctor positioning scenario. A significant group by gender interaction was also noted for the time to peak force and rate of force production variables.
  
  
  CONCLUSIONS
  The results of the present study confirm the importance of chiropractic technique curriculum and perhaps gender in spinal manipulation skill learning. It also stresses the importance of integrating spinal manipulation skills practice early in training to maximize the number and the quality of significant learner-instructor interactions.
authors: Université du Québec à Trois-Rivières.
authors: Marie-Pierre
authors: MP
authors: Harvey
authors: Shari
authors: S
authors: Wynd
authors: Lance
authors: L
authors: Richardson
authors: Claude
authors: C
authors: Dugas
authors: Martin
authors: M
authors: Descarreaux