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Research in the Classroom
Are you teaching research in your classrooms?
If so, which aspects (basic terms, read and interpret studies, research skills)?
How are you integrating research into other topics such as massage effects and treatment planning?
Views: 181
Replies to This Discussion
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Permalink Reply by Susan G. Salvo on
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Robin,
I like the idea of having two classes (literacy and application). I also appreciate your comment about students having a hard time relating to research until you make it relevant to our profession.
That’s why these discussions are so important. Educators need to know what is working.
What resource do you use when teaching research?
What are the criteria for your case studies?
___________________
At our school, we introduce research with the scientific method and then move into massage effects that are researched-based.
Then, as an assignment, students are given two report forms in which they are asked to locate and read two articles on massage or hydrotherapy. Then they are to write at least one new concept from each study they gained from their reading. We go over these in class.
When learning about pathologies, we then discuss the research available on how massage affects pathologies.
Finally, we discuss how research plays a role in treatment planning.
I'm hoping to find ways to improve what we are doing...
Robin Byler Thomas said:BTW, thanks for linking us to your discussion Susan. Does your school touch on research? -
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Dawn,
Wow, what you are doing sounds fantastic. You are soo on the ball. I hope more instructors at massage schools move in the direction you are taking your students (and the profession).
Being a person who wants to support the process of integrating research into entry level curriculum, I would love any guidance you can offer.
Dawn M. Saunders, BS, LMT, RMTI said:Good day...
We teach a 20 hour Research course as part of our 360 hour medical massage program. I am currently the Director of Education at UTMI in Albuquerque, NM, but at the time we were developing the curriculum for this advanced, post entry-level program I was an instructor who had just attended the 2005 Highlighting Massage Therapy in CAM Research conference. I pushed our administration and advisory board to accept that research was an integral part of a medical / clinical massage therapist's knowledge base. We utilize Glenn Hymel's chapter 2 in Sandy Fritz's Clinical Massage text. I think that chapter is too involved, too heavy on stats, and not an easy read, but it is a point of reference for our students.
Our course consists of: an introduction to the scientific method, why we ask questions in research, how to pose clinical questions with research, who / what organizations are currently conducting / publishing research (MTF, NCCAM, Touch Research Institute), how to find and read research articles, basic, basic intro to statistics, and how to translate research results into clinical applications (we have them choose a pathology, research what new forms of complementary medicine treatments there are "out there", then talk about what massage therapy clinical applications could be applied to their pathology of choice).
This is not an entry level course! Our therapeutic massage program is 720 hours. We utilize your Massage Therapy Practice & Principles text & online resources in our modality courses (i.e., case studies) and your Mosby's Pathology for Massage Therapists text & online resources in our Physiology & Pathology classes. However, we have not integrated research concepts into our entry level program.
It is challenging for some of our younger students in our TM program to see the connection between research and massage therapy. Only 17% of high school graduates in our state are prepared for the math & science courses at the college level!!! That statistic is a huge challenge for our school!!! Most TM students "glaze over" when math and science is mentioned because they are not prepared in high school for the level of education we are offering in our advanced program.
If I could integrate more research in our overall curriculum, I would. I know your text resources will continue to help me/us with that aspect. Thank you for what you are doing for our profession!
Dawn Saunders -
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Christopher, given your example, I would most likely use both methods; with more treatment time spent employing method B.
Given the traditions of our profession and free will of both clients and therapists, all methods have a place at the therapy table. While I have great respect for research, I don’t base all my treatment decisions on it.
I just don’t see things in black or white, but rather shades of gray (or is it grey [Pun intended]). Research often leads to the need for more research. Furthermore, research gives us a clear picture, but not the whole picture.
I’m taking a course this semester on qualitative research. Since I am finishing up with an online course in pathology for massage therapists, I am doing my research project on comparing online with traditional face-to-face learning.
The lit review renders conflicting findings with online in the lead IF the learner is self motivated. Studies also suggest that online learning is best for visual and kinesthetic learners and face-to-face is better for auditory learners.
Meta analysis implies that a combined method is best with more options for the learner.
Christopher, do you teach research in your classes (and what is your teaching specialty)? If yes, what research approach do you take?
