title: Staging the use of teaching aids in the development of manipulation skill.
abstract: Skill development in manual therapies is influenced by a number of factors. The effects of the training program organization, mentor coaching, feedback in various forms, and electromechanical training aids are factors that have been studied. A significant gap exists in understanding when teaching aids might be most effective within a defined curriculum structure. This project used the ratio of instructional theory and laboratory practice to define the learning context. An electromechanical training aid (Dynadjust™) was introduced at different stages (year 2 and year 4) of training for high-velocity, low-amplitude (HVLA) manipulation. Learners were assigned to either the Aid group or the NoAid group. Independent assessment of skill was evaluated before and after 6 weeks by means of recording force-time profiles of HVLA performance. Repeated measures analysis of variance (ANOVA) evaluated change scores in the force amplitude and rate of rise in force. Program features were dominated by a low ratio of laboratory practice to didactic foundational education components. Use of the aid was not associated with any measurable gains for participants when used in year 2. Later participation in year 4 suggested enhanced development in rate of rise for force (p < 0.0597) and for peak force (p < 0.0303). Careful attention should be given to the sequencing of content and laboratory work in designing curricula for training programs. For programs using lower ratios of laboratory contact hours, teaching aids to augment practice may result in better performance gains when introduced later than if added early in the curriculum.
authors: Graduate Education and Research Program, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H J1. Electronic address: jtriano@cmcc.ca.
authors: John J
authors: JJ
authors: Triano
authors: Graduate Education and Research Program, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H J1.
authors: Marion
authors: M
authors: McGregor
authors: Graduate Education and Research Program, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H J1.
authors: Maricelle
authors: M
authors: Dinulos
authors: Biomechanics and Elastography Laboratory, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario, Canada M2H J1.
authors: Steven
authors: S
authors: Tran
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002684:Chiropractic / Q000193:education* / Q000458:organization & administration; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations / Q000193:education / Q000379:methods*; D009864:Ontario; D015397:Program Evaluation; D013664:Teaching Materials
keywords: Feedback; Manipulation therapy; Skill; Training techniques