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April 2024

J Manipulative Physiol Ther. 1998 May; 21(4): 241-5.

A cervical manikin procedure for chiropractic skills development.

Young TJ, Hayek R, Philipson SA.

School of Biological Sciences, Macquarie University, Sydney, Australia.

OBJECTIVE: To determine whether chiropractic students can effectively acquire adjustive skills for the cervical spine by utilizing a Thrust in Motion Cervical (TMC) manikin and to evaluate its value as a teaching aid. A pilot study was formulated and incorporated into the skills tutorial program at Macquarie University. Centre for Chiropractic in Sydney, Australia. DESIGN AND SETTING: A prospective study was performed on chiropractic students with no prior experience in performing spinal adjustments. SUBJECTS: Twenty subjects were selected randomly from a population of 75 students about to commence their 4th-yr Master's of Chiropractic program. INTERVENTION: Students who formed the experimental group (n = 6) did not perform any thrusting maneuvers on human subjects while practicing Diversified chiropractic cervical spinal techniques. They practiced the adjustive thrust only on the TMC manikin. The control group (n = 14) learned in the established "hands-on" approach, performing thrusting maneuvers on fellow student subjects. Both groups were supervised, taught and examined in an otherwise identical fashion. RESULTS: The data indicate there is no significant difference between the examination scores of the student group that practiced on the TMC manikin (average, 2.17 points) compared with the controls (2.13 points), with a confidence interval at p = .985, assuming that 0.5 marks is clinically important in these examination results. Interexam reliability was acceptable (Pearson's r = .73) for both experimental and control examination performances. CONCLUSION: The null hypothesis is accepted, and no significant difference in student examination performance was found between those who learned thrusting on the manikin alone and those who learned on fellow students. Further, for the first time, a manikin has been shown to be effective in teaching chiropractic skills. The implications of the TMC manikin procedure will revolutionize the acquisition of motor learning skills that are essential for chiropractic skills training.


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