Skills and factors influencing the development of competencies in manual therapy: a Delphi investigation

A total of 80 manual therapy educators from both entry level and post-entry level educational settings participated in a web-based, three-round Delphi investigation that was designed to identify psychomotor skills/abilities and additional factors that are important for the development of manual therapy competencies. Round I of the Delphi instrument asked respondents to identify those psychomotor skills/abilities and additional factors that they deemed important to manual therapy competency development. A work group coded the Round I responses into descriptor categories under the Psychomotor Skills/Abilities and Additional Factors headings. Round II asked respondents to score each descriptor statement in terms of its importance for manual therapy competency development using the following scoring scale: Not at all important; Moderately unimportant; Moderately important; and Essential. Data from Round II were compiled and statistics were completed, establishing the percentage scores for each descriptor that represented the percentage of respondents that selected each score for each descriptor. Round III asked respondents to rescore each descriptor after observing a graph of it's previous score results. From Round III results, the investigator determined each descriptor's consensus status. Consensus was reached for a descriptor when 75 percent or greater of the respondents scored the skill or factor as "No" or "Yes", where "Not at all important" and "Moderately unimportant" constituted "No" and "Moderately important" and "Essential" scores constituted "Yes. A total of 96.5 percent of the descriptors under the Psychomotor Skills/Abilities heading reached consensus as being important for manual therapy competency development, whereas 3.5 percent reached near consensus as being important. A total of 83.3 percent of the descriptors under the Additional Factors heading reached consensus as being important for manual therapy competency development, whereas 8,3 percent reached near consensus as being important and 8.3 percent reached near consensus as being not important. Each descriptor was assigned a composite score and then ranked under the respective heading. "Examination" and "Adjusting to Patient Response" were ranked numbers one and two under the Psychomotor Skills/Abilities heading, whereas "Cognitive Processing" and "Adaptation" were ranked numbers one and two under the Additional Factors heading. Inferential statistical analyses demonstrated no significant differences between educational settings or between educational models. From these outcomes, one may surmise that educators from each setting and each model share similar perceptions regarding which psychomotor skills/abilities and additional factors are important to learners for manual therapy competency development.