Background

Palpation is a fundamental and complex skill for manual practitioners, it is a very difficult task to teach and to learn. Trials suggest that training might increase the reliability of palpation in detection of bony landmarks, nevertheless the poor dependability of the examined tests suggests that teaching methods must be reviewed. Different training methodologies have been implemented to improve learning experience of manual therapists, but none of them were based on students' and teachers’ suggestions.

Objectives

This study aims to find an efficient training, tailored on students' needs, that improve students’ palpatory skills.

Design

Mixed-method study.

Methods

this study was divided in four phases, two quantitative and two qualitative. Pelvis asymmetries were evaluated by 112 students from the Accademia Italiana di Medicina Osteopatica osteopathic Institute using two bony landmarks: the greater trochanter (GT) and the posterior superior iliac spine. The volunteers had a hidden wedge of 2 cm under their heel using a randomization process. Nine students and three teachers were interviewed to explore their lived learning experiences. A tailored training of 1 h was implemented based on their suggestions. Students were then randomly divided into three training groups: tailored training, P.A.L.P.A.T.E. and no training. A second data collection was performed. Students were re-evaluated, asked to make another assessment on another volunteer. Two students and one teacher were then re-interviewed to assess if the tailored training met their expectations. A generalized linear model was used to analyze the data.

Results

76 students completed the trial. Generally, correct detections of higher landmarks increased from the first to the second data collection, except for 5th year students who decreased their performances. Tailored training achieved the best results with a correct detection of the great trochanter by 69% of students and for posterior superior iliac spine by 78% of students. The generalized linear model showed a strong association between correct detection of PSIS and training type (p-value = 0.009) and over time (p-value = 0.01) but no association with year of school (p-value = 0.434). No association between year of study (p-value = 0.228), training types (p-value = 0.267) and correct GT detection over time (p-value = 0.529) was found.

Conclusions

Tailored training was shown to be effective and useful in the improvement of students’ performance, especially for posterior superior iliac spine. Interest levels played an important role in correct detection.

中文翻译：

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根据学生和教师的需求量身定制的培训，以提高触诊技能：混合方法研究的定量部分

背景

触诊对于手工操作者来说是一项基本而复杂的技能，是一项非常难教和学的任务。试验表明，培训可能会提高触诊检测骨标志的可靠性，但所检查的测试的可靠性较差，表明必须审查教学方法。为了改善手法治疗师的学习体验，已经实施了不同的培训方法，但没有一种方法是基于学生和教师的建议。

目标

本研究旨在找到一种根据学生需求量身定制的有效培训，以提高学生的触诊技能。

设计

混合方法研究。

方法

这项研究分为四个阶段，两个定量阶段和两个定性阶段。来自意大利医学学院骨科整骨研究所的 112 名学生使用两个骨标志：大转子(GT) 和髂后上棘对骨盆不对称进行了评估。通过随机化过程，志愿者的脚后跟下方隐藏了一个 2 厘米的楔子。九名学生和三名老师接受了采访，探讨他们的生活学习经历。根据他们的建议，实施了1小时的定制培训。然后，学生被随机分为三个训练组：定制训练组、PALPATE 组和无训练组。进行了第二次数据收集。学生们被重新评估，要求对另一名志愿者进行另一次评估。随后，两名学生和一名教师接受了重新采访，以评估量身定制的培训是否满足他们的期望。使用广义线性模型来分析数据。

结果

76名学生完成了试验。一般来说，从第一次到第二次数据收集，对更高地标的正确检测有所增加，但五年级学生的表现有所下降。定制训练取得了最佳效果，69% 的学生正确检测到大转子，78% 的学生正确检测到髂后上棘。广义线性模型显示 PSIS 的正确检测与训练类型 (p 值 = 0.009) 和随时间变化 (p 值 = 0.01) 之间存在很强的关联，但与学年没有关联 (p 值 = 0.434)。研究年份（p 值 = 0.228）、训练类型（p 值 = 0.267）和一段时间内正确的 GT 检测（p 值 = 0.529）之间没有发现关联。

结论

事实证明，量身定制的训练对于提高学生的表现是有效且有用的，特别是对于髂后上棘。兴趣水平在正确检测中发挥着重要作用。