Christopher A. Moyer said:Let's say research suddenly invalidates my primary method (Swedish). If I am attendee at a workshop you were conducting, what would you tell me?
Interesting question. The first thing that occurs to me is that it would be unusual, or maybe even impossible, for research to 'suddenly' invalidate your example of Swedish massage therapy. We would need a series of high-quality studies with consistent null results to reach that conclusion; this is even more true given we already have a fair amount of studies that demonstrate effects from Swedish massage therapy.
Allow me to alter your example a little. Let's say that you advertise yourself as a massage therapist specializing in reduction of painful condition X. Currently there are two massage modalities used for this condition, modality A and modality B. Both A and B have been around a long time, have their proponents, and seem to work, but no one has ever compared them scientifically. You happen to be trained in A.
Several well-designed studies are now performed in which A and B are compared. The findings show that A consistently reduces symptoms by about 15% better than no treatment, whereas B consistently reduces symptoms by about 45% better than no treatment. It's very clear that B is the better modality than A in all important respects.
What do you do now? Keep doing A, in which you were trained? (It does work, after all, just not very well.) Or do you abandon A and take the time, effort, and expense to learn B?
Should modality A even be taught anymore? Should it be abandoned by the profession? -
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Permalink Reply by Robin Byler Thomas on
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Hi Susan,
What you're currently doing sounds great. You might give your students an evaluation at the end of the class and find out what they liked and disliked and ask for suggestions to make the class better.
You asked:
What resource do you use when teaching research?
I was a guest lecturer to this class; not their regular instructor. She asked me to share with them what's happening in the world of MT research, my research experience (finishing a graduate degree) and my massage experience (15 years).
I showed them a power point presentation, from a literature review I'd done the previous semester, which focused on 5 randomized control trials and one longitudinal study. The PP showed them a variety of settings and outcomes and the importance of the outcomes, to not only MT's, but physicians as well. For example, a post-surgery massage reduced patient anxiety and pain and was feasible in a hospital setting; important for high risk patients who have trouble taking pain medications coming out of surgery.
I suggested they first read Martha Brown Menard's articles, posted on the Massage Therapy Foundation website, along with the other articles they have posted on research found here.
Then to read past student case report winners posted here:
I had a copy of Glenn Hymel's book on MT research and suggested to have it as a reference.
The instructor had a take home reading, for each student, of Chris Moyer's Directions and Dilemmas in MT Research, here.
These links were provided as resources for their search:
http://www.ncbi.nlm.nih.gov/pubmed/
MassageTherapyFoundation.org
miami.edu/touchresearch/TRIResearch/massageres
InternetHealthLibrary.com
Massage Therapy Research
ClinicalTrials.gov
http://www.cochrane.org/index.htm
You asked:
What are the criteria for your case studies?
Criteria for the case reports can also be found here.
We didn't have an internet connection the day I was there, otherwise I would have walked them through a pub med search of a student suggested topic. I think that's what they were the most afraid of to start.
BTW, this class was Research Applications for the advanced students. The Research Literacy class was a prerequisite and required to graduate; it was introductory and did not include writing a case report.
Susan G. Salvo said:Robin,
I like the idea of having two classes (literacy and application). I also appreciate your comment about students having a hard time relating to research until you make it relevant to our profession.
That’s why these discussions are so important. Educators need to know what is working.
What resource do you use when teaching research?
What are the criteria for your case studies?
___________________
At our school, we introduce research with the scientific method and then move into massage effects that are researched-based.
Then, as an assignment, students are given two report forms in which they are asked to locate and read two articles on massage or hydrotherapy. Then they are to write at least one new concept from each study they gained from their reading. We go over these in class.
When learning about pathologies, we then discuss the research available on how massage affects pathologies.
Finally, we discuss how research plays a role in treatment planning.
I'm hoping to find ways to improve what we are doing...
Robin Byler Thomas said:BTW, thanks for linking us to your discussion Susan. Does your school touch on research? -
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Thanks Stephen, I enjoyed meeting and talking with the students and hope they got something from it as well.
Your video taping of a session is a good idea. Any researcher out there with access to equipment and more experience that could take this on?
