Effect of Interactive Multimedia on Basic Clinical Psychomotor Skill Performance by Physical Therapist Students

Journal of Physical Therapy Education, Fall 2006 by Smith, A Russell Jr, Jones, Joyce, Cavanaugh, Catherine, Venn, John, Wilson, William

Background and Purpose. Physical therapist educators are challenged to provide quality instruction in psychomotor skills. Multimedia instruction may facilitate and enhance psychomotor skill acquisition and therefore is of significant interest to physical therapist educators. The purpose of this study was to examine the differences between physical therapist student cognitive and psychomotor performance on basic clinical skills when taught traditionally versus with interactive multimedia.

Subjects. Participants were recruited from 2 physical therapist programs. Twenty-four students volunteered to participate from Program 1 and 21 students volunteered from Program 2.

Methods. Students were randomly assigned to an instructional strategy: (1) an experimental group receiving an instructional CD of clinical orthopedic techniques for the knee and practice with instructor feedback, or (2) a control group receiving live demonstration of clinical orthopedic techniques for the knee and practice with instructor feedback. Instructional strategies were then switched for instruction of clinical skills for the ankle/foot.

Results. Written examination scores improved with both instructional strategies, demonstrating no differences observed between the strategies. No differences in practical examination knee scores were observed between instructional strategy groups. Practical examination ankle scores were significantly higher in participants receiving CD instruction than in participants receiving live presentation. Age and sex were found to have no effect on written or practical scores.

Discussion and Conclusion. This study supports the use of multimedia instruction as an effective strategy to instruct clinical skills related to the knee and ankle. A better understanding of the role of multimedia instruction in teaching psychomotor skills will aid physical therapist educators in improving the performance of clinical skills by future clinicians.

Key Words: Computer-assisted instruction, Psychomotor skills, Multimedia instruction.

INTRODUCTION

Physical therapist educators are challenged to provide quality instruction for the acquisition of psychomotor skills in concert with clinical reasoning skills. This challenge is particularly amplified in the presence of the increasing knowledge base within physical therapy and changing health care environment. Physical therapist educators are facing multifront challenges, including rising education costs, decreasing funding, and increasing student diversity in higher education.1 Today's health care educators are in critical need of effective, efficient, teaching methods that facilitate greater learning of psychomotor skills in diverse student populations. Lecture, textbooks, self-instruction, audiotutorials, and videos are traditional strategies used to teach psychomotor skills in health care.2,3,4,5,6,7

Multimedia instruction has been defined as the "seamless digital integration of text, graphics, animation, audio, still images, and motion video in a way that provides individual users with high levels of control and interaction."8(p51) Computer accessibility and technology have led to increased development and access to instructional multimedia including computer-based training, computerassisted instruction, computer-assisted learning, Web-based instruction, and Web-based training.9 Multimedia instruction has been applied as a component of classroom activities, in preclass preparation, or as a standalone learning experience.1,8,9 Proposed advantages of multimedia instruction over traditional instruction include increased availability of the instruction, repetition of the instruction, content presentation, and level of student control of the material.1,8,9

The purpose of this study was to compare physical therapist student cognitive and psychomotor performance related to basic clinical skills taught with interactive multimedia to those taught by traditional instructor presentation without interactive multimedia. Three research questions guided this study:

1. Does the performance on a written cognitive examination differ between students receiving traditional methods of instruction versus students receiving multimedia instruction?

2. Does the performance on a practical psychomotor examination differ between students receiving traditional methods of instruction versus students receiving multimedia instruction?

3. Do student characteristics, including sex and age, affect student cognitive and/or psychomotor performance?

Review of Literature

Multimedia use has predominantly been examined relative to cognitive skills.10,11 The effects of multimedia instruction on the learning of psychomotor skills have received less attention, primarily explored by the fields of nursing, athletic training, and physical education.2,10,12,13 Very few authors have investigated the role of multimedia instruction in physical therapy.2,14,15 Generally, equal performances have been observed in this body of literature investigating the differences in physical therapist students receiving traditional versus multimedia instruction. No significant differences in physical therapist students' written test scores were noted between groups receiving multimedia instruction or interactive lecture presentation of patients with carpal tunnel syndrome. However, greater efficiency was observed with the multimedia instruction group (mean, 82.6 minutes) completing the lesson 24% more quickly than the interactive lecture group (124.6 minutes).15 Campbell & Kohli14 investigated the effect of audio-tutorial instruction on written and psychomotor performance of upper extremity range of motion assessment skills in 40 undergraduate physical therapist students. Again, no differences in written or psychomotor performance were observed between the groups. But, participants in the multimedia group actually reported increased time demand when using the multimedia (11.16 hours as compared to 8.39 hours). The effectiveness of multimedia instruction on functional motor skill acquisition was investigated in undergraduate physical therapist student performing sliding board transfers.2 Results again indicated no difference in written test scores or psychomotor performance between videodisc and lecture groups.