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Teaching Palpatory Force to Osteopathic Medical Students

Journal: The Journal of the American Osteopathic Association Date: 2007/08, 107(8):Pages: 364. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2007.107.8.327/html)

Keywords:

medical students [448]
osteopathic medicine [1631]
palpation [190]
pressure [118]
randomized controlled trial [766]
USA [1166]

Abstract:

Purpose: To determine the effect of providing palpatory pressure feedback training to 1st year osteopathic medical students (OMS 1) on their ability to subsequently and repeatedly replicates a given palpatory pressure. Methods: Twenty-one OMS 1 students were recruited and randomly assigned to control or experimental groups. Both groups palpated a standard subject over the T4 and L4 spinous processes after being told to “Palpate the area with enough pressure to spring the spinous process”. Each subject applied the pressure he/she thought appropriate 4 times rhythmically. Applied pressure was monitored by a Tekscan transducer placed over the spinous process. Experimental subjects were then trained by watching the pressure readout and instructed to apply 10N of force. They practiced this task until they felt able to replicate 10 N force (about 1-2 minutes), then were immediately retested. All subjects were retested each week for 4 weeks and neither group was allowed to see the pressure readout. The NSU IRB approved the study. Results: There was no difference in average pressure applied during the initial session between the 2 groups. Most students started with pressures of about 2 N or less, although 2 in the control and 2 in the experimental group began with T4 pressures of above 6N (4 Ss in Experimental Group for L4). Students in the control group who began above 6N dropped their pressures over the testing to 1N or less, while the others remained at about 1N. All students in the experimental group palpated at 5N or above and all but 2 palpated at pressures of 10N or above immediately after training. In subsequent sessions, most showed some decrease in palpatory pressures, but only 1 dropped to 1N or less. Comment: One session of feedback training resulted in an immediate but variable change in palpatory behavior. The students in the experimental group verbalized an excitement in having the feedback training to guide their palpatory ability. It is evident that more training is necessary to accurately reproduce a specified pressure, but that even a short training session may provide a long-lasting change in palpatory behavior for beginning students. Further studies are underway to quantify the training necessary for students to retain the ability to accurately replicate given palpatory pressures.


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