A model for teaching and learning spinal thrust manipulation and its effect on participant confidence in technique performance.

BACKGROUND: Despite emerging evidence to support the use of high velocity thrust manipulation in the management of lumbar spinal conditions, utilization of thrust manipulation among clinicians remains relatively low. One reason for the underutilization of these procedures may be related to disparity in training in the performance of these techniques at the professional and post professional levels. PURPOSE: To assess the effect of using a new model of active learning on participant confidence in the performance of spinal thrust manipulation and the implications for its use in the professional and post-professional training of physical therapists. METHODS: A cohort of 15 DPT students in their final semester of entry-level professional training participated in an active training session emphasizing a sequential partial task practice (SPTP) strategy in which participants engaged in partial task practice over several repetitions with different partners. Participants' level of confidence in the performance of these techniques was determined through comparison of pre- and post-training session surveys and a post-session open-ended interview. RESULTS: The increase in scores across all items of the individual pre- and post-session surveys suggests that this model was effective in changing overall participant perception regarding the effectiveness and safety of these techniques and in increasing student confidence in their performance. Interviews revealed that participants greatly preferred the SPTP strategy, which enhanced their confidence in technique performance. CONCLUSION: Results indicate that this new model of psychomotor training may be effective at improving confidence in the performance of spinal thrust manipulation and, subsequently, may be useful for encouraging the future use of these techniques in the care of individuals with impairments of the spine. Inasmuch, this method of instruction may be useful for training of physical therapists at both the professional and post-professional levels.

A case report of a student-led pro bono clinic: a proposed model for meeting student and community needs in a sustainable manner.

BACKGROUND AND PURPOSE: The Chester Community Physical Therapy Clinic (clinic) is a student-led pro bono clinic that provides physical therapy services to uninsured and underinsured community members. The purposes of this administrative case report are to describe the creation and implementation of a student-led pro bono clinic model designed to meet student and community needs and to consider its potential for sustainability. CASE DESCRIPTION: Students and faculty created an organizational model with a Student Board at the center of clinic leadership. A Faculty Board provides oversight to the Student Board. State-licensed faculty and alumni provide the direct supervision of the treating student physical therapists. Evaluation of our clinic model was performed using strategies for the creation of sustainable community engagement initiatives. OUTCOMES: This model of a student-led pro bono clinic has elements of all 8 steps to sustainable community engagement. The model of a student-led pro bono clinic is feasible and sustainable. DISCUSSION: A student-led pro bono clinic serving the physical therapy needs of the uninsured and underinsured residents in an urban community presents an innovative educational and leadership development opportunity for students and alumni as well as partnership opportunities with the community.

Students mentoring students in a service-learning clinical supervision experience: an educational case report.

BACKGROUND AND PURPOSE: Service-learning projects present the opportunity to combine academic skill practice and peer mentorship with meaningful community service. Implicit learning outcomes include an enhanced understanding of social responsibility and professional development-concepts difficult to teach in the classroom. The purpose of this educational case report is to describe the development, application, and outcomes of a service-learning project designed to facilitate peer mentorship and the development of social responsibility. DEVELOPMENT OF THE PROCESS: Widener University mandated that all programs offer student community service opportunities on Martin Luther King Day. In response, the physical therapy program developed a plan to clean and screen assistive and mobility devices and provide blood pressure screening at designated community sites. APPLICATION OF THE PROCESS: All faculty and all members of the first-year and third-year Doctor of Physical Therapy (DPT) classes participated. The students and a faculty member traveled to designated community sites in teams. First-year students were able to practice newly acquired skills under the supervision and peer mentorship of third-year students. OUTCOMES: Outcomes of the service-learning project were assessed through a tally of services rendered, measurement of curricular goal achievement, a survey of the community partners' satisfaction with the event, and consideration of both first-year and third-year DPT student reflection papers. DISCUSSION: The service-learning project was effective in meeting a community need, enhancing community partner relationships, fostering student understandings of social responsibility, and creating a valuable peer mentorship experience.

Effect of ischemic pressure using a Backnobber II device on discomfort associated with myofascial trigger points.

OBJECTIVE: The purpose of this study was to assess the effectiveness of ischemic pressure on myofascial trigger point (MTrP) sensitivity. DESIGN: Randomized, controlled study with the researcher assessing MTrP sensitivity blinded to the intervention. PARTICIPANTS: Twenty-eight people with two MTrPs in the upper back musculature. INTERVENTION: The sensitivity of two MTrPs in the upper back was assessed with a JTECH algometer. One of the two MTrPs was randomly selected for treatment with a Backnobber II, while the other served as a control. OUTCOME MEASURES: Pre- and post-test pressure-pain thresholds of the MTrPs RESULTS: There was a significant difference between the pre- and post-test sensitivities of the treated and non-treated MTrPs (p=0.04). CONCLUSIONS: The results of this study confirm that the protocol of six repetitions of 30-s ischemic compression with the Backnobber II rendered every other day for a week was effective in reducing MTrP irritability.

A conceptual framework for international service-learning course planning: promoting a foundation for ethical practice in the physical therapy and occupational therapy professions.

As physical therapy (PT) and occupational therapy (OT) educational programs endeavor to foster core values of social responsibility, justice, and altruism in an increasingly global community, the incorporation of local and international service-learning (ISL) into the curriculum is growing. Much of the research has focused on the measurement of student learning, with little written about the impact on the host community. Proponents of global health initiatives are calling for consideration of all stakeholders to ensure ethical practice. This paper explores the current literature related to PT and OT ISL and builds a conceptual framework for ISL course planning. The essential phases in the framework include: 1) pre-experience planning/preparation stage, 2) field immersion experience stage, and 3) postexperience stage. The essential elements are: 1) cultural competency training, 2) communication and coordination with community, 3) comprehensive assessment, and 4) strategic planning. The authors suggest this framework as a practical tool to structure ISL courses with an explicit emphasis on ethical concerns. Additionally, they seek to foster more dialogue and action related to the promotion of ethical practices in ISL in PT and OT education programs.