“Princess and the pea” – an assessment tool for palpation skills in postgraduate education
Abstract Background In osteopathic medicine, palpation is considered to be the key skill to be acquired during training. Whether palpation skills are adequately acquired during undergraduate or postgraduate training is difficult to assess. The aim of our study was to test a palpation assessment tool...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12909-019-1619-6 |
| _version_ | 1818420243461046272 |
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| author | Rainer Kamp Andreas Möltner Sigrid Harendza |
| author_facet | Rainer Kamp Andreas Möltner Sigrid Harendza |
| author_sort | Rainer Kamp |
| collection | DOAJ |
| description | Abstract Background In osteopathic medicine, palpation is considered to be the key skill to be acquired during training. Whether palpation skills are adequately acquired during undergraduate or postgraduate training is difficult to assess. The aim of our study was to test a palpation assessment tool developed for undergraduate medical education in a postgraduate medical education (PME) setting. Methods We modified and standardized an assessment tool, where a coin has to be palpated under different layers of copy paper. For every layer depth we randomized the hiding positions with a random generator. The task was to palpate the coin or to determine that no coin was hidden in the stack. We recruited three groups of participants: 22 physicians with no training in osteopathic medicine, 25 participants in a PME course of osteopathic techniques before and after a palpation training program, 31 physicians from an osteopathic expert group with at least 700 h of osteopathic skills training. These experts ran the test twice to check for test-retest-reliability. Inferential statistical analyzes were performed using generalized linear mixed models with the dichotomous variable “coin detected / not detected” as the dependent variable. Results We measured a test-retest reliability of the assessment tool as a whole with 56 stations in the expert group of 0.67 (p < 0.001). For different paper layers, we found good retest reliabilities up to 300 sheets. The control group detected a coin significantly better in a depth of 150 sheets (p = 0.01) than the pre-training group. The osteopathic training group showed significantly more correct coin localizations after the training in layer depths of 200 (p = 0.03) and 300 sheets (p = 0.05). This group also had significantly better palpation results than the expert group in the depth of 300 sheets (p = 0.001). When there was no coin hidden, the expert group showed significantly better results than the post-training group (p = 0.01). Conclusions Our tool can be used with reliable results to test palpation course achievements with 200 and 300 sheets of paper. Further refinements of this tool will be needed to use it in complex assessment designs for the evaluation of more sophisticated palpatory skills in postgraduate medical settings. |
| first_indexed | 2024-12-14T12:51:22Z |
| format | Article |
| id | doaj.art-b1fc9e89ca3f403595f4d577c53927c9 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-14T12:51:22Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-b1fc9e89ca3f403595f4d577c53927c92022-12-21T23:00:40ZengBMCBMC Medical Education1472-69202019-05-011911610.1186/s12909-019-1619-6“Princess and the pea” – an assessment tool for palpation skills in postgraduate educationRainer Kamp0Andreas Möltner1Sigrid Harendza2Academy of Medical Education of the Medical Council Westphalia-Lippe, Ärztekammer Westfalen-Lippe and Kassenärztliche Vereinigung Westfalen-LippeRuprecht-Karls-University, Center of Excellence for Assessment in Medicine – Baden WürttembergIII. Department of Internal Medicine, University Medical Center Hamburg-EppendorfAbstract Background In osteopathic medicine, palpation is considered to be the key skill to be acquired during training. Whether palpation skills are adequately acquired during undergraduate or postgraduate training is difficult to assess. The aim of our study was to test a palpation assessment tool developed for undergraduate medical education in a postgraduate medical education (PME) setting. Methods We modified and standardized an assessment tool, where a coin has to be palpated under different layers of copy paper. For every layer depth we randomized the hiding positions with a random generator. The task was to palpate the coin or to determine that no coin was hidden in the stack. We recruited three groups of participants: 22 physicians with no training in osteopathic medicine, 25 participants in a PME course of osteopathic techniques before and after a palpation training program, 31 physicians from an osteopathic expert group with at least 700 h of osteopathic skills training. These experts ran the test twice to check for test-retest-reliability. Inferential statistical analyzes were performed using generalized linear mixed models with the dichotomous variable “coin detected / not detected” as the dependent variable. Results We measured a test-retest reliability of the assessment tool as a whole with 56 stations in the expert group of 0.67 (p < 0.001). For different paper layers, we found good retest reliabilities up to 300 sheets. The control group detected a coin significantly better in a depth of 150 sheets (p = 0.01) than the pre-training group. The osteopathic training group showed significantly more correct coin localizations after the training in layer depths of 200 (p = 0.03) and 300 sheets (p = 0.05). This group also had significantly better palpation results than the expert group in the depth of 300 sheets (p = 0.001). When there was no coin hidden, the expert group showed significantly better results than the post-training group (p = 0.01). Conclusions Our tool can be used with reliable results to test palpation course achievements with 200 and 300 sheets of paper. Further refinements of this tool will be needed to use it in complex assessment designs for the evaluation of more sophisticated palpatory skills in postgraduate medical settings.http://link.springer.com/article/10.1186/s12909-019-1619-6AssessmentPalpation skillPhysical examinationPostgraduate medical educationOsteopathic medicineManual medicine |
| spellingShingle | Rainer Kamp Andreas Möltner Sigrid Harendza “Princess and the pea” – an assessment tool for palpation skills in postgraduate education BMC Medical Education Assessment Palpation skill Physical examination Postgraduate medical education Osteopathic medicine Manual medicine |
| title | “Princess and the pea” – an assessment tool for palpation skills in postgraduate education |
| title_full | “Princess and the pea” – an assessment tool for palpation skills in postgraduate education |
| title_fullStr | “Princess and the pea” – an assessment tool for palpation skills in postgraduate education |
| title_full_unstemmed | “Princess and the pea” – an assessment tool for palpation skills in postgraduate education |
| title_short | “Princess and the pea” – an assessment tool for palpation skills in postgraduate education |
| title_sort | princess and the pea an assessment tool for palpation skills in postgraduate education |
| topic | Assessment Palpation skill Physical examination Postgraduate medical education Osteopathic medicine Manual medicine |
| url | http://link.springer.com/article/10.1186/s12909-019-1619-6 |
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