Acquisition of Procedural Skills in Preregistration Physiotherapy Education Comparing Mental Practice Against No Mental Practice: The Learning of Procedures in Physiotherapy Education Trial - A Development of Concept Study

Abstract

Introduction: Procedural skills are a central element in the education of physiotherapists. Procedural skills relate to the execution of a practical task. An educational intervention, which can be used to support skill acquisition of procedural skills, is mental practice (MP). Several studies have investigated the use of MP or imaging in medical education. This pilot study evaluated the application of MP on the acquisition of procedural skills in physiotherapy education.

Methods: This pilot randomised controlled study recruited a convenience sample of 37 BSc physiotherapy student participants. Two different complex task procedures (transfer and vestibular rehabilitation) were trained during this study. Participants in both the transfer (task procedure 1) and the vestibular rehabilitation (task procedure 2) arm of the study were randomly assigned to either MP or no MP.

Results: For the transfer task, median performance at post-acquisition testing showed a moderate effect size in favour of the group using MP (r: -0.3), but the findings were not statistically significant (P: 0.2). Similar results were found for the vestibular rehabilitation task (r: 0.29; P: 0.21). In addition, the self-reported confidence was higher in the MP group.

Conclusion: Moderate effect sizes were identified in favour of MP at post-acquisition testing. In addition, the between-group difference was higher than the minimally important difference. The feasibility of the study was high based on quantitative feasibility measures such as the recruitment rate. Both these findings suggest larger well-powered studies should be considered to confirm the findings of this pilot study.

Keywords: Learning [F02.463.425]; mental practice; motor skills [F02.808.260]; psychomotor performance [F02.808]; public health professional education [I02.358.556].

Figure 1.

Study flow – task procedures 1 and 2 of the LEArN trial. LEArN indicates Learning of Procedures in Physiotherapy Education.

Figure 2.

APSPT 29 – comparison of MP (1A) versus nMP (1B) task procedure 1. Individual participant data are presented as dots. Density curves are plotted in blue (MP) or red (nMP). APSPT indicates Assessment for Procedural Skills in Physiotherapy Education with 29 items; MP, mental practice; nMP, no mental practice; T1, post-acquisition test; T2, retention test.

Figure 3.

Self-reported confidence – comparison of MP (2A) versus nMP (2B) task procedure 2. Individual participant data are presented as dots. Density curves are plotted in blue (MP) or red (nMP). MP indicates mental practice; nMP, no mental practice; T1, post-acquisition test; T2, retention test.

Appendix 1

Overview MP script for task procedure 1. MP indicates mental practice. The transfer procedure (task procedure 1) was appraised as having 1 preparation phase (PRE) and 11 procedure parts. For each procedure part, cognitive (blue), collaborative (red), and kinaesthetic cues (green) are presented. A specific example is given for procedure part 5. The task for this procedure part was ‘the patient is asked to sit on one side’. The cognitive cue was ‘Make the decision to go over the weaker or the stronger side’. A kinaesthetic cue for this procedure part was ‘The patient slowly slides over your legs to the floor’. The MP script for task procedure 2 was designed using the same structure.