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Lo CN1, Choi YM1, Goff A1, Soon TC1, Abedlkader T1, Carpio GAC2, Krishnasamy S2, Lee TH1
1Singapore Institute of Technology, Cluster of Health and Social Sciences, Singapore, Singapore, 2Singapore Institute of Technology, Singapore, Singapore
Background: Education research shows that healthcare professional training can be made more efficient and effective with the integration of simulation technology, including the use of virtual reality. Despite the relevance of this technology in the training of medical students, evidence on the effectiveness of virtual reality simulation in manual therapy training is limited.
Purpose: To compare the effectiveness of two dimensional (2D) versus three dimensional (3D) graphics for the introduction of manual therapy skills to physiotherapy students, with a blended learning activity.
Methods: Using a randomised controlled trial design, first-year students enrolled in a 4 year bachelor with honours physiotherapy programme, participated in a 2-hour blended learning session. Three manual assessment techniques were presented namely cervical compression, distraction and flexion-rotation test. The techniques were presented through two sets of learning materials with either real-object rotatable three dimensional (3D) graphics created by Close-range Photogrammetry (intervention group) or traditional two dimensional (2D) graphics (control group) together with the same set of standardized text description and a 3-mins once-off demonstrating video. All students had basic knowledge and skills in musculoskeletal assessment but no prior knowledge of the techniques used in the study. After going through the material, all students were examined in a random sequence within 2 hours after the training using a standardized objective practical examination where both participants and assessors were blinded to group allocation. The practical examination required the participants to demonstrated the three techniques with three assessment criteria as 1. therapist's position and skills 2. patient's position and 3. overall management of the practical examination scored from 1 (poor) to 6 (excellent) each. The score of the practical examination as 3 skills x 3 items, with a maximum score of 54, was used as the primary outcome measure for analyses.
Results: A total of 77 students were included in the study (40 in the intervention group). There were no differences between groups in age, gender and academic grade scores. After the blended learning session, the intervention group students performed significantly better than the control group in practical examination scores. The mean score of the intervention group was 41.3 (SD=3.9) while that in the control group was 39.1 (SD= 4.5) (p = 0.02). Gender subgroup comparison shows that the difference was more significant in male students.
Conclusion(s): Real-object rotatable 3D graphics were found to be more effective than 2D graphics for the learning of the three cervical spine assessment skills in first-year physiotherapy students.
Implications: With the use of Close-range Photogrammetry, the production of real-object rotatable 3D images is becoming more convenient and economical. Given that they appear to be more effective at teaching and performance of manual skills than traditional 2D images, training institutes should explore the possibility of incorporating real-object 3D images more into the training materials for physical therapy students.
Keywords: Simulation, virtual reality, manual therapy
Funding acknowledgements: The experiment was unfunded.
Purpose: To compare the effectiveness of two dimensional (2D) versus three dimensional (3D) graphics for the introduction of manual therapy skills to physiotherapy students, with a blended learning activity.
Methods: Using a randomised controlled trial design, first-year students enrolled in a 4 year bachelor with honours physiotherapy programme, participated in a 2-hour blended learning session. Three manual assessment techniques were presented namely cervical compression, distraction and flexion-rotation test. The techniques were presented through two sets of learning materials with either real-object rotatable three dimensional (3D) graphics created by Close-range Photogrammetry (intervention group) or traditional two dimensional (2D) graphics (control group) together with the same set of standardized text description and a 3-mins once-off demonstrating video. All students had basic knowledge and skills in musculoskeletal assessment but no prior knowledge of the techniques used in the study. After going through the material, all students were examined in a random sequence within 2 hours after the training using a standardized objective practical examination where both participants and assessors were blinded to group allocation. The practical examination required the participants to demonstrated the three techniques with three assessment criteria as 1. therapist's position and skills 2. patient's position and 3. overall management of the practical examination scored from 1 (poor) to 6 (excellent) each. The score of the practical examination as 3 skills x 3 items, with a maximum score of 54, was used as the primary outcome measure for analyses.
Results: A total of 77 students were included in the study (40 in the intervention group). There were no differences between groups in age, gender and academic grade scores. After the blended learning session, the intervention group students performed significantly better than the control group in practical examination scores. The mean score of the intervention group was 41.3 (SD=3.9) while that in the control group was 39.1 (SD= 4.5) (p = 0.02). Gender subgroup comparison shows that the difference was more significant in male students.
Conclusion(s): Real-object rotatable 3D graphics were found to be more effective than 2D graphics for the learning of the three cervical spine assessment skills in first-year physiotherapy students.
Implications: With the use of Close-range Photogrammetry, the production of real-object rotatable 3D images is becoming more convenient and economical. Given that they appear to be more effective at teaching and performance of manual skills than traditional 2D images, training institutes should explore the possibility of incorporating real-object 3D images more into the training materials for physical therapy students.
Keywords: Simulation, virtual reality, manual therapy
Funding acknowledgements: The experiment was unfunded.
Topic: Education; Education: methods of teaching & learning
Ethics approval required: Yes
Institution: Singapore Institute of Technology
Ethics committee: Institutional Review Board
Ethics number: 2018006
All authors, affiliations and abstracts have been published as submitted.
