Contemporary perspectives in teaching and assessment of thrust joint manipulation of the spine or pelvis in entry-level Doctor of Physical Therapy programs

To describe the current status of spinal and pelvic thrust joint manipulation (TJM) educationin entry-level Doctor of Physical Therapy (DPT) programs within the United States. Accredited DPT programs were recruited through electronic communications to take part in an anonymous survey and optional follow up interview. The study evaluated TJMJ curriculum design, faculty qualifications, and perceived barriers to teaching and learning TJM. Seventy-eight programs met the study's inclusion criteria (response rate: 28%). All participating programs taught TJM of the spine or pelvis, with 96% believing it to be an achievable entry-level skill. However, variability was noted in the specific spinal regions covered within TJM curricula. Faculty credentials primarily included orthopedic certified specialist (80%). Didactic hours devoted to TJM were commonly 1-10 hours for lecture (65%) and 10-20 hours for laboratory instruction (42%), with a typical faculty-to-student ratio of 1:10 (65%). Competency assessments most often consisted of practical exams (87%) and skills checks (82.1%). Faculty cited multiple barriers to TJM education and emphasized the need for post-professional instructor training, greater opportunities for experiential learning, and more consistent integration of TJM across the core curriculum. Contemporary TJM curricula appear generally consistent to those reported a decade ago, although a larger proportion of programs now use competency-based assessments. Despite this progress, educators identified persistent barriers to TJM education and advocated for enhancements in faculty development and curriculum integration.