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, Trevor A. Dyson-Hudson, Mary Shea, Allen W. Heinemann, Jessica Presperin Pedersen, Michael L. Boninger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective: To test the hypotheses that remote training improves trainer confidence and when these trainers train others the capacity and confidence of the trainees improves. Design: Cohort study with pre- vs posttraining comparisons. Setting: Four spinal cord injury model systems centers. Participants: Convenience sample of 7 clinician trainers and 19 able-bodied trainees (N=26). Interventions: Part 1 focused on trainer skill acquisition with self-study of the Wheelchair Skills Program Manual and instructional videos focused on motor learning, spotting, and 10 intermediate and advanced wheelchair skills. Trainers practiced in pairs, receiving asynchronous feedback on video recordings from a remote instructor. Part 2 included additional video modules targeted at “how to” assess and train others in 4 wheelchair skills: gets over obstacle, ascends low curb, ascends high curb with caregiver assistance, and performs stationary wheelie. Upon completion, the trainers each provided 1:1 in-person training for 2-3 trainees. Main Outcome Measures: Trainer confidence was assessed using the Self-Efficacy on Assessing, Training, and Spotting Test for Manual Wheelchairs. Trainee capacity (“Can you do it?”) and confidence (“How confident are you?”) were evaluated using the Wheelchair Skills Test Questionnaire (WST-Q). Results: Trainer confidence increased for assessment (P=.003) and training (P=.002) but not spotting (P=.056). Trainee 4-item median (interquartile range) WST-Q scores significantly increased with training for capacity (13% [6-31] to 88% [75-88], P<.001) and confidence (13% [0-31] to 88% [81-100], P<.001). Conclusions: Remote training improves trainers’ confidence with respect to wheelchair skills testing and training and the wheelchair skills capacity and confidence of their trainees.

Original languageEnglish (US)
Pages (from-to)798-806
Number of pages9
JournalArchives of physical medicine and rehabilitation
Volume103
Issue number4
DOIs
StatePublished - Apr 2022

Funding

We thank Joseph Ruffing for his work as videographer and the University of Pittsburgh Department of Rehabilitation Science and Technology, University of Pittsburgh Department of Rehabilitation Science and Technology Continuing Education (RST CE), and Human Engineering Research Laboratories for the use of equipment and facilities for the modules in part 2 of this training intervention. Supported by the Administration for Community Living (ACL) National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) (grant no. 90DP0025) and the National Institute of Child Health and Human Development (NICHD) (grant no. K23HD096134). Supported by the Administration for Community Living (ACL) National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) (grant no. 90DP0025) and the National Institute of Child Health and Human Development (NICHD) (grant no. K23HD096134).

Keywords

  • Clinician
  • Motor skills
  • Rehabilitation
  • Wheelchairs

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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