Eight Critical Skill Sets Required for Manual Therapy Competency: A Delphi Study and Factor Analysis of Physical Therapy Educators of Manual Therapy

Erudition of clinical "skills" used by manually trained physical therapists involves the complex domain of cognitive, affective, and psychomotor concepts. The purpose of the study was to obtain consensus among manual therapy educators regarding stand-alone skills required during competent application of manual therapy and to distill these stand-alone skills into smaller but more homogeneous skill sets. Eighty manual therapy educators in entry-level and post-entry-level educational programs completed a three-round Delphi survey aimed at developing consensus among experts in the field regarding the stand-alone skills that are important to a learners' development of manual therapy competencies. From the Delphi outcomes, a principal component factor analysis distilled eight component skill sets that were associated with orthopedic manual therapy (OMT) proficiency: (1) manual joint assessment, (2) proficiency of fine sensorimotor characteristics, (3) manual patient management, (4) bilateral hand-eye coordination, (5) manual gross characteristics of the upper extremity, (6) manual gross characteristics of the lower extremity, (7) control of self and patient movement, and (8) discriminate touch. Manual joint assessment comprised 46% of the factor analysis variance and contained the majority of stand-alone descriptor statements from a Delphi survey. This study found that despite the disparate backgrounds among respondents, the eight skill sets were identified as important to OMT competency and application. By identifying the key skill sets required for OMT competency and application, OMT educators may more effectively identify teaching methods associated with improved educational outcomes.