Stephen Jeffrey said:Robin you said
I had the opportunity, a couple weeks ago, to guest lecture for the research applications class at their second meeting. This group had elected to add a 4th quarter to a 3 quarter program; from 750 to 1000 hours. So, they wanted to be there, however, research was their least favorite class. From what I could tell that's because they were so new to the idea of research, and of course, they were dying to become experienced with hands on techniques.
They also couldn't relate to research at all. However, after we went around the room getting some basic background information and what their interests were, I was able to share with them the research being done along those lines and where to find the proper resources for study information. They became very animated, asked tons of questions, and my one hour visit turned into three.
How lucky those students were to have you.....can you not vidoe your next talk, then get a condensed version online ? It may help educators to realize there is a budding researcher wanting to be born from within some/most students ?
It may get other students interested ? you may even find some old stick in the muds like me have a reawakening to research.?
Susan, or indeed all of you :-
How about asking about the volume of time students might like allocated learning research out on the main forum? just in case you are not (in your enthusiasm for research ) forgetting just how tough the first rung of the ladder already is ?
Or is this envisaged for advanced courses?
Jenny
Chris gives us fair warnings about research and findings,..so how prepared are any of us for results that make us out to be fake. Its something I personaly would get very upset about.?
Respectfully yours. -
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Permalink Reply by Matthew D. Stewart on
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Are you teaching research in your classrooms?
When you say 'teaching research' what do you mean? The focus is an important consideration as in my experience I have seen programs try to teach diploma-level students graduate-school material and wonder why student morale is low and classroom attendance is low (even for a required class).
I would support Christopher Moyer's comment that research literacy is the first key goal. Teaching research literacy is an achievable goal in a diploma program, trying to develop research capacity is not. My experience is in New Zealand where our entry level diploma course is an 18 month program, full-time. This equates to a 1600 hour qualification. Students can progress further on a pathway to complete a clinical sports massage option which leads to a 2000 hour qualification. We also offer a full-time three year degree program, the first degree in the Southern Hemisphere specialising in Massage and Neuromuscular Therapy. Each qualification step includes a course in research methodology. All students have an introduction to research literacy, including research paradigms, the scientific method, qualitative and quantitative methodology, research designs, where to find relevant literature, how to search the literature as well as cultural and ethical aspects of research from the first 100 hour course. The sports diploma incorporates the second course, which spends more time on qualitative methods (taught by a professor in research) and research article critiquing in groups and individually in a written assignment. The degree students work through the 5-step evidence-based practice model in the third research methodology paper to answer a clinical dilemma they have faced in the student clinics. In addition, the third-year degree students also choose a topic to prepare a literature review on a pathological condition and the appropriate management of the condition including massage therapy. In the final assessment of the degree students they are required to present a six-session case study of a client incorporating their clinical reasoning, and evidence-based treatment planning and management.
I have been working to translate the introductory paper into a on-line course offering, at present 2 of the course topics are entirely on-line, with forums for discussion and links to the wealth of great material on the web. If anyone is interested let me know and I'll pick up the pace to get the whole course online!
One obstacle to integrating research literacy into a massage school program is getting access to quality research articles. Even though open access journals are very welcome addition to the literature, a vast amount of research still sits in subscription-based databases. We have managed to solve this challenge by forming a consortium of CAM colleges to spread the cost of this access.
On the textbook front, and we have used Polit and Beck, Essentials of Nursing Research for years two and three. The introductory course has its own purpose written course notes.
My understanding of the situation in the US is that most programs are 550 to 600 hours in duration, with exceptions of course. I can see real pressure in trying to integrate a research literacy course in a program of that length.
In the other subject area that I administer - musculoskeletal anatomy - I am always looking for new research findings to integrate into these courses. I have found attending the International Fascia Research Congress particularly useful in staying abreast of the most recent developments. I think staff attending these types of events further reinforces the need for continuing professional development to students. Basically, it sets a good example! -
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Permalink Reply by Sandy Fritz on
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Again Christopher, you are identifying not only a possiblity but a current reality. Research has shown that reciprocal inhibition is NOT a factor in ability to lenghen soft tissue related to muscle energy methods. When this came to light Dr; Chaitow immediately began to disclose the issue during courses taught even though many of his textbook (and mine) are going to have to rewrite segments based on current information. The current fascia research is explaining some of the benefits of massage but not in ways that we think. Are we as professionals going to seek, support and respond to the research findings. Eventually (and hopefully) many current myths will be exposed. It is beginning now and I have already seen resistance. Change is hard but oh well.
