Journal of Educational Evaluation for Health Professions

Research article

Priorities in updating training paradigms in orthopedic manual therapy: an international Delphi study: Damian Keter, David Griswold, Kenneth Learman, Chad Cook; J Educ Eval Health Prof. 2023;20:4. Published online January 27, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.4

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Purpose
Orthopedic manual therapy (OMT) education demonstrates significant variability between philosophies and while literature has offered a more comprehensive understanding of the contextual, patient specific, and technique factors which interact to influence outcome, most OMT training paradigms continue to emphasize the mechanical basis for OMT application. The purpose of this study was to establish consensus on modifications & adaptions to training paradigms which need to occur within OMT education to align with current evidence.
Methods
A 3-round Delphi survey instrument designed to identify foundational knowledge to include and omit from OMT education was completed by 28 educators working within high level manual therapy education programs internationally. Round 1 consisted of open-ended questions to identify content in each area. Round 2 and Round 3 allowed participants to rank the themes identified in Round 1.
Results
Consensus was reached on 25 content areas to include within OMT education, 1 content area to omit from OMT education, and 34 knowledge components which should be present in those providing OMT. Support was seen for education promoting understanding the complex psychological, neurophysiological, and biomechanical systems as they relate to both evaluation and treatment effect. While some concepts were more consistently supported there was significant variability in responses which is largely expected to be related to previous training.
Conclusion
The results of this study indicate manual therapy educators understanding of evidence-based practice as support for all 3 tiers of evidence were represented. The results of this study should guide OMT training program development and modification.

Citations

Citations to this article as recorded by

Mechanismen der spinalen hypomobilen Dysfunktion
Chad Cook, Giacomo Rossettini, William R. Reed, Damian Keter
MSK – Muskuloskelettale Physiotherapie.2026; 30(01): 9. CrossRef
Beyond “YouTube clips”: a qualitative study of manual therapy educators’ perceptions of 3D technology in MT education
Kesava Kovanur Sampath, Cindy McIntyre, Ashokan Arumugam, Oliver P Thomson, Patrea Andersen
Journal of Manual & Manipulative Therapy.2026; : 1. CrossRef
Developing consensus on competency-based educational standards in orthopaedic manual physical therapy fellowship training: findings from a modified Delphi: part 3: communication and education
Megan Donaldson, Ngozi Akotaobi, Jake Awruch, Jennifer Bent, Derek Clewley, Kyle Covington, Chad E. Cook, Nathan Hutting, William H. Kolb, Kenneth Learman, Paul Mintken, Mark Shepherd, Brett Windsor, Damian Keter
Journal of Manual & Manipulative Therapy.2026; : 1. CrossRef
Developing consensus on competency-based educational standards in orthopaedic manual physical therapy fellowship training: findings from a modified Delphi: part 1: clinical reasoning
Damian Keter, Jennifer Bent, Kyle Covington, Chad E. Cook, Paul Bliton, Amy McDevitt, Mark Shepherd, Jason Silvernail, Megan Donaldson
Journal of Manual & Manipulative Therapy.2026; : 1. CrossRef
Developing consensus on competency-based educational standards in orthopaedic manual physical therapy fellowship training: findings from a modified Delphi part 4: systems-based practice and patient management
Megan Donaldson, Jennifer Bent, Kyle Covington, Chad E. Cook, Ina Diener, Mareli Klopper, John Magel, Amy McDevitt, Bryan O’Halloran, Emilio Puentedura, Pierre Röscher, Chris Showalter, Moyo Tillery, Damian Keter
Journal of Manual & Manipulative Therapy.2026; : 1. CrossRef
The Effectiveness of Spinal Manipulative Therapy in Treating Spinal Pain Does Not Depend on the Application Procedures: A Systematic Review and Network Meta-analysis
Casper Nim, Sasha L. Aspinall, Chad E. Cook, Leticia A. Corrêa, Megan Donaldson, Aron S. Downie, Steen Harsted, Simone Hansen, Hazel J. Jenkins, David McNaughton, Luana Nyirö, Stephen M. Perle, Eric J. Roseen, James J. Young, Anika Young, Gong-He Zhao, Ja
Journal of Orthopaedic & Sports Physical Therapy.2025; 55(2): 109. CrossRef
The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews
Damian L. Keter, Joel E. Bialosky, Kevin Brochetti, Carol A. Courtney, Martha Funabashi, Steve Karas, Kenneth Learman, Chad E. Cook, Claudia Sommer
PLOS ONE.2025; 20(3): e0319586. CrossRef
Patient and physical therapist perspectives on spinal manipulative therapy for low back pain and associated clinical outcomes: protocol for a prospective, single-arm intervention study
Jason M Beneciuk, Joel Bialosky, Jill R Hayes, Katherine E Buzzanca-Fried, Robert Rowe, Sara Cristello, Trent Harrison, Ryan Vickers, Guogen Shan
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Delphi Studie zur Modernisierung der Ausbildung für Orthopädische Manuelle Therapie

