title: The effectiveness of a mobile application for the development of palpation and ultrasound imaging skills to supplement the traditional learning of physiotherapy students.
abstract: BACKGROUND
  Mobile learning (m-learning) has becoming very popular in education due to the rapidly advancing technology in our society. The potentials of the mobile applications should be used to enhance the education process. Few mobile applications have been designed to complement the study of physical therapy skills for physiotherapy students. The aim of this study was to investigate whether a mobile application, as a supplement to traditional learning, is useful for physiotherapy students in the acquisition of palpation and ultrasound skills in the shoulder area.
  
  
  METHODS
  Forty-nine students participated in this single-blinded, randomized controlled study. They were randomly distributed into two groups: experimental, with free access to the mobile application; and control, with access to traditional learning materials on the topic. Objective structured clinical evaluation (OSCE) and multiple-choice questionnaire (MCQ) were used to assess the educational intervention. Then, we also assessed the time taken to get a reliable ultrasound image and to localize a specific shoulder structure by palpation.
  
  
  RESULTS
  There was no significant intergroup difference in the acquisition of theoretical knowledge (p = .089). Scores were significantly higher in the experimental group than in the control group for the majority items in the ultrasound assessment; positioning of patient (p < .001), positioning of ultrasound probe (p = 0.007), handling of ultrasound probe (p = .013) and global OSCE (p < .001) and skills in palpation of the shoulder; position of patient (p = .009), direction of palpation contact (p = .021) and global OSCE (p = .034). There were no significant differences in the time required to perform the examination between groups in ultrasound (p = .944) and palpation (p = .393). The results from the post-program survey assessing the global satisfaction with the mobile application were high (8.200 ± .767), on an 11 numeric point rating scale.
  
  
  CONCLUSIONS
  These results suggest the effectiveness of an m-learning program as a complement to traditional education for developing skills in ultrasound and palpation of the shoulder region in undergraduate physiotherapy students.
authors.affiliation: Physical Therapy Department, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada, Spain. carolinafl@ugr.es.|Physical Therapy Department, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración 60, 18071, Granada, Spain. carolinafl@ugr.es.
authors.forename: Carolina
authors.initials: C
authors.lastname: Fernández-Lao
authors.affiliation: Physical Therapy Department, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Cantarero-Villanueva
authors.affiliation: Physical Therapy Department, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Galiano-Castillo
authors.affiliation: Physical Therapy Department, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Caro-Morán
authors.affiliation: Nursing Department, Instituto Biosanitario Granada (IBS.Granada), University of Granada, Granada, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Díaz-Rodríguez
authors.affiliation: Physical Therapy Department, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, Granada, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Arroyo-Morales
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003194:Computer-Assisted Instruction; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods; D004521:Educational Measurement; D006801:Humans; D063731:Mobile Applications; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D010173:Palpation / Q000295:instrumentation; D010808:Physical Examination; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D026761:Physical Therapy Specialty / Q000193:education*; D013030:Spain; D014463:Ultrasonography / Q000295:instrumentation
keywords: M-learning; Physical therapy; Teaching/learning strategies