Cory Manton is the assistant professor in the Doctor of Physical Therapy Program, and director in the Orthopedic Physical Therapy Residency Program at the Arizona School of Health Sciences at the A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206 (
Quincy Conley is the director of the Teaching & Learning Center at the A.T. Still University.
J Phys Ther Educ. 2024 Sep 1;38(3):212-220. doi: 10.1097/JTE.0000000000000321. Epub 2023 Nov 29.
Uncertainty exists regarding the best method for teaching thrust joint manipulation (TJM) to student physical therapists. The purpose of this study was to compare the effectiveness of Peyton's 4-step (P4) approach with the "see one, do one" (S1D1) approach for teaching students to perform a lumbar spine TJM task in an academic setting. Secondary objectives were to compare the effects of each instructional approach on students' attitudes and beliefs toward spinal TJM and on their motivation to learn to perform lumbar spine TJM.
The S1D1 approach is used in the health care professions for teaching clinical tasks to students. It is unclear whether the P4 approach may better prepare students to practice TJM.
Student physical therapists.
Using a factorial quasi-experimental design, an equal number of students were assigned to a P4 or S1D1 instruction group for the TJM task. Students' performance accuracy, time, and outcome performing TJM in an academic setting were measured. Paper surveys were used to collect data about students' attitudes and beliefs toward spinal TJM and their motivation to learn TJM. A generalized estimating equations approach was used for data analysis.
Fifty-eight students (29 per group) completed the study. There was an interaction between the instruction group and time on task performance accuracy favoring the P4 approach (P = .03). There was no interaction between the instruction group and task performance time, task performance outcome, attitudes and beliefs toward spinal TJM, or motivation to learn TJM (all P > .19).
The P4 approach more effectively improved student accuracy when performing the TJM task in an academic setting than the S1D1 approach. However, no differences between instruction were found for performance time or outcome. Students reported a favorable perception of learning lumbar spine TJM. These preliminary results suggest that instructors may use the P4 approach to improve students' TJM procedural knowledge before task practice. However, limitations of the study may affect the internal validity and generalizability of results.
在教授学生物理治疗师进行推力关节操作（TJM）时，哪种方法最佳尚不确定。本研究的目的是比较 Peyton 的 4 步（P4）方法与“见一，做一”（S1D1）方法在学术环境中教授学生进行腰椎 TJM 任务的效果。次要目标是比较每种教学方法对学生对脊柱 TJM 的态度和信念以及他们学习进行腰椎 TJM 的动机的影响。
S1D1 方法用于教授学生进行临床任务。尚不清楚 P4 方法是否可以更好地为学生进行 TJM 实践做准备。
学生物理治疗师。
使用析因准实验设计，将数量相等的学生分配到 TJM 任务的 P4 或 S1D1 教学组。在学术环境中测量学生进行 TJM 的表现准确性、时间和结果。使用纸质问卷收集有关学生对脊柱 TJM 的态度和信念以及学习 TJM 的动机的数据。使用广义估计方程方法进行数据分析。
58 名学生（每组 29 名）完成了研究。在任务表现准确性方面，教学组和时间之间存在交互作用，P4 方法更有利（P =.03）。在任务执行时间、任务执行结果、对脊柱 TJM 的态度和信念以及学习 TJM 的动机方面，教学组和任务之间均无交互作用（所有 P >.19）。
与 S1D1 方法相比，P4 方法在学术环境中更有效地提高了学生进行 TJM 任务的准确性。然而，在执行时间或结果方面，两种教学方法之间没有差异。学生报告说他们对学习腰椎 TJM 有很好的看法。这些初步结果表明，在进行任务实践之前，教师可以使用 P4 方法来提高学生的 TJM 程序性知识。然而，研究的局限性可能会影响结果的内部有效性和普遍性。