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Musculoskeletal Science and Practice.2023; 65: 102777. CrossRef

Educational/Faculty training material

Online interprofessional education materials through a community learning program during the COVID 19 pandemic in Chile: Sandra Oyarzo Torres, Mónica Espinoza Barrios; J Educ Eval Health Prof. 2022;19:6. Published online March 24, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.6

8,182 View
305 Download
3 Web of Science
4 Crossref

Abstract PDF Supplementary Material

This article aims to share the online collaborative experience of interprofessional teamwork among healthcare undergraduate students based on community learning during the coronavirus disease 2019 (COVID-19) pandemic in Chile. This experience took place in 48 different communities in Chile from November 10, 2020 to January 12, 2021. It was a way of responding to the health education needs of the community when the entire Chilean population was in confinement. Students managed to adapt to the COVID-19 pandemic despite the challenges, including internet connectivity problems and the limited time available to do the work. The educational programs and videos shared in this article will be helpful for other interprofessional health educators to implement the same kind of program.

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Interdisciplinary Vocational Training for Resilient, Integrated, and Person-Centered Health Systems
Mónica Valenzuela, Osvaldo Artaza, Javier Santa Cruz, Marcelo Fagalde, Mónica Espinoza, Sandra Oyarzo, Erich V. De Paula, Rogelio Pizzi
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Educational/faculty development material

Interprofessional health education teacher training at the University of Chile: Mónica Espinoza Barrios, Sandra Oyarzo Torres; J Educ Eval Health Prof. 2021;18:30. Published online November 15, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.30

7,433 View
275 Download
8 Web of Science
12 Crossref

Abstract PDF Supplementary Material

The first interprofessional course that included students in the 8 undergraduate health programs at the Faculty of Medicine of the University of Chile was implemented in 2015. For the 700 students, 35 teachers were trained as facilitators. The use of several strategies to train facilitators in interprofessional health education, such as working in small groups, role-playing, case analysis, personal development workshops with experts’ participation, teamwork skills, feedback, videos, and reading articles, proved to be helpful. Facilitators highlighted the use of syllabi as a fundamental tool for teaching and coordination. This guide describes the experience of interprofessional health education teacher training from 2015 to 2019, highlighting the following lessons learned: the importance of support from university authorities, raising faculty awareness about interprofessional health education and collaborative practice, creating a teachers’ coordination team including representatives from all health programs, and ongoing monitoring and feedback from participants.

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Research article

Evaluation of student perceptions with 2 interprofessional assessment tools—the Collaborative Healthcare Interdisciplinary Relationship Planning instrument and the Interprofessional Attitudes Scale—following didactic and clinical learning experiences in the United States: Vincent Dennis, Melissa Craft, Dale Bratzler, Melody Yozzo, Denise Bender, Christi Barbee, Stephen Neely, Margaret Robinson; J Educ Eval Health Prof. 2019;16:35. Published online November 5, 2019; DOI: https://doi.org/10.3352/jeehp.2019.16.35

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246 Download
14 Web of Science
15 Crossref

Abstract PDF Supplementary Material

Purpose
This study investigated changes in students’ attitudes using 2 validated interprofessional survey instruments—the Collaborative Healthcare Interdisciplinary Relationship Planning (CHIRP) instrument and the Interprofessional Attitudes Scale (IPAS)—before and after didactic and clinical cohorts.
Methods
Students from 7 colleges/schools participated in didactic and clinical cohorts during the 2017–2018 year. Didactic cohorts experienced 2 interactive sessions 6 months apart, while clinical cohorts experienced 4 outpatient clinical sessions once monthly. For the baseline and post-cohort assessments, 865 students were randomly assigned to complete either the 14-item CHIRP or the 27-item IPAS. The Pittman test using permutations of linear ranks was used to determine differences in the score distribution between the baseline and post-cohort assessments. Pooled results were compared for the CHIRP total score and the IPAS total and subdomain scores. For each score, 3 comparisons were made simultaneously: overall baseline versus post-didactic cohort, overall baseline versus post-clinical cohort, and post-didactic cohort versus post-clinical cohort. Alpha was adjusted to 0.0167 to account for simultaneous comparisons.
Results
The baseline and post-cohort survey response rates were 62.4% and 65.9% for CHIRP and 58.7% and 58.1% for IPAS, respectively. The post-clinical cohort scores for the IPAS subdomain of teamwork, roles, and responsibilities were significantly higher than the baseline and post-didactic cohort scores. No differences were seen for the remaining IPAS subdomain scores or the CHIRP instrument total score.
Conclusion
The IPAS instrument may discern changes in student attitudes in the subdomain of teamwork, roles, and responsibilities following short-term clinical experiences involving diverse interprofessional team members.

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