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David Griswold 1 Article
Priorities in updating training paradigms in orthopedic manual therapy: an international Delphi study  
Damian Keter, David Griswold, Kenneth Learman, Chad Cook
J Educ Eval Health Prof. 2023;20:4.   Published online January 27, 2023
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AbstractAbstract PDFSupplementary Material
Orthopedic manual therapy (OMT) education demonstrates significant variability between philosophies and while literature has offered a more comprehensive understanding of the contextual, patient specific, and technique factors which interact to influence outcome, most OMT training paradigms continue to emphasize the mechanical basis for OMT application. The purpose of this study was to establish consensus on modifications & adaptions to training paradigms which need to occur within OMT education to align with current evidence.
A 3-round Delphi survey instrument designed to identify foundational knowledge to include and omit from OMT education was completed by 28 educators working within high level manual therapy education programs internationally. Round 1 consisted of open-ended questions to identify content in each area. Round 2 and Round 3 allowed participants to rank the themes identified in Round 1.
Consensus was reached on 25 content areas to include within OMT education, 1 content area to omit from OMT education, and 34 knowledge components which should be present in those providing OMT. Support was seen for education promoting understanding the complex psychological, neurophysiological, and biomechanical systems as they relate to both evaluation and treatment effect. While some concepts were more consistently supported there was significant variability in responses which is largely expected to be related to previous training.
The results of this study indicate manual therapy educators understanding of evidence-based practice as support for all 3 tiers of evidence were represented. The results of this study should guide OMT training program development and modification.


Citations to this article as recorded by  
  • A critical review of the role of manual therapy in the treatment of individuals with low back pain
    Jean-Pascal Grenier, Maria Rothmund
    Journal of Manual & Manipulative Therapy.2024; : 1.     CrossRef
  • Modernizing patient-centered manual therapy: Findings from a Delphi study on orthopaedic manual therapy application
    Damian Keter, David Griswold, Kenneth Learman, Chad Cook
    Musculoskeletal Science and Practice.2023; 65: 102777.     CrossRef

JEEHP : Journal of Educational Evaluation for Health Professions