Christopher A. Moyer said:Let's say research suddenly invalidates my primary method (Swedish). If I am attendee at a workshop you were conducting, what would you tell me?
Interesting question. The first thing that occurs to me is that it would be unusual, or maybe even impossible, for research to 'suddenly' invalidate your example of Swedish massage therapy. We would need a series of high-quality studies with consistent null results to reach that conclusion; this is even more true given we already have a fair amount of studies that demonstrate effects from Swedish massage therapy.
Allow me to alter your example a little. Let's say that you advertise yourself as a massage therapist specializing in reduction of painful condition X. Currently there are two massage modalities used for this condition, modality A and modality B. Both A and B have been around a long time, have their proponents, and seem to work, but no one has ever compared them scientifically. You happen to be trained in A.
Several well-designed studies are now performed in which A and B are compared. The findings show that A consistently reduces symptoms by about 15% better than no treatment, whereas B consistently reduces symptoms by about 45% better than no treatment. It's very clear that B is the better modality than A in all important respects.
What do you do now? Keep doing A, in which you were trained? (It does work, after all, just not very well.) Or do you abandon A and take the time, effort, and expense to learn B?
Should modality A even be taught anymore? Should it be abandoned by the profession? -
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Permalink Reply by Jenny Ray on
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I can offer one simple example of current research where resistance is making it difficult to influence our industry. When Geothermal Therapy first reached the massage industry under the brand name of LaStone Therapy 15 years ago little was known about MRSA in the community setting. This sometimes deadly staph infection was considered a confined medical issue with concern only in the surgical realm. New research by the CDC has shown it spreading by what was considered less invasive action....it is now in the community setting such as nursing homes, health clubs and gyms,... and although not yet reported I think it will soon find its way to massage tables and spas.
Clients who have shaved their legs or faces prior to massage, received a waxing, pedicure or manicure are suffering from minor skin lesions too small for visible detection. These lesions are adequate to spread the infection.
LaStone Therapy, often considered the expert ,(it was the first CE provider in our profession so longevity is the factor for this assumption) had a sanitation program designed by a dentist. It suggested cleaning the stones with soap and water bath at the end of the day and using Listerine in the water bath for disinfectant between clients.
Unfortunately, oral bacteria is not related to skin bacteria and the Listerine does little more than smell clean. The entire Geothermal Therapy modality is threatened because it is hard to convince practitioners to change their sanitation systems to those approved by the CDC. The only approved water bath antibacterial agent is a hospital grade antibacterial disinfectant such as MCP. Each stone must receive an alcohol bath between uses and the water should be changed between each client with MCP added. This is more time consuming and more costly than the old approved method. it requires self discipline since there is no regulatory board for sanitation in each state. Unlike the hairdresser who must prove the barbasol is full strength in her comb bath, massage practitioners have no one to see if they clean implements between clients..
We have found a lot of resistance and out right denial among practitioners who are using stones (I would assume this should apply to all massage tools) on the body.
So even when our new research proves or disproves the facts as they are known today, it is the 'change' that is the real challenge.
But that should not stop us from constantly seeking to learn more....
Sandy Fritz said:Again Christopher, you are identifying not only a possiblity but a current reality. Research has shown that reciprocal inhibition is NOT a factor in ability to lenghen soft tissue related to muscle energy methods. When this came to light Dr; Chaitow immediately began to disclose the issue during courses taught even though many of his textbook (and mine) are going to have to rewrite segments based on current information. The current fascia research is explaining some of the benefits of massage but not in ways that we think. Are we as professionals going to seek, support and respond to the research findings. Eventually (and hopefully) many current myths will be exposed. It is beginning now and I have already seen resistance. Change is hard but oh well.
Christopher A. Moyer said:Let's say research suddenly invalidates my primary method (Swedish). If I am attendee at a workshop you were conducting, what would you tell me?
