PURPOSE Orthopedic manual therapy (OMT) education demonstrates significant variability between philosophies and while literature has offered a more comprehensive understanding of the contextual, patient specific, and technique factors which interact to influence outcome, most OMT training paradigms continue to emphasize the mechanical basis for OMT application. The purpose of this study was to establish consensus on modifications & adaptions to training paradigms which need to occur within OMT education to align with current evidence. METHODS A 3-round Delphi survey instrument designed to identify foundational knowledge to include and omit from OMT education was completed by 28 educators working within high level manual therapy education programs internationally. Round 1 consisted of open-ended questions to identify content in each area. Round 2 and Round 3 allowed participants to rank the themes identified in Round 1. RESULTS Consensus was reached on 25 content areas to include within OMT education, 1 content area to omit from OMT education, and 34 knowledge components which should be present in those providing OMT. Support was seen for education promoting understanding the complex psychological, neurophysiological, and biomechanical systems as they relate to both evaluation and treatment effect. While some concepts were more consistently supported there was significant variability in responses which is largely expected to be related to previous training. CONCLUSION The results of this study indicate manual therapy educators understanding of evidence-based practice as support for all 3 tiers of evidence were represented. The results of this study should guide OMT training program development and modification.

中文翻译：

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更新骨科手法治疗培训范式的优先事项：一项国际德尔菲研究

目的骨科手法治疗 (OMT) 教育表明哲学之间存在显着差异，虽然文献提供了对相互作用影响结果的背景、患者特定和技术因素的更全面理解，但大多数 OMT 培训范例继续强调 OMT 的机械基础应用。本研究的目的是就 OMT 教育中需要发生的培训范式的修改和适应建立共识，以与当前证据保持一致。方法 一项 3 轮德尔菲调查工具旨在确定基础知识，包括和省略 OMT 教育，由 28 名在国际高水平手法治疗教育项目中工作的教育工作者完成。第一轮由开放式问题组成，以确定每个领域的内容。第 2 轮和第 3 轮允许参与者对第 1 轮中确定的主题进行排名。结果就 25 个内容领域达成共识，包括在 OMT 教育中，1 个内容领域从 OMT 教育中省略，以及 34 个知识组件应该存在于那些提供OMT。支持教育促进理解复杂的心理、神经生理学和生物力学系统，因为它们与评估和治疗效果有关。虽然一些概念得到了更一致的支持，但反应存在显着差异，这在很大程度上预计与以前的培训有关。结论 这项研究的结果表明手法治疗教育者对循证实践的理解是对所有 3 层证据的支持。