{"title":"Inter-rater Reliability of Pressure Pain Threshold Between Experienced and Novice Examiners: A Case Study of 2 Educational Approaches.","authors":"Abigail T Wilson, Carey E Rothschild","doi":"10.1097/JTE.0000000000000376","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Pressure Pain Threshold (PPT) is used to objectively assess pain in clinical settings and is a recommended part of physical therapist education. An individual who is experienced in administering PPT will frequently train a student on the technique; however, optimal educational approaches for this instruction have not yet been identified. Therefore, the purpose of this case report is to describe 2 educational approaches (unstructured lecture and structured feedback with clinical relevance) in training 2 separate cohorts of Doctor of Physical Therapy students in PPT. The primary outcome of interest was the inter-rater reliability of PPT between an experienced and novice examiner.</p><p><strong>Case description: </strong>Cohort 1 (n = 37) received a traditional lecture approach consisting of watching a prerecorded video online, an in-person lecture with demonstration of the technique, and time to practice. Cohort 2 (n = 34) received the prerecorded video online and lecture with demonstration; however, key additions included a clinical relevance discussion along with structured peer-to-peer and instructor-to-student feedback using a competency-based checklist. PPT was assessed by each student (novice examiner) and one instructor (experienced examiner). Inter-rater reliability of PPT between a novice and experienced examiner was evaluated.</p><p><strong>Outcomes: </strong>Inter-rater reliability improved from poor/moderate (intraclass correlation coefficient low back = 0.46 [0.16-0.68], quadriceps = 0.54 [0.26-0.73]) to good (low back = 0.84 [0.67-0.92], quadriceps = 0.90 [0.79-0.95]) after the addition of structured feedback.</p><p><strong>Discussion: </strong>Structured feedback from peers and instructors may be useful when learning PPT and improving inter-rater reliability, which has implications for training students within a laboratory or classroom. However, this case study would need to be replicated in an experimental design to examine the effects of varying types of feedback on learning outcomes.</p>","PeriodicalId":517432,"journal":{"name":"Journal, physical therapy education","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal, physical therapy education","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/JTE.0000000000000376","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background and purpose: Pressure Pain Threshold (PPT) is used to objectively assess pain in clinical settings and is a recommended part of physical therapist education. An individual who is experienced in administering PPT will frequently train a student on the technique; however, optimal educational approaches for this instruction have not yet been identified. Therefore, the purpose of this case report is to describe 2 educational approaches (unstructured lecture and structured feedback with clinical relevance) in training 2 separate cohorts of Doctor of Physical Therapy students in PPT. The primary outcome of interest was the inter-rater reliability of PPT between an experienced and novice examiner.
Case description: Cohort 1 (n = 37) received a traditional lecture approach consisting of watching a prerecorded video online, an in-person lecture with demonstration of the technique, and time to practice. Cohort 2 (n = 34) received the prerecorded video online and lecture with demonstration; however, key additions included a clinical relevance discussion along with structured peer-to-peer and instructor-to-student feedback using a competency-based checklist. PPT was assessed by each student (novice examiner) and one instructor (experienced examiner). Inter-rater reliability of PPT between a novice and experienced examiner was evaluated.
Outcomes: Inter-rater reliability improved from poor/moderate (intraclass correlation coefficient low back = 0.46 [0.16-0.68], quadriceps = 0.54 [0.26-0.73]) to good (low back = 0.84 [0.67-0.92], quadriceps = 0.90 [0.79-0.95]) after the addition of structured feedback.
Discussion: Structured feedback from peers and instructors may be useful when learning PPT and improving inter-rater reliability, which has implications for training students within a laboratory or classroom. However, this case study would need to be replicated in an experimental design to examine the effects of varying types of feedback on learning outcomes.
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