Abstract:

Introduction.
Manual medicine is the complex of manual diagnostics and manual therapy, focused on the functional blockages of the joints (spine, upper and lower extremities). In our country, manual medicine is part of the physical and rehabilitation medicine (PRM) and is done as a super-specialization for medical doctors (professional field Medicine). In Bulgaria, bachelors and masters in Kinesiotherapy (Physiotherapy) and Rehabilitation (professional fields: Health Care and Public Health) have the right to apply part of the manual therapeutic techniques (tractions and mobilizations of peripheral joints).
During last year we prepared an electronic book with presentations and videos. The e-book contains theoretical bases, description of principal diagnostic and therapeutic techniques ((tractions, mobilizations and manipulations), and some clinical cases. The e-book is oriented to the necessities of the mentioned different types of medical specialists and health professionals. We offered the book to all students in Physiotherapy (Kinesitherapy) and to all participants in long-life-learning (LLL) training courses on Manual therapy (medical doctors and physiotherapists).

Goal of the study:
The objective of current work was to realize a comparison of the level of theoretical knowledge and practical skills of these different types of practitioners – before and after the edition of the e-book, and to evaluate the value of the application of electronic learning on the professional competences in this field.

Methodology:
We created a set of tests and practical exams (including analysis of clinical cases) in the field of manual medicine and manual therapy, adapted to the level of education of different types of practitioners (for students, for physiotherapists – bachelors and masters; for medical doctors – PRM specialists and PRM-trainees). We applied these different levels of the exam set in: medical doctors (PRM-specialists and PRM-trainees) during the process of training and during LLL courses; in students in Kinesitherapy – bachelor’s degree and students in “Medical Rehabilitation and Balneology” - master’s degree)]; and in physiotherapists during LLL courses, organized by the Medical Universities of Sofia and Pleven (2009-2019). We compared the level of theoretical knowledge and practical skills in groups of practitioners before and after the edition and application of the e-book and the video-films in the clinical practice.

Results:
The results of this qualitative and quantitative evaluation demonstrates a statistically significant improvement in the level of theoretical knowledge and practical skills in case of application of the electronic learning (using the e-book with the video-films) – in all groups. The increase of the level of theoretical knowledge is most significant in the groups of medical doctors – PRM-specialists and PRM-trainees. The increase of the level of practical skills is most significant in the groups of physiotherapists – students and during LLL-courses (manual tractions and mobilizations of peripheral joints). All students and participants in the LLL training courses of the current year are pleased of the e-book.

Conclusions:
The qualitative and quantitative comparison of the results in both groups validated the value of the introduction of electronic learning and video-films during the process of training in the field of manual medicine and manual therapy - for medical doctors and physiotherapists.

Keywords:

Electronic book, video-film, e-learning, manual diagnostics, manual therapy, physical medicine, rehabilitation.