Manual therapy education. Does e-learning have a place?

The practical, psychomotor skills integral to manual therapy require considerable development to ensure a practitioner is competent to practise safely. Traditionally, this has been learnt through a cycle of observed demonstration, practice and teacher feedback where the student's attempts are observed and commented upon, followed by a refinement of practice, of tasks designed with a gradual increase in complexity. This process is both effective and efficient for the learner. To enable autonomous professional clinical practise these skills must be embedded within a framework of assessment, diagnosis, clinical decision-making, evaluation and reflection. This ensures that an individual needs-based assessment package is prescribed and delivered effectively over a course of time (Holey and Cook, 2003). The resulting reflective practitioner (Schon, 1987) that is able to be self-critical and maintain competence over a working life. Experience has shown that learning the psychomotor skills and intellectual framework in an integrated way is the most effective. This has led to an assumption that e-learning, therefore, is an inappropriate learning and teaching strategy for manual therapy, but this paper argues that it has a place in supporting and enhancing the learning of the manipulative therapies.