PTOTCohortArchives of physical medicine and rehabilitation2022

Efficacy of a Remote Train-the-Trainer Model for Wheelchair Skills Training Administered by Clinicians: A Cohort Study With Pre- vs Posttraining Comparisons.

Lynn A Worobey, R Lee Kirby, Rachel E Cowan and 5 others

PMID 34090853

WHAT IT FOUND

Remote train-the-trainer methods significantly improved clinician confidence in assessing and teaching wheelchair skills.

Trainees who received in-person coaching from these newly trained clinicians showed significant gains in both wheelchair skill capacity and confidence, demonstrating that this model effectively transmits clinical teaching skills.

Key findings

01Trainers showed significant improvements in self-efficacy for assessing and training wheelchair skills after remote training, but no significant change in spotting skills.

02Trainees demonstrated significant increases in wheelchair skills test questionnaire capacity and confidence scores following in-person training from the remote-trained trainers.

03The majority of trainers and trainees rated the remote and in-person training components as useful, relevant, tolerable, understandable, and enjoyable.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study used a cohort design with pre- and post-training comparisons rather than a randomized controlled trial, limiting causal inference. Trainees were able-bodied and naïve to wheelchair skills, which may not reflect the learning curve or challenges of actual wheelchair users. The sample was small, primarily young, white, and female, limiting generalizability to more diverse clinician populations. There was ambiguity in how participants interpreted the 'ascends high curb' item on the WST-Q, potentially affecting the accuracy of reported capacity and confidence for that skill. No delayed follow-up was conducted to assess skill retention.

Declared interests

None to disclose.

The easy way to misread this

Do not interpret these results as evidence that remote training alone is sufficient for teaching wheelchair skills to patients. The model relies on trainers first mastering skills remotely and then delivering in-person coaching. Furthermore, the trainees were able-bodied novices, so the findings do not directly generalize to the complex needs of actual wheelchair users.

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