Interesting question. The first thing that occurs to me is that it would be unusual, or maybe even impossible, for research to 'suddenly' invalidate your example of Swedish massage therapy. We would need a series of high-quality studies with consistent null results to reach that conclusion; this is even more true given we already have a fair amount of studies that demonstrate effects from Swedish massage therapy.
Allow me to alter your example a little. Let's say that you advertise yourself as a massage therapist specializing in reduction of painful condition X. Currently there are two massage modalities used for this condition, modality A and modality B. Both A and B have been around a long time, have their proponents, and seem to work, but no one has ever compared them scientifically. You happen to be trained in A.
Several well-designed studies are now performed in which A and B are compared. The findings show that A consistently reduces symptoms by about 15% better than no treatment, whereas B consistently reduces symptoms by about 45% better than no treatment. It's very clear that B is the better modality than A in all important respects.
What do you do now? Keep doing A, in which you were trained? (It does work, after all, just not very well.) Or do you abandon A and take the time, effort, and expense to learn B?
Should modality A even be taught anymore? Should it be abandoned by the profession? -
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I am really enjoying this discussion. Just a couple of general comments and observation. Glen Hymel's name has appeared a couple of times. Dawn mentioned using chapter 2 in the Clinical Massage in the Health Care Setting. She said "I think that chapter is too involved, too heavy on stats, and not an easy read, but it is a point of reference for our students."
Glen's full textbook on research was written a few years ago and the profession was not ready to tackle the -new language, involved processes, stats, heavy reading and so it is not being used as often as it should. I have had a segment in Fundimentals of Therapeutic Massage text on research literacy which included portions of Glen's text for the past 6 ish years. Interestly one on the original sourses was the Girl Scouts approach to the scientific method. The scientific method is very similar in process to a critical thinking process. I have been writing based on a four part critical thinking method imbedded into all of the textbooks for over 10 years. Now here is the point.- even though these textbooks are used in many educational programs this particular content is seldom used even though in Fundimentals it is presented for entry level. My belief is that instructors are passing over this content because they are uncomfortable with it, don't understand it and do not want to look "stupid" in front of student. This belief has been validated in a few instances when in private conversations or in consulting formats individuals disclosed that they indeed were uncomfortable. Now back to Glen's book. Yup, it is complex but if one takes the time to wade through it he did an excellent job present the content in an understandable and at times funny ways. I was a major reviewer for the book and more that once Glen and I had the conversation about keeping it as simple as possible and remove his "Glenisems" such as indeed and aformentioned and there were others. The first part of book is entry level research literacy based, middle is more toward critical analysis and the last part targets how to actually do research. With the book are detailed lesson plans, examples and tests. If anyone has every been able to take one of his workshops he is great and embraces his nerdness. I came up under the mentoring of Dr. Chaitow- a research advocate who insists on relevant and cited content. Not an easy mentor to write with but I have learned tons. During my masters degree completion I had to do a research design class and a statistic class both of which turned my little dyslexic brain inside out and then had to do research of which I biased, had fundimental errors and wanted to pull my hair out. I remember when Chris Moyer presented for the foundation and how Dr Chaitow insisted that I attend his presentation. I was thrilled and really glad he was doing the research and not me. I was not as thrilled as his meta analysis challenged Dr. Field's conclusions about changes in certain neurochemical in response to massage but if our thinking is based on flawed information and we perpetuate the belief that how professional are we? As I continue to ramble here, I have taught for 24years and the hardest thing for students to learn is to use a critically thinking process. In the 3 ed of Fundimentals I added a chapter of 20 case studies that detail (in lots of detail) the process of thinking though assessment to a treatment plan. This is practical application for students and (whine,whine whine) these cases are seldom used. We as educators need to lead which means many need to learn and use the information that is available. Lets admit that we are unsure and learning too and ask students to be part of the teaching learning circle. If we are educators then we should challenge ourselved to absorb the content of Glen's and other's textbook. Bless our collective souls-we owe it to the students since they are the future. We cannot let them be stuck in the past because we are unable to show them how to get to the future and teach them to be there own teachers-research literacy. It is ok if it is hard, confusing and yes frustrating at times. It is ok for students to struggle and yes we will have to present the information in ways that beginners can grasp it. One of my client's little girls, in first grade, explained the scientific method to me based on a project she had to do about freezing and melting water. The PBS show- Sid the Science Kid does research in every show-targeting preschool. If we have to begin the understanding with Dora the Explorer ( all based on critical thinking and problem solving) than thats where we start. I have yet to discover research value in Sponge Bob Square Pants but I am looking since I spend time with my little granddaughter watching this things. I challenge you to watch Sid the Science Kid -- and wade through Glen's Book. -
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Permalink Reply by Vlad on
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Just from an LMTs point of view - Glenn Hymel's book is great.
