Physiotherapy Theory and Practice
An International Journal of Physical Therapy
ISSN: 0959-3985 (Print) 1532-5040 (Online) Journal homepage: https://www.tandfonline.com/loi/iptp20
Educational programs for learning to observe
movement quality in physical therapy: a design-
based research approach
Lieke M Dekkers, Ton Satink, Maria W Nijhuis-Van Der Sanden, Bert J De
Swart, Marjo J Maas & Anjo J Janssen
To cite this article: Lieke M Dekkers, Ton Satink, Maria W Nijhuis-Van Der Sanden, Bert J De
Swart, Marjo J Maas & Anjo J Janssen (2020): Educational programs for learning to observe
movement quality in physical therapy: a design-based research approach, Physiotherapy Theory
and Practice, DOI: 10.1080/09593985.2020.1712754
To link to this article: https://doi.org/10.1080/09593985.2020.1712754
© 2020 The Author(s). Published with
license by Taylor & Francis Group, LLC.
Published online: 16 Jan 2020.
Submit your article to this journal
Article views: 1138
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at
https://www.tandfonline.com/action/journalInformation?journalCode=iptp20
, PHYSIOTHERAPY THEORY AND PRACTICE
https://doi.org/10.1080/09593985.2020.1712754
Educational programs for learning to observe movement quality in physical
therapy: a design-based research approach
Lieke M Dekkers, PPT, MSc a,b,c, Ton Satink, PhD a, Maria W Nijhuis-Van Der Sanden, PPT, PhD b,c
,
Bert J De Swart, PhDa,b, Marjo J Maas, PT, PhD a,c, and Anjo J Janssen, PPT, PhD b
a
Department of Allied Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands; bRadboud Institute for Health Sciences,
Department of Rehabilitation, Pediatric Physical Therapy, Radboud University Medical Center, Nijmegen, Netherlands; cRadboud Institute for
Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
ABSTRACT ARTICLE HISTORY
Introduction: Movement observation is a core aspect in physical therapists’ diagnosis to deter- Received 17 June 2019
mine which interventions are adequate to improve functional abilities. The aim of this study was Revised 15 November 2019
to derive design principles for an educational program for the development of observational skills. Accepted 3 December 2019
Methods: We used a qualitative approach within a design-based research methodology. In four KEYWORDS
rounds, 8 physical therapy students, 16 teachers, and 9 practitioners participated in five Nominal Design-based research;
Group Technique meetings and six interviews. Meetings and interviews were transcribed verbatim qualitative research; physical
and analyzed using thematic analysis. therapy; professional
Results: We identified three themes, each with several design principles: (1) didactics; (2) profes- education; observational
sional content; and (3) conditions for optimal learning. We developed a proto-theory underpinned skills
with underlying educational theories.
Conclusions: To learn observational skills, students, facilitated by an experienced teacher, need to
take the lead in their own learning process. This might imply a need for additional training for
teachers. A realistic context is a precondition for learning; it might be necessary to increase possibi-
lities for observations in clinical contexts or to invest in training for (simulated) patients as participants
in education. Further research is needed to test the applicability of the design principles and a proto-
theory for other professionals with a focus on observation and analysis of movements.
Introduction and Morrison, 2002; Skjaerven, Kristoffersen, and Gard,
2008) physical therapists must rely on observational skills.
A core aspect of diagnosis in rehabilitation is the observa-
The observation process involves gathering, organizing,
tion of movements as a basis for interventions to improve
and giving meaning to visual, auditory, and sensory infor-
functional abilities (Skjaerven, Kristoffersen, and Gard,
mation obtained while observing the moving person
2008). During the assessment, a physical therapist
(Knudson and Morrison, 2002; Skjaerven, Kristoffersen,
observes the quantity and quality of movements. The
and Gard, 2008). Earlier studies (Janssen et al., 2012;
quantity of movements reflects the acquisition or re-
Skjaerven, Kristoffersen, and Gard, 2008) found that
acquisition of new or more complex motor skills
how physical therapists describe their observations is
(Schmidt and Wrisberg, 2008). The quality of movement
not standardized; it varies among therapists, depending
gives an impression of how movements are controlled
on the theoretical constructs used, which precludes com-
and coordinated (Magill and Anderson, 2014). In this
parability and longitudinal evaluation.
way, movement quality represents the interaction
Observation is a fundamental skill for physical therapists
between personal characteristics and experiences, the
(Skjaerven, Kristoffersen, and Gard, 2008). Curricula for
task difficulty, and the environmental conditions; and it
bachelor students in physical therapy address knowledge
gives insight into the possibilities and potential of the
and observational skills focused on the measurement and
person’s system for reacting or adapting to changing
interpretation of the quantity and quality of human move-
conditions (Skjaerven, Kristoffersen, and Gard, 2008).
ments. However, there is disagreement about the details of
For the assessment of movement quality which is impor-
what constitutes good clinical observation, its conceptual
tant for recognizing motor problems, designing and eval-
basis, and how it is learned or developed (Boudreau,
uating interventions, and predicting recovery (Knudson
CONTACT Lieke Dekkers, PPT, MSc Department of Allied Health Studies, HAN University of Applied Sciences, Kapittelweg 33,
Nijmegen 6525 EN, Netherlands
Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/iptp.
© 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-
nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built
upon in any way.
