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

Academic Article

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 post-training comparisons. SETTING: Four Spinal Cord Injury Model Systems Centers. PARTICIPANTS: Convenience sample of 7 clinician trainers and 19 able-bodied trainees. INTERVENTION: 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 four 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 (SEATS) 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=0.003) and training (p=0.002), but not spotting (p=0.056). Trainee 4-item median [IQR] WST-Q scores significantly increased with training for capacity (13% [6,31] to 88% [75,88], p < 0.001) and confidence (13% [0,31] to 88% [81,100], p < 0.001). CONCLUSIONS: Remote training improves trainers' confidence with respect to wheelchair-skills testing and training, and the wheelchair-skills capacity and confidence of their trainees.
  • Authors

    Keywords

  • Clinician, Motor skills, Rehabilitation, Wheelchairs
  • Digital Object Identifier (doi)

    Pubmed Id

  • 23758707
  • Author List

  • Worobey LA; Kirby RL; Cowan RE; Dyson-Hudson TA; Shea M; Heinemann AW; Pedersen JP; Boninger ML