The Effect of Real Time Auditory Feedback during Palpation of a Simulated Lumbar Spine in the Education of Physical Therapy Students

Objectives: Health professionals recognize simulation training as a beneficial educational technology. Physical therapy programs are slow to embrace this technology as a high-impact teaching tool, leaving students to learn in a more traditional, subjective manner with minimal objective feedback. Simulation technologies used during student physical therapist (SPT) education have been limited to mobilization and palpation. When learning palpation skills, SPTs rely mainly upon subjective feedback from peers and instructors to verify correct skill performance. Simulation with real time auditory feedback (RAF) as a teaching device may eliminate this bias. We hypothesize that the utilization of real-time audio feedback (RAF) during simulated lumbar spine palpation will improve the speed and accuracy skills of SPTs.

Methods: This was a mixed design study. The effect of RAF on palpation speed and accuracy during use of a simulated lumbar spine was examined in 30 SPTs. All were randomly assigned to one of three groups: RAF/tactile feedback training, tactile feedback training, and a control without training. A mixed ANOVA was performed if any interaction effect existed within and among groups.

Results: No significant interaction effect was found for actual accuracy (p=0.90), self-perceived accuracy (p=0.30), or speed (p=0.46). Within group difference for actual accuracy was found significant with those training with RAF. (p=0.038) Accuracy for those training with RAF/tactile feedback was 55% higher than those who trained with tactile feedback alone.

Conclusion: In this study, SPTs improved their palpation accuracy using RAF and a lumbar spine palpation simulator. Those who received RAF during training outperformed their peers by 55% greater accuracy. These findings support the use of RAF and simulation technology in education to enhance palpation skill development for SPTs.