Purposeful Error as a Diagnostic Tool to Assess Student Understanding and Determine Teaching Needs in the Neuromuscular Curriculum

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Abstract

Background and Purpose.

Entry-level physical therapist (PT) students tend to make common errors when learning critical examination skills. Instructors often provide feedback on these errors during laboratory activities to enhance learning and knowledge of performance. Purposeful error by the instructor may also be used as a learning tool and as a tool for instructors to understand areas of difficulty for students. The purpose of this case report is to describe the development, implementation, and outcomes of a neurologic examination demonstration and discussion that included purposeful error to assess student weaknesses. Instructor reflections and student feedback following the session were then used to inform teaching priority areas.

Case Description.

Upon reflecting on performance during practical examinations, common mistakes were being made. To address these issues early in Neuromuscular 2 (NM2), the second course in a 3-part series, a plan was developed to simulate an examination. The instructors served as the patient/PT team and simulated an examination in which some items were performed correctly and others incorrectly. Students observed and identified correct/incorrect components. Areas of confusion were discussed as each error was identified. The simulation served several purposes: (1) to act as a diagnostic test to understand areas in which students were struggling, (2) to allow clarification of points of confusion, and (3) to allow instructor reflection on student weaknesses to guide teaching.

Outcomes.

This simulation lab has been conducted for 3 years. Each year, the instructor reflected on the examination demonstration lab and used these reflections to modify teaching of difficult concepts throughout the course. Students were pleased with the demonstration activity and felt that it was beneficial. Throughout the course, the instructor felt that student decision making improved at the midterm practical examination and scores on the final practical examination steadily increased.

Discussion and Conclusion.

This demonstration laboratory activity led to changes within the neuromuscular courses that were successful in improving student performance. Through a process of identifying the problem, conducting the exam as a diagnostic test, assessing immediate outcomes, altering teaching, and assessing student outcomes, the instructor was able to address the initial concern about student difficulty with some aspects of the neurologic examination. In the process, the instructor also developed as a teacher through reflection and application of change.

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