Developing best practices teaching procedures for skinfold assessment: observational examination using the Think Aloud method.

Skinfold assessment is valid and economical; however, it has a steep learning curve, and many programs only include one exposure to the technique. Increasing the number of exposures to skinfold assessment within an undergraduate curriculum would likely increase skill proficiency. The present study combined observational and Think Aloud methodologies to quantify procedural and cognitive characteristics of skinfold assessment. It was hypothesized that 1) increased curricular exposure to skinfold assessment would improve proficiency and 2) the combination of an observational and Think Aloud analysis would provide quantifiable areas of emphasis for instructing skinfold assessment. Seventy-five undergraduates with varied curricular exposure performed a seven-site skinfold assessment on a test subject while expressing their thoughts aloud. A trained practitioner recorded procedural observations, with transcripts generated from audio recordings to capture cognitive information. Skinfold measurements were compared with a criterion value, and bias scores were generated. Participants whose total bias fell within ±3.5% of the criterion value were proficient, with the remainder nonproficient. An independent-samples t-test was used to compare procedural and cognitive observations across experience and proficiency groups. Additional curricular exposure improved performance of skinfold assessment in areas such as the measurement of specific sites (e.g., chest, abdomen, and thigh) and procedural (e.g., landmark identification) and cognitive skills (e.g., complete site explanation). Furthermore, the Think Aloud method is a valuable tool for determining curricular strengths and weaknesses with skinfold assessment and as a pedagogical tool for individual instruction and feedback in the classroom.