Utilizing Technology to Improve the Quality of Compression Bandaging
Purpose/Hypothesis: Mastery of figure-8 compression wrapping is difficult for many students. Use of markings on the leg and bandage may enable students to more rapidly learn the technique. Number of Subjects: 20 Materials and Methods: Double-blinded, randomized control trial; two groups each of 10 entry-level students in a cardiovascular and pulmonary PT courses were randomly assigned to a control group and technology group. Five bandages were calibrated and marked such that rectangles would be transformed to squares at 50 mmHg pressure. Individual stockings were created for each of five models with markings to indicate the path for creating the figure-8 wrapping pattern. Five random students entered a closed room and were instructed either without (C) or with the technological assistance (T) and were instructed as both a group and individually in performing compression bandaging with a figure-8 technique for 30 minutes. Students did not know that they were being instructed differently. Every other group was taught with the other method in random order. After two groups were taught, five random students of the 10 performed wrapping without the technology and without the instructor present. After the students left the room, the quality of the wrapping was graded, thus blinding the instructor grading the quality. The remaining 5 students then performed the technique. This pattern continued until all 20 students were graded blindly. This scoring was not used as part of a course grade. Students were given future instruction in compression bandaging in a subsequent integumentary course. Results: Although the means of the scores of C and T groups were not different (p = .116), the distribution of scores was markedly different (p = .011). Chi-squared was used to distinguish the proportions of passing scores within the two groups. The C group had 8 passing and 2 failing scores and T had 4 passing and 6 failing scores. The calculated odds ratio showed that C students were 6.0 times more likely to achieve a passing score than T. Conclusions: Based on motor learning theory, a one-off teaching session was insufficient for many of the students in the T group to move from the cognitive stage to the associative stage and into the autonomic stage. Withdrawing the assistive technology for students still in the associative stage may be responsible for a greater proportion of failing scores for students in the T group. Clinical Relevance: Although use of technologic assistance may assist learning, a single session of assistance is counterproductive. A greater period of mentoring is necessary to produce quality compression bandaging results.