An International Journal of Physical Therapy
ISSN: 0959-3985 (Print) 1532-5040 (Online) Journal homepage: https://www.tandfonline.com/loi/iptp20
Educational programs for learning to observe
movement quality in physical therapy: a design-
based research approach
Lieke M Dekkers, Ton Satink, Maria W Nijhuis-Van Der Sanden, Bert J De
Swart, Marjo J Maas & Anjo J Janssen
To cite this article: Lieke M Dekkers, Ton Satink, Maria W Nijhuis-Van Der Sanden, Bert J De
Swart, Marjo J Maas & Anjo J Janssen (2020): Educational programs for learning to observe
movement quality in physical therapy: a design-based research approach, Physiotherapy Theory
and Practice, DOI: 10.1080/09593985.2020.1712754
To link to this article: https://doi.org/10.1080/09593985.2020.1712754
© 2020 The Author(s). Published with
license by Taylor & Francis Group, LLC.
Published online: 16 Jan 2020.
Submit your article to this journal
Article views: 1138
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at
https://www.tandfonline.com/action/journalInformation?journalCode=iptp20
, PHYSIOTHERAPY THEORY AND PRACTICE
https://doi.org/10.1080/09593985.2020.1712754
Educational programs for learning to observe movement quality in physical
therapy: a design-based research approach
Lieke M Dekkers, PPT, MSc a,b,c, Ton Satink, PhD a, Maria W Nijhuis-Van Der Sanden, PPT, PhD b,c
,
Bert J De Swart, PhDa,b, Marjo J Maas, PT, PhD a,c, and Anjo J Janssen, PPT, PhD b
a
Department of Allied Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands; bRadboud Institute for Health Sciences,
Department of Rehabilitation, Pediatric Physical Therapy, Radboud University Medical Center, Nijmegen, Netherlands; cRadboud Institute for
Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
ABSTRACT ARTICLE HISTORY
Introduction: Movement observation is a core aspect in physical therapists’ diagnosis to deter- Received 17 June 2019
mine which interventions are adequate to improve functional abilities. The aim of this study was Revised 15 November 2019
to derive design principles for an educational program for the development of observational skills. Accepted 3 December 2019
Methods: We used a qualitative approach within a design-based research methodology. In four KEYWORDS
rounds, 8 physical therapy students, 16 teachers, and 9 practitioners participated in five Nominal Design-based research;
Group Technique meetings and six interviews. Meetings and interviews were transcribed verbatim qualitative research; physical
and analyzed using thematic analysis. therapy; professional
Results: We identified three themes, each with several design principles: (1) didactics; (2) profes- education; observational
sional content; and (3) conditions for optimal learning. We developed a proto-theory underpinned skills
with underlying educational theories.
Conclusions: To learn observational skills, students, facilitated by an experienced teacher, need to
take the lead in their own learning process. This might imply a need for additional training for
teachers. A realistic context is a precondition for learning; it might be necessary to increase possibi-
lities for observations in clinical contexts or to invest in training for (simulated) patients as participants
in education. Further research is needed to test the applicability of the design principles and a proto-
theory for other professionals with a focus on observation and analysis of movements.
Introduction and Morrison, 2002; Skjaerven, Kristoffersen, and Gard,
2008) physical therapists must rely on observational skills.
A core aspect of diagnosis in rehabilitation is the observa-
The observation process involves gathering, organizing,
tion of movements as a basis for interventions to improve
and giving meaning to visual, auditory, and sensory infor-
functional abilities (Skjaerven, Kristoffersen, and Gard,
mation obtained while observing the moving person
2008). During the assessment, a physical therapist
(Knudson and Morrison, 2002; Skjaerven, Kristoffersen,
observes the quantity and quality of movements. The
and Gard, 2008). Earlier studies (Janssen et al., 2012;
quantity of movements reflects the acquisition or re-
Skjaerven, Kristoffersen, and Gard, 2008) found that
acquisition of new or more complex motor skills
how physical therapists describe their observations is
(Schmidt and Wrisberg, 2008). The quality of movement
not standardized; it varies among therapists, depending
gives an impression of how movements are controlled
on the theoretical constructs used, which precludes com-
and coordinated (Magill and Anderson, 2014). In this
parability and longitudinal evaluation.
way, movement quality represents the interaction
Observation is a fundamental skill for physical therapists
between personal characteristics and experiences, the
(Skjaerven, Kristoffersen, and Gard, 2008). Curricula for
task difficulty, and the environmental conditions; and it
bachelor students in physical therapy address knowledge
gives insight into the possibilities and potential of the
and observational skills focused on the measurement and
person’s system for reacting or adapting to changing
interpretation of the quantity and quality of human move-
conditions (Skjaerven, Kristoffersen, and Gard, 2008).
ments. However, there is disagreement about the details of
For the assessment of movement quality which is impor-
what constitutes good clinical observation, its conceptual
tant for recognizing motor problems, designing and eval-
basis, and how it is learned or developed (Boudreau,
uating interventions, and predicting recovery (Knudson
CONTACT Lieke Dekkers, PPT, MSc Department of Allied Health Studies, HAN University of Applied Sciences, Kapittelweg 33,
Nijmegen 6525 EN, Netherlands
Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/iptp.
© 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-
nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built
upon in any way.
