The influence of sensory awareness training, additional motor practice and usual practice on scalpel skill learning in podiatry students.

Sensory awareness training - Participants randomised to the sensory awareness group were initially separated and provided sensory awareness training in the form of face-to-face Feldenkrais ATM (awareness through movement) for approximately 40 minutes. Feldenkrais method is an "..educational system that develops a functional awareness of the self in the environment" (Buchanan & Ulrich 2001). The practitioner verbally guides participants through a sequence of gentle movements based on functional activities such as reaching, and encourages attention of these. The initial training was delivered as a group by a trained Feldenkrais practitioner who is also a Neurophysiotherapist. The initial training was supplemented with audio recordings of two sessions, a 'sitting' session focussing on relaxation and awareness, and another lesson targeting the dominant hand. Each lesson goes for approximately 40 minutes. The audio recordings were provided via a CD and a download link, to allow downloading of the audio file over the internet if required. (Additional) Motor Practice - Participants randomised to the additional Motor practice group were separated and instructed in methods for motor practice in the form of staged scalpel practice, including: holding a pen in the same manner as a scalpel and replicating usual movement either in free space or on paper, varying the applied pressure; using a scalpel on inanimate objects such as soap or oranges. The initial session was run by a podiatrist not involved in data collection. Subsequent sessions could be done by each participant in their own time, although a set time in which participants could access the student clinic for practice was also provided at one of the sites. Participants from both groups were instructed to undertake training as regularly as they could, but at least three times per week. The timing of, and specific activity in which they were to engage (ie which lesson for the sensory awareness group, or which motor activity for the additional motor practice group), was not specified but left to the discretion and motivation of each participant. It was hoped this would improve compliance and reflect more real-life conditions. Each participant from the two intervention groups were required to keep a small log book of the duration of each practice session undertaken and the chosen activity was completed. The training period was defined as being of at least two weeks duration, but needed to be continued until follow-up testing was undertaken.