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The Misuse of the Phrase "Evidence-Based" in Course Descriptions
Therapists should be aware that there is a good likelihood that this term has (and will continue to be) used as a marketing tool for course descriptions. I've seen *evidence* of this for at least 3 different courses. One was for for a modality in which the general claims are most definitely not evidence-based. The others were for online courses in which some research articles were referred to which were obviously cherry picked.
I don't want to go into describing what an evidence-based practice is since this has already been covered in other discussions on this site. I suggest that anyone that is unclear about this read this description of it (with attention paid to "Best available research evidence (as determined by critical appraisal)")
What I do want to highlight is that there may be some teachers that are:
- not really aware of what "evidence-based" means
- don't really care what it means
- have their own definition (e.g.I have enough *evidence* in my practice to teach it and therefore I can use that term)
- OK with cherry picking studies and calling a course "evidence-based". This is probably one of the worst things any educator can do.
- use it as a marketing strategy to try to lure therapists who want to be well informed by research in order to improve their therapeutic decision making (in which case, the therapist should be commended, but be aware of what may be happening).
There is a lot of freedom given to teachers within our profession as far as how things can be described and taught, along with what claims can be made. I'm not saying that all or most teachers don't care, but the fact that I've seen courses that are not evidence-based means that at least some are doing this and there will more than likely be more join them.
My advice to any therapist is that if you want to really seek out teachers that are evidence-based, be extra careful when coming across the term in course descriptions. Take a research literacy course and be sure to become well accustomed to be able to seek out the best available evidence for whatever modality (or massage for a specific condition, which we should be doing in our practices anyway - the only problem is that most of us aren't taught to do so) before investing money and time in a class.
Perhaps down the road there will be some mechanism in place that will prevent the use of the term in such a loose way, but if not, then consumers of courses should be extra vigilant.
Cheers.
Views: 250
Replies to This Discussion
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Permalink Reply by Daniel Cohen on
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Vlad, unfortunately in our current society accurate terminology is secondary to putting a spin that sells. It isn't just massage, the food industry and supplements industry are probably the best at using selected facts as they are not intended, to sell product. The government in recent years has played along and failed to enforce deception as fraud.
It seems most people view "evidence based" to mean anything they can show to prove their point. With our "new speak" society I doubt this will change.
It is especially common for any other modality to use research conducted for one modality as evidence of their claims.
Sad but true.
While we tend to feel we are safe because they couldn't say it unless it was true. Truth is the maxim "buyer be aware" has never been truer. Teams of lawyers, psychologists and promotional experts are working against us to undermine our common sense for the sake of marketing.
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Permalink Reply by Laura Allen on
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People need to remember that when someone is trying to sell you something, be it a massage course or some other product, any "evidence" presented on a website or other marketing materials is of course going to be in their favor. And the key as Vlad says is research literacy. People think just because something is on the Internet it's true.
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Permalink Reply by Vlad on
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Yes, the "evidence" presented on websites can be compelling and sometimes deadly. (And before anyone says "that website you listed isn't evidence - it's just a list to a bunch of newspaper articles and stuff" - yeah, you're right. It's kind of interesting though). I bet if it were a site that listed a bunch of cures (with wee stories from newspapers) that a significant number of people would believe what they read much more easily.
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Permalink Reply by Boris Prilutsky on
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Hi Vlad .In general speaking very difficult to disagree with you , but in
particular difficult to agree with you that research literacy can really help
to avoid misleading advertising as well can help to choose beneficial CEs. Both
conventional and not conventional methodologies of treatments is supposedly
evidence-based . Which means , that scientifically/during research
was discovered evidence indicating of possible positive clinical outcome. The
problem is that sometimes this scientifically based theories when start to be massively utilized is not clinically proven as working. On other hand some research protocols and process of conducting this research can be despicable wrong and incompetent but published. Should we
rely on this kind of data? Will in such cases research literature prevent us from false data?
Probably not always . There is a new trend within our industry, with any
article to offer reference and a lot of them. Does this reference make this
articles reliable? Not always. It is a little bit like the wild West.
Many ruling the rules.the matter-of-fact my feeling that you know about how to
use , research literature but also attended few very bad seminars.it looks like
it not always helping.
Traditionally when we using terminology like “evidence based therapy” ,it
means medicine like Chinese medicine. During 5000 years + it evidently survived
because of clinical outcome and even if mechanism not always can be
scientifically explained.
You saying:” There is a lot of freedom given to teachers within our profession
as far as how things can be described and taught, along with what claims can be
made.”
This phenomenon is a very bad one. Agree with you. Have to admit that lucky I am. As a professional I grew up in different much more restricted environment. What you described in your post never could happen. Not a lot of publication was allowed but only in small exclusive circulation but if one publishing then editorial committee wouldn't allow to something like you described to be published. From this perspective it was like at New England Journal of Medicine. I'm not missing Soviet dictatorship, but organization and order in my fields.Best wishes.
