Knowledge Translation: Can high-fidelity human simulators (SIM Man 3G) be successfully used as a training tool for teaching spinal manipulation? An educatorÕs perspective.

Background & Purpose: The use of high-fidelity human simulators (HFHS) for knowledge translation of real-life situations is common practice in the field of nursing and medicine. In the physical therapy (PT) domain education using HFHS is still in its infancy. Literature supports using HFHS to prepare PT students for intensive care settings, cardiac distress scenarios and interprofessional educational opportunities. Although older research has examined the effectiveness of mechanical joint translation simulators there is a paucity of literature describing HFHS as a potential tool for teaching spinal manipulations. Description: The purpose of this pilot work was to determine the feasibility of using HFHS technology for classroom spinal manipulation education. Set up included: a typical nursing school simulated patient lab, one full body HFHS model (SIM Man 3G manufactured by Laerdal), wireless internet connection to the software, a registered nurse qualified as a certified human simulator educator (CHSE), a fellowship credentialed (FAAOMPT) PT educator and a video recording device. First phase of the pilot work included an educational session on how the HFHS interfaced with the software. Next a brief training period was completed to help the PT educator recognize artificial breaths from the mannequin (manipulations were timed with exhalation). Practice sessions monitoring clinician hand depth, hand release, application of thrusts and timing of thrust to breaths were then completed. Finally, a series of 3-4 high velocity low amplitude (HVLA) thrust spinal manipulations were performed on the mannequinÕs mid thoracic region in two different positions: HVLA posterior-anterior thrust manipulations (facet closing bias) in prone and HVLA anterior-posterior thrust manipulations (facet gapping bias) in a seated positions. Outcomes: Data demonstrated that compression depth during the thrust maneuvers could be effectively evaluated (in millimeters) and timing with breath exhalation could be checked for accuracy. A video recording of the event verified the information. Pitfalls included: non-flexible mannequin arms for the seated technique (thrust applied directly to sternum); fluctuations in thrust compression depth based on mannequin stomach distention and barriers related to using of a hospital bed versus mobilization table. Discussion: It appears feasible to utilize HFHS as a resource for developing PT student motor skills related to the application/timing of HVLA thrust spinal manipulations in a low risk environment. Further research studying the reliability of these methods and randomized studies using HFHS in a classroom setting should both be studied in detail. Further collaborative efforts with nursing students could enhance interprofessional learning.

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  • Control #: 2027023
  • Type: Platform
  • Event/Year: CSM2015
  • Authors: Mary Beth Geiser, Jennifer Delwiche, Brenda Jobe
  • Keywords: education|simulator|manipualtion

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