Effect of Visual Feedback on Force Application in Semmes-Weinstein Monofilament Testing: A Randomized Controlled Trial

Objectives: This study aimed to compare the effectiveness of traditional simulation training (TST) and visual feedback training (VFT) in improving force accuracy and consistency during the application of the Semmes-Weinstein Monofilament Test (SWMT) among occupational therapy students. Materials and Methods: A randomized controlled trial was conducted with 52 senior-year occupational therapy students (TST:n = 25; VFT:n = 27). All participants received standardized theoretical instruction before undergoing either TST or VFT. Pre- and post-training assessments were conducted using a high-precision force sensor. Main outcome measures included maximum applied force (MaxF1–3), absolute error, contact duration (T1–3), and inter-application intervals (L1–2). Non-parametric tests and effect sizes (r) were used for statistical comparisons. Results: Post-training comparisons revealed significantly greater force consistency in the VFT group compared to TST: MaxF1 (p = 0.04, r = 0.273), MaxF2 (p = 0.02, r = 0.318), MaxF3 (p = 0.03, r = 0.302). Absolute error increased in TST (MaxF2: +0.25g), while it decreased in VFT (MaxF2: –0.20g). Touch durations (T1–T3) significantly improved only in the VFT group (p < 0.001), with large effect sizes (r= 0.721 to 0.772). No significant improvements were observed in TST. Conclusion: VFT enhanced students’ ability to apply consistent and accurate force during SWMT compared to TST. These findings highlight the value of integrating objective feedback tools into clinical training protocols to improve psychomotor performance in sensory testing. Future studies should investigate the long-term retention of skills and the clinical applicability of this approach in real patient scenarios.