| Physical therapy students beginning clinical internships often have difficulty in applying their classroom knowledge to making clinical judgments. Fifty physical therapy students were randomly assigned to one of two video training programs. The programs were organized to compare contiguous with spaced presentations of three treatment sessions for three patients with shoulder dysfunction. Students assessed range of motion (ROM), quality of motion, pain, and overall patient change, followed by feedback created from expert ratings. The contiguous program presented video clips showing all three sessions for the first patient, before presenting those for the second and third respectively. For each patient, similar tasks were blocked and presented sequentially, i.e., ROM 1-2-3, quality 1-2-3, and pain 1-2-3. The spaced program presented the session one clips for all patients, then session two and three respectively. Within each session, the ROM, quality and pain clips for one patient were each presented before those for the next patient.; A test of clinical judgment was developed to assess accuracy of judgments of ROM, quality, pain, and overall change displayed on videotapes of 14 patients with shoulder dysfunction, each patient observed on two occasions. This test was given to all 50 students before and after training.; Students showed significantly greater error than 22 advanced physical therapists on assessments of ROM, quality, and pain. Although error in assessing change was not significantly different, student ratings of change were significantly smaller than those for advanced physical therapists. Students rated pain significantly higher than advanced physical therapists on the pretest, and both groups significantly decreased their pain assessment error on the posttest. Posttest ROM error differed significantly between the two training groups, but only students in the spaced program reduced their errors for ROM assessment. The correlation of error in ROM with confidence in the rating did not improve for either group, but only the spaced group improved in their correlation of error in change ratings with confidence ratings. Overall, both videotaped programs were effective in teaching students how to assess pain, but the spaced program was more effective than the contiguous program in teaching them how to assess ROM. |
