NEXT meeting of the American Physical Therapy Association

Document Type

Conference Proceeding





The purpose of this study was to assess the effectiveness of interactive e-learning modules to supplement traditional instruction for range of motion (ROM) clinical skill acquisition in a doctor of physical therapy(DPT) curriculum.


Online resources have become highly favored to augment learning especially by millennials for convenience, self-paced content, and versatility in learning styles. It has been reported that elearning platforms are as effective as traditional face-to-face instruction, but may be best utilized as an adjunctive resource for teaching psychomotor skills. Student confidence has also been analyzed with reports of increased self-efficacy with use of online learning materials. There are deficiencies in the literature related to the use of e-learning and student outcomes. There are no studies investigating the use of online technologies to supplement ROM skill acquisition and an overall deficiency regarding interactive learning platforms in DPT curriculum. During the last two years at one institution, only about half of the class passed the ROM lab practical on the first attempt. Requests by students for a supplemental resource beyond the textbook as well as faculty searching for an option that would appeal to the millennial generation and address common errors lead to the development of interactive e-learning modules to fill in the gap. This study aims serve as a comprehensive evaluation of modules by analyzing pass rates, confidence, usage, and student satisfaction. We hypothesized the modules would be highly regarded, utilized by students, and result in increased lab practical pass rates.


52/53 first-year DPT students consented to participate.


This was prospective cohort study about supplemental modules created by a faculty-student team to be highly-engaging and media rich where the learner decides the pace and order of content delivered. Embedded quizzes provided immediate feedback for the learner to reflect on their understanding. Modules supplemented 4 labs with faculty demonstrations, peer practice and lab assistant feedback. Students were assessed by a high-stakes lab practical of ROM measurements on a standardized patient: upper extremity (UE), lower extremity(LE) and spine. At the beginning of the semester, students were randomly divided into 2 groups with 1 group receiving access to the UE modules and the other having access to the LE modules. To reduce the crossover effect between the groups and maintain the integrity of the study, students were educated on the importance of only viewing the modules they had access to and faculty were blinded to group assignment. Mid-way through the semester all students had the option to choose if they wanted access to the last set of modules focused on the spine. Students rated confidence on a 10-point Likert scale and self-reported module usage was confirmed by the learning management system. Student satisfaction was assessed by an end of semester course evaluation.


Chi-square tests were used to determine associations between groups for lab practical pass rates. Logistic regression was used to analyze differences between cohorts by year (α= 0.05).


Data was analyzed from 44/52 students. 8 students were excluded (6 for not using modules, 1 had previously taken the class, 1 viewed modules not of their assigned group). There were 34 females and 10 males with a mean age of 23 years (21-28), who reported race as Caucasian (n=41), Asian (n=2) and Hispanic (n=1). There were no significant differences between groups for gender, age or race. The average module usage per person was 2.4hours (10 min-7 hours). The average self-reported confidence for both groups combined increased from 4.3/10 to9.0/10 at the end of the semester. There was no significant difference between groups in the first time lab practical pass rate (p=0.30) and no significant differences in passing the UE (p=0.23) or LE (p=0.66) measurement. The first time lab practical pass rate for all students in 2015 was 71%. Without modules available, first time pass rates were 63% in 2013 and 47% in 2014.Individual year effects show a significant difference between 2015 and 2014 (p=0.02), but no difference for 2015 and2013 (p=0.40).All students requested access to the spine modules. Student satisfaction results of the modules: 78% reported appropriate interactivity, 80% wanted access beyond the semester, 76% said it helped them learn, and 85%recommended using them in the future.


The results support the use of interactive e-learning modules to supplement ROM clinical skill acquisition in a DPT curriculum. It appears that the interactive modules were well utilized by the students, increased confidence, and had a high rate of satisfaction as indicated by the course evaluation and students wanting access to the spine modules. Additionally, there were significant improvements in first time pass rates from the previous year when the modules were not available. Our results are congruent with previous studies that reported online technologies are best used to supplement traditional instruction. Limitations include a small sample size from a single institution and the inherent inaccuracies in students’ recall of self-reported data. Strengths include outcomes that went beyond student satisfaction. Furthermore, this interactive module served as a readily accessible resource and allowed students to study at their own pace and learning style. This platform for supplemental materials should be strongly considered for attainment of ROM psychomotor skills and could be valuable for instruction of other foundational clinical skills in physical therapy.


University of Nebraska Medical Center College of Allied Health Professions and the Office of the Vice Chancellor for Academic Affairs.