Development of a Small-Group Teaching Method for Enhancing the Learning of Basic Acupuncture Manipulation Optimized with the Theory of Motor Learning

Authors: Wen-Chao Tang, Tang-Yi Liu, Ming Gao, Gang Xu, Hua-Yuan Yang

Abstract:

This study developed a method for teaching acupuncture manipulation in small groups optimized with the theory of motor learning. Sixty acupuncture students and their teacher participated in our research. Motion videos were recorded of their manipulations using the lifting-thrusting method. These videos were analyzed using Simi Motion software to acquire the movement parameters of the thumb tip. The parameter velocity curves along Y axis was used to generate small teaching groups clustered by a self-organized map (SOM) and K-means. Ten groups were generated. All the targeted instruction based on the comparative results groups as well as the videos of teacher and student was provided to the members of each group respectively. According to the theory and research of motor learning, the factors or technologies such as video instruction, observational learning, external focus and summary feedback were integrated into this teaching method. Such efforts were desired to improve and enhance the effectiveness of current acupuncture teaching methods in limited classroom teaching time and extracurricular training.

Keywords: Acupuncture, group teaching, video instruction, observational learning, external focus, summary feedback.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.3566317

References:

[1] H.-L. Park, H.-S. Lee, B.-C. Shin, J.-P. Liu, Q. Shang, H. Yamashita, and B. Lim, “Traditional medicine in china, korea, and japan: a brief introduction and comparison,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, 2012.
[2] N. Ishizaki, T. Yano, and K. Kawakita, “Public status and prevalence of acupuncture in japan,” Evidence-Based Complementary and Alternative Medicine, vol. 7, no. 4, pp. 493–500, 2010.
[3] S. M. Ock, J. Y. Choi, Y. S. Cha, J. Lee, M. S. Chun, C. H. Huh, S. Y. Lee, and S. J. Lee, “The use of complementary and alternative medicine in a general population in south korea: results from a national survey in 2006,” Journal of Korean Medical Science, vol. 24, no. 1, pp. 1–6, 2009.
[4] D. Su and L. Li, “Trends in the use of complementary and alternative medicine in the united states: 2002–2007,” Journal of health care for the poor and underserved, vol. 22, no. 1, pp. 296–310, 2011.
[5] S. Janz, J. Adams et al., “Acupuncture education standards in australia: a critical review,” Australian Journal of Acupuncture and Chinese Medicine, vol. 6, no. 1, p. 3, 2011.
[6] F. chun Wang, Acupuncture and Moxibustion Techniques and Manipulations. Shanghai Science and Technology Press, 2009.
[7] S.-h. Hong, S.-s. Ding, F. Wu, Y. Bi, F. Xu, Y.-j. Wan, and L.-h. Xuan, “Efficacy and safety of manual acupuncture manipulations with different frequencies on epigastric pain syndrome (eps) in functional dyspepsia (fd) patients: study protocol for a randomized controlled trial,” London, 2017.
[8] G. H. Kim, M. Yeom, C. S. Yin, H. Lee, I. Shim, M. S. Hong, C.-J. Kim, and D.-H. Hahm, “Acupuncture manipulation enhances anti-nociceptive effect on formalin-induced pain in rats,” Neurological Research, vol. 32, no. sup1, pp. 92–95, 2010.
[9] W. Li and A. Ahn, “Effect of acupuncture manipulations at li4 or li11 on blood flow and skin temperature.” Journal of acupuncture and meridian studies, vol. 9, pp. 128–33, Jun 2016.
[10] T. Huang, X. Huang, W. Zhang, S. Jia, X. Cheng, and G. Litscher, “The influence of different acupuncture manipulations on the skin temperature of an acupoint,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, 2013.
[11] G. J. Xeroulis, J. Park, C.-A. Moulton, R. K. Reznick, V. LeBlanc, and A. Dubrowski, “Teaching suturing and knot-tying skills to medical students: a randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback,” Surgery, vol. 141, no. 4, pp. 442–449, 2007.
[12] C. H. Shea, G. Wulf, and C. Whltacre, “Enhancing training efficiency and effectiveness through the use of dyad training,” Journal of motor behavior, vol. 31, no. 2, pp. 119–125, 1999.
[13] G. Wulf, N. McNevin, and C. H. Shea, “The automaticity of complex motor skill learning as a function of attentional focus,” The Quarterly Journal of Experimental Psychology Section A, vol. 54, no. 4, pp. 1143–1154, 2001.
[14] W.-C. Tang, H.-Y. Yang, T.-Y. Liu, M. Gao, and G. Xu, “Motion video-based quantitative analysis of the lifting-thrustingmethod: a comparison between teachers and students of acupuncture,” Acupuncture in Medicine, pp. acupmed–2016, 2017.
[15] T. Liu, L. Kuai, H. Yang, and M. Gao, “Preliminary research on the standardization of acupuncture manipulation,” Zhongguo zhen jiu= Chinese acupuncture & moxibustion, vol. 28, no. 5, pp. 356–358, 2008.
[16] R. T. Davis, D. L. Churchill, G. J. Badger, J. Dunn, and H. M. Langevin, “A new method for quantifying the needling component of acupuncture treatments,” Acupuncture in Medicine, vol. 30, no. 2, pp. 113–119, 2012.
[17] T. Kohonen, “The self-organizing map,” Neurocomputing, vol. 21, no. 1, pp. 1–6, 1998.
