Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial.
OBJECTIVE
To assess the use of peer-assisted learning (PAL) of complex manipulative motor skills with respect to gender in medical students.


METHODS
In 2007-2010, 292 students in their 3rd and 4th years of medical school were randomly assigned to two groups [Staff group (SG), PAL group (PG)] led by either staff tutors or student-teachers (ST). The students were taught bimanual practical and diagnostic skills (course education module of eight separate lessons) as well as a general introduction to the theory of spinal manipulative therapy. In addition to qualitative data collection (Likert scale), evaluation was performed using a multiple-choice questionnaire in addition to an objective structured clinical examination (OSCE).


RESULTS
Complex motor skills as well as palpatory diagnostic competencies could in fact be better taught through professionals than through ST (manipulative OSCE grades/diagnostic OSCE score; SG vs. PG; male: P = 0.017/P < 0.001, female: P < 0.001/P < 0.001). The registration of theoretical knowledge showed equal results in students taught by staff or ST. In both teaching groups (SG: n = 147, PG: n = 145), no significant differences were observed between male and female students in matters of manipulative skills or theoretical knowledge. Diagnostic competencies were better in females than in males in the staff group (P = 0.041) Overall, students were more satisfied with the environment provided by professional teachers than by ST, though male students regarded the PAL system more suspiciously than their female counterparts.


CONCLUSIONS
The peer-assisted learning system does not seem to be generally qualified to transfer such complex spatiotemporal demands as spinal manipulative procedures.
Department of Orthopedic and Trauma Surgery, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany. mknobe@ukaachen.de
Matthias
M
Knobe
Malte
M
Holschen
Saskia Catharina
SC
Mooij
Richard Martin
RM
Sellei
Ralf
R
Münker
Pia
P
Antony
Roman
R
Pfeifer
Wolf
W
Drescher
Hans-Christoph
HC
Pape
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008503:Medical Staff; D009048:Motor Skills; D010379:Peer Group; D011446:Prospective Studies; D012189:Retrospective Studies; D012737:Sex Factors; D013334:Students; D011795:Surveys and Questionnaires