The development of an instructional video for the teaching of acupressure for pain management in acute musculoskeletal injuries: A knowledge translation study

Highlights

• KTA model provided the bases for the development of the instructional video.

• This study shows a way of including stakeholders in knowledge translation process.

• The video should include a clear demonstration combined with verbal instruction.

• Keeping the video content to a minimum was recommended.

• Professionalism in presentation and production of the video is important.

Abstract

Objectives

To survey potential stakeholders to obtain information relevant to the production of a video on teaching acupressure for sports injury management, and gain feedback from potential users on the prototype video.

Design

Focus groups and online survey methods nested within a knowledge translation framework.

Participants

Four focus groups (n = 24) were conducted, two with sports medics and two with sports physiotherapists as a part of the development of a prototype video. Nineteen stakeholders viewed the prototype video and participated in the subsequent online survey.

Main outcome measures

Focus groups' transcripts were analysed to develop themes using a general inductive approach. Survey data analysis incorporated quantitative and qualitative analysis.

Results

Three key themes concerning the design of the video emerged from the focus groups: 1) the recommendation for both demonstration and verbal instructions on the acupressure technique; 2) keeping the content of the video to a minimum; and 3) the need for professionalism in the production of the video, and highlighting the presenter's expertise and qualifications. The survey participants found the video to be clear and professional.

Conclusions

Collectively these studies described the development and assessment of a user-oriented instructional video on teaching of acupressure for the management of sports injuries.

Introduction

Acupressure is one of the complementary and alternative medicine (CAM) modalities (Barnes et al., 2008, Mącznik et al., 2014) originating from oriental medicine and emerging more recently in western medicine (Hopwood, Lovesey, & Mokone, 1997, p. 79). This intervention is administered by applying pressure via a finger, thumb or elbow at particular points on the body to modulate physiological responses. Acupressure has been successfully used to manage pain in acute and chronic musculoskeletal conditions (Chen and Wang, 2014, Kim et al., 2012, Lee and Frazier, 2011). In healthy individuals, acupressure has been significantly associated with increasing the pain threshold (Tekeoglu et al., 1998, Tekeoǧlu et al., 1996), increasing oxygen uptake during and after exercise, and reducing lactic acid levels after exercise (Jaung-Geng, Salahin, & Jung-Charng, 1995). A specific application of acupressure in athletes with acute musculoskeletal injuries has been found to reduce pain following 3 min of application to one acupoint (Mącznik, Schneiders, Athens, & Sullivan, 2016). However, despite promising applications, acupressure is not widely used. This could be due to lack of knowledge about this technique, or hesitance around its effectiveness. In general, CAM is not widely taught in standard health professions curricula (Längler et al., 2013), but both students and professionals see the need for CAM training (Chaterji et al., 2007), and seek opportunities to fulfil it (Münstedt, Harren, von Georgi, & Hackethal, 2011). Therefore, acupressure needs to be translated into a readily understood and widely accessible format.

Traditional educational interventions (e.g. educational meetings, instructive printed materials) are often ineffective (Scott et al., 2012), therefore, there is a need to find new ways to translate knowledge within the health context. The use of online technology has been suggested to facilitate knowledge translation from research findings to the end-users (Eccles and Grimshaw, 2004, Levac et al., 2015), in areas including the prevention of injuries (Eime et al., 2004, Richmond et al., 2014), and patients' support (Ahmed et al., 2010, Pagoto et al., 2014, Van Uden-Kraan et al., 2009). Video technologies in particular, have been shown to be effective in teaching practical skills in a health professional education context (Botticelli et al., 2005, Janda et al., 2005, Pan et al., 2014, Preston et al., 2012). Although, evidence from the literature specific to the teaching of acupressure through video is uncommon, one study (Kim, Chang, Lee, Jun, & Kim, 2003) has shown video instruction to be equally effective and significantly more satisfying than printed materials in teaching acupressure for labour pain. Videos are often made freely available through sharing web sites such as YouTube, which makes them readily accessible globally. However, not all content is quality-assured or professionally produced (Richardson et al., 2011, Williams et al., 2014). Therefore, in order to produce an instructional video of an appropriate standard it is important to systematically navigate through the design and production process taking into account both stakeholders feedback (Graham et al., 2006, Hudon et al., 2015) and the literature (Evans, 2012, Preston et al., 2012).

Ideally the video development process should be underpinned with an appropriate conceptual model to achieve a logical progression. While there are the number of models available in the area of health professionals' education (Jacobson et al., 2003, Logan and Graham, 1998), one which is gaining momentum in development of ‘knowledge translation products’ (Brosseau et al., 2014, Strachan et al., 2014, Yu et al., 2014) is the Knowledge-to-Action model (KTA model) (Graham et al., 2006), outlining steps facilitating knowledge translation. Therefore, the purpose of this research was to: 1) survey potential stakeholders in order to obtain information relevant to the production of a video, 2) gain feedback from potential users on their impressions of the prototype video. These two steps were derived from the KTA model, and employed focus group and online survey methods.