[18] J. MacQueen et al., “Some methods for classification and analysis of multivariate observations,” in Proceedings of the fifth Berkeley symposium on mathematical statistics and probability, vol. 1, no. 14. Oakland, CA, USA, 1967, pp. 281–297.
[19] J. Vesanto, “Som-based data visualization methods,” Intelligent data analysis, vol. 3, no. 2, pp. 111–126, 1999.
[20] T. Matsuo, T. Jinji, D. Hirayama, D. Nasu, H. Ozaki, and D. Kumagawa, “Middle finger and ball movements around ball release during baseball fastball pitching,” Sports biomechanics, pp. 1–12, 2017.
[21] A. Hadjakos, E. Aitenbichler, and M. M¨uhlh¨auser, “Potential use of inertial measurement sensors for piano teaching systems: Motion analysis of piano playing patterns,” in Proceedings of the 4th i-Maestro Workshop on Technology-Enhanced Music Education, 2008, pp. 61–68.
[22] T. Greenhalgh, “Computer assisted learning in undergraduate medical education,” BMJ: British Medical Journal, vol. 322, no. 7277, p. 40, 2001.
[23] E. L. Deci and R. M. Ryan, “Self-determination theory: A macrotheory of human motivation, development, and health.” Canadian psychology/Psychologie canadienne, vol. 49, no. 3, p. 182, 2008.
[24] D. I. Cordova and M. R. Lepper, “Intrinsic motivation and the process of learning: Beneficial effects of contextualization, personalization, and choice.” Journal of educational psychology, vol. 88, no. 4, p. 715, 1996.
[25] P. G. Post, J. T. Fairbrother, and J. A. Barros, “Self-controlled amount of practice benefits learning of a motor skill,” Research quarterly for exercise and sport, vol. 82, no. 3, pp. 474–481, 2011.
[26] G. Wulf, M. Raupach, and F. Pfeiffer, “Self-controlled observational practice enhances learning,” Research Quarterly for Exercise and Sport, vol. 76, no. 1, pp. 107–111, 2005.
[27] P. McCullagh and M. R. Weiss, “Modeling: Considerations for motor skill performance and psychological responses,” in Handbook of sport psychology. Wiley, 2001, pp. 205–238.
[28] W. L. Shebilskem, J. W. Regian, W. Arthur Jr, and J. A. Jordan, “A dyadic protocol for training complex skills,” Human Factors, vol. 34, no. 3, pp. 369–374, 1992.
[29] C. H. Shea, D. L. Wright, G. Wulf, and C. Whitacre, “Physical and observational practice afford unique learning opportunities,” Journal of motor behavior, vol. 32, no. 1, pp. 27–36, 2000.
[30] G. Wulf, “Attentional focus and motor learning: a review of 15 years,” International Review of Sport and Exercise Psychology, vol. 6, no. 1, pp. 77–104, 2013.
[31] ——, Attention and motor skill learning. Human Kinetics, 2007.
[32] G. Wulf, S. Chiviacowsky, and R. Drews, “External focus and autonomy support: Two important factors in motor learning have additive benefits,” Human Movement Science, vol. 40, pp. 176–184, 2015.
[33] Y.-A. Kuhn, M. Keller, J. Ruffieux, and W. Taube, “Adopting an external focus of attention alters intracortical inhibition within the primary motor cortex,” Acta Physiologica, vol. 220, no. 2, pp. 289–299, 2017.
[34] A. OConnor, S. Schwaitzberg, and C. Cao, “How much feedback is necessary for learning to suture?” Surgical endoscopy, vol. 22, no. 7, pp. 1614–1619, 2008.
[35] D. Stefanidis, J. R. Korndorffer, B. T. Heniford, and D. J. Scott, “Limited feedback and video tutorials optimize learning and resource utilization during laparoscopic simulator training,” Surgery, vol. 142, no. 2, pp. 202–206, 2007.
[36] M. C. Porte, G. Xeroulis, R. K. Reznick, and A. Dubrowski, “Verbal feedback from an expert is more effective than self-accessed feedback about motion efficiency in learning new surgical skills,” The American Journal of Surgery, vol. 193, no. 1, pp. 105–110, 2007.
[37] E. A. Locke and G. P. Latham, “The application of goal setting to sports,” Journal of sport psychology, vol. 7, no. 3, pp. 205–222, 1985.
[38] M. W. Kernodle and L. G. Carlton, “Information feedback and the learning of multiple-degree-of-freedom activities,” Journal of motor behavior, vol. 24, no. 2, pp. 187–195, 1992.
[39] S. Chiviacowsky and G. Wulf, “Feedback after good trials enhances learning,” Research Quarterly for Exercise and Sport, vol. 78, no. 2, pp. 40–47, 2007.
[40] G. Wulf and R. Lewthwaite, “Effortless motor learning? an external focus of attention enhances movement effectiveness and efficiency,” Effortless attention: A new perspective in attention and action, pp. 75–101, 2010.
[41] ——, Attentional and motivational influences on motor performance and learning. na, 2009.
[42] B. P. Brown, T. Hedinger, and G. Mieiing, “The power in universality of experience: A homogeneous group approach to social skills training for individuals with learning disabilities,” Journal for Specialists in Group Work, vol. 20, no. 2, pp. 98–107, 1995.
[43] B. Du-Babcock, “A comparative analysis of individual communication processes in small group behavior between homogeneous and heterogeneous groups,” in Proceedings of the 68th Association of Business Communication Convention, Albuquerque, New Mexico, USA, 2003, pp. 1–16.
[44] P. Maftoun and N. Ghafori, “A comparative study of the effect of homogeneous and heterogeneous collaborative interaction on the development of efl learnerswriting skill,” The Journal of Applied Linguistics, vol. 1, no. 2, pp. 127–58, 2009.