The Part IV Technique Station: Setups You Must Know

The technique station catches people off guard because you don't adjust anyone — you talk. It's 2 minutes of chart review and 14 minutes of setups, and your score is built entirely from what you say and how you position. Precise words are the whole game.

What's actually being scored

Every setup is judged on eight domains. Think of them as a checklist you narrate out loud, in order, every single time:

1. Patient position — supine, prone, seated, or side-lying. State it.
2. Your position — your stance relative to the patient and the segment.
3. Segmental contact point — the exact bony landmark on the target segment, and the side.
4. Your contact point — the part of your hand making contact (pisiform, hypothenar, thumb, etc.).
5. Stabilization hand — your support hand and what it stabilizes.
6. Line of drive — the vector of the correction (e.g., posterior-to-anterior and superior).
7. Communication — narrating each step clearly to the examiner.
8. Professionalism & safety — you set up only; you never actually thrust.

Turn the checklist into a script

The candidates who score well have a fixed verbal template and drop the specifics into it. Out loud, it sounds like one flowing sentence:

Notice what that does: it hits all eight domains in order, names the landmark and the side, and explicitly states you're not thrusting. That's a full-marks setup.

Know your regions cold

You can be asked to set up anywhere along the spine and into the extremities. Have the contact point, stabilization, and line of drive ready for each region:

• Cervical — articular pillar / lateral mass contacts; careful, deliberate positioning; state the vector precisely.
• Thoracic — transverse process or spinous contacts; patient often prone; know your stabilization.
• Lumbar — mammillary process (side posture) is the classic; get the side right.
• Pelvis / SI — PSIS, sacral base, ischial contacts depending on the listing.
• Extremities — know the joint, the contact, and the direction for common peripheral setups.

Where points quietly disappear

• Vague line of drive — “I'd push down” isn't a vector. Name the plane and direction.
• Wrong side — the listing tells you the side; contact the wrong one and the setup is wrong.
• Forgetting stabilization — it's its own domain. Always say what your other hand is doing.
• Not narrating — if you do it silently, the examiner can't score communication.
• Safety slips — implying a thrust, or an unsafe position, costs professionalism points.

How to practice it

Because it's verbal, you practice it out loud — set a timer, pull a random region and listing, and talk through the full eight-domain setup until it's reflexive. Silent flashcards won't build the skill the station actually tests. For how this fits the whole exam's scoring, see How Part IV Is Actually Graded.