Enhancing students' learning of palpatory skills: a focus on language

Although debates about the validity and reliability of palpation as an assessment tool continue, palpation remains one of the core assessment skill of osteopathic medicine. Teaching palpation to osteopathic students is a complex and challenging task which is compounded by the limitations of human communication. According to sociocultural learning theory, learning results from verbal interactions with others and verbal support from the learning context. Students learn best when they are given the opportunity to discuss their experiences with their peers and this also applies to learning palpation. The choice of terms used by teachers and learners of palpation is particularly important because of the need to adequately represent individual palpatory experiences. Inadequacy of palpatory language and/or expectations of shared interpretations for descriptors of palpatory findings may inhibit student learning of palpatory skills. This paper describes a pilot study which explored the role of language in teaching palpation. Searches were conducted in osteopathic, chiropractic, physiotherapy and medical literature to explore the language used to describe palpatory experiences in physical examination of musculoskeletal anatomy. Search results were compared with the language used to describe palpatory experiences in a class of fourth year osteopathic students. Findings of the study highlight the range of palpatory terms used by fourth year osteopathic students to describe the same palpatory phenomena and suggest the need for instructional strategies that develop students’ palpatory skills by encouraging verbal interactions among students and teachers about their personal experiences of palpation.