A Skills-Focused Approach to Improving Therapist Goniometry Accuracy Using a Simulation Laboratory

Goniometric measurements are widely used in the field of occupational therapy to measure range of motion, define and describe movement, and predict the functional implications of joint limitations. These measurements are further used in documentation and as a means of justifying reimbursement. While goniometrics are a hallmark of our practice, therapist competency is rarely assessed. This study sought to evaluate whether a skill focused, simulation assisted training could lead to improvements in accuracy and consistency of goniometric measurements. Ten therapists at a single facility completed goniometric testing utilizing a simulation module to assess three joint motions (shoulder abduction, elbow flexion and neck extension). Testing was followed by extended, joint specific education prior to retesting. Estimates of consistency improved for all joint motions from pre to post training. Measurement accuracy improved in shoulder abduction and neck extension. Therapists reported improved level of comfort for specific joint measurements and for goniometry in general. Training laboratories such as the one described in this paper, can be an effective way of establishing a consistent departmental standard, assessing current competency, and providing hands-on training in a new and innovative way.