A manipulation device is programmable with different parameters associated with different manipulation exercises for different types of simulated patients. A measuring system determines the success or failure for any of the programmable manipulation exercises and tracks specific results that precisely track how close a student comes to specific target force values. This allows a student to more accurately track performance improvements and more effectively focus practice sessions on problem manipulation techniques. The measurement system not only measures the time and force values associated with the manipulation exercises but also measures angular displacement of the manipulation apparatus during the manipulation exercise. This allows the student to not only determine if a proper amount of force was applied during the manipulation exercise but also to determine if the force was maintained in the same direction and angle.