I've read quite a bit of it and I think it is very well structured, very well laid out and I love the way he dives into studies to discuss and critique each part of them. I love his "Bare Bones" boxes, the way he lays out objectives for the chapters so that you can go back and make sure you've got most of it and to make notes from them or test yourself. It's heavy on terminology, but it explains them very well. His use of charts and diagrams is fab. He has packed a helluva lot of information into quite a short book (for all that it contains). His cartoons are even funny and I don't have a sense of humor (kidding - kind of).
Yep, I'm officially a Hymel fan. Great book. -
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Robin,
Many many thanks for sharing.
I am very grateful for the support you and others are providing.
It has helped tremendously to conceptualize the direction to I need to go.
As I put things on paper (the digital kind), I may ask a few more questions...
Robin Byler Thomas said:Hi Susan,
What you're currently doing sounds great. You might give your students an evaluation at the end of the class and find out what they liked and disliked and ask for suggestions to make the class better.
You asked:
What resource do you use when teaching research?
I was a guest lecturer to this class; not their regular instructor. She asked me to share with them what's happening in the world of MT research, my research experience (finishing a graduate degree) and my massage experience (15 years).
I showed them a power point presentation, from a literature review I'd done the previous semester, which focused on 5 randomized control trials and one longitudinal study. The PP showed them a variety of settings and outcomes and the importance of the outcomes, to not only MT's, but physicians as well. For example, a post-surgery massage reduced patient anxiety and pain and was feasible in a hospital setting; important for high risk patients who have trouble taking pain medications coming out of surgery.
I suggested they first read Martha Brown Menard's articles, posted on the Massage Therapy Foundation website, along with the other articles they have posted on research found here.
Then to read past student case report winners posted here:
I had a copy of Glenn Hymel's book on MT research and suggested to have it as a reference.
The instructor had a take home reading, for each student, of Chris Moyer's Directions and Dilemmas in MT Research, here.
These links were provided as resources for their search:
http://www.ncbi.nlm.nih.gov/pubmed/
MassageTherapyFoundation.org
miami.edu/touchresearch/TRIResearch/massageres
InternetHealthLibrary.com
Massage Therapy Research
ClinicalTrials.gov
http://www.cochrane.org/index.htm
You asked:
What are the criteria for your case studies?
Criteria for the case reports can also be found here.
We didn't have an internet connection the day I was there, otherwise I would have walked them through a pub med search of a student suggested topic. I think that's what they were the most afraid of to start.
BTW, this class was Research Applications for the advanced students. The Research Literacy class was a prerequisite and required to graduate; it was introductory and did not include writing a case report.
Susan G. Salvo said:Robin,
I like the idea of having two classes (literacy and application). I also appreciate your comment about students having a hard time relating to research until you make it relevant to our profession.
That’s why these discussions are so important. Educators need to know what is working.
What resource do you use when teaching research?
What are the criteria for your case studies?
___________________
At our school, we introduce research with the scientific method and then move into massage effects that are researched-based.
Then, as an assignment, students are given two report forms in which they are asked to locate and read two articles on massage or hydrotherapy. Then they are to write at least one new concept from each study they gained from their reading. We go over these in class.
When learning about pathologies, we then discuss the research available on how massage affects pathologies.
Finally, we discuss how research plays a role in treatment planning.
I'm hoping to find ways to improve what we are doing...
Robin Byler Thomas said:BTW, thanks for linking us to your discussion Susan. Does your school touch on research? -
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Anytime Susan; glad to share, and to hear what others see works for students. Thanks for starting this thread.
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