Boris
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Traditionally when we using terminology like “evidence based therapy” ,it
means medicine like Chinese medicine. During 5000 years + it evidently survived
because of clinical outcome and even if mechanism not always can be
scientifically explained.I disagree with that. If the term "evidence-based" has been used in this way, then this is an example of it's misuse - i.e. "the evidence comes from it's use for centuries - therefore it has to work". If you look at the initial post above it gives a link to what the term means. If you are saying that the description of it is wrong, then you would have to explain why OR if you're saying that the term *used to mean* (since you're saying traditionally) then you're adding to the confusion. This is an example of where people need to be clear on the correct use of the term.
research literature but also attended few very bad seminars.it looks like it not always helping.
I agree that research literacy courses could possibly be of poor quality. Indeed, one concern is that they could not incorporate crticial thinking skills into them since that would be a vital component in the critical appraisal of research.
On other hand some research protocols and process of conducting this research can be despicable wrong and incompetent but published.
I think that this is an example of why we need research literacy. Critical appraisal is needed. People should be aware that bias will come into play and they should know what mechanisms are used in order to control for biases. Also, when attending courses, they should be able to bring up "What about this research that says ...." and the teachers should be aware of the references (which most are not since they are not taught how to interpret or use research). I could go on an list a lot more reasons why it's needed, but that was not the intention of the original post.
The main intention for it was for people to be aware of what "Evidenced-Based" means and that there is a chance that it will be misused. It shouldn't be.
By the way, Boris. I see you've got a course on "Reflexology is evidence- based clinical foot massage" coming up. "You're a hell of a long way from the pituitary, man".
I'm sure you'll have a full class.
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http://calteches.library.caltech.edu/3043/1/CargoCult.pdf Well written and to the point. Critical thinking is what is needed the most. I think if something appears to benefit it should not be thrown out because we can't prove it.Something is happening even if it is a placebo. The only reason to throw out something effective is if we disprove it and have something more effective to replace it with. On the other hand different people respond to different modalities. So if it works for some who might not respond to the replacement, why not use it for them anyway.
I think the general rule should be to allow unless it causes more harm than good. Isn't that how the Pharmaceutical industry operates? Unless it does more harm than good but makes huge profits.
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Vlad. Thank you for promoting my seminars. It is nice of you. On one thing I can assure you that A) I am teaching only protocols that clinically proven as a working ones. Being it scientifically designed protocols or evidence-based treatments, all of what I teach It clinically proven and for a long time in utilization and by many practitioners, and on thousands professional / competitive ahtlets and as well as for general public. In such a case difficult to get wrong. Too many evidence indicating that working in treatment room. And this is what our occupation about.this is what I am teaching, is to reach results.
You said :” (since you're saying traditionally) then you're adding to the confusion. This is an example of where people need to be clear on the correct use of the term. “
My apology if I confuse you, I hope not other members but if did so then we using our discussion to clarify as much as possible. When I said :” Traditionally when we using terminology like “evidence based therapy” ,it
means medicine like Chinese medicine. During 5000 years + it evidently survived
because of clinical outcome and even if mechanism not always can be
scientifically explained.I meant tradition in scientific clinical society to call evidence-based therapy the therapy that during long time proven clinically working with minimum side effects but cannot be explained scientifically. I hope I did clarify what I meant.
I believe that it could be very helpful for everyone to clarify as much as possible this issue if you would describe three seminars that you have attended, that have attracted you by using “evidence-based” words. I mean please describe ,what topic was presented, why you think that this seminars introduce you to wrong and not useful information and hands-on techniques. Because you have attended three different workshops we will be able to learn a lot. Up front thank you.
Boris.
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Permalink Reply by Noel Norwick on
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Vlad: This is an interesting topic whose presentation appears to be part of an ongoing turf war regarding who will control the future of professional massage practice. I wonder if this is just one more front of contention between those promoting the need for ever more money to be spent by would be massage practitioners on Vocational/College/University and continuing education programs vs targeting current complementary medical research spending into which career massage practitioners appear to be consistently producing client (and the general public's) desired outcomes, specifically what these practitioners do to achieve such outcomes and then developing testable medical hypotheses regarding cause and effect relationships that clinical practitioners can validate or disprove.
Vlad and Bodhi Haraldsson suggest we use the following definition of evidence-based practice; “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." (Sackett, 2000), along with what they allege to be it's three corner stones;
1. "Best available research evidence (as determined by critical appraisal)"
2. "Clinical experience, clinical reasoning"
3. "Practical, patient-centred application"
What I would like Bodhi & Vlad to tell us is what qualification they suggest we consider when deciding if someone is or is not to be presumed competent to:
1. Conduct "critical appraisal" of what massage practitioners do and/or research studies?
2. Claim to have sufficient "clinical experience" to design and perform research studies into the linkages between massage practice and client outcomes?
3. Practice "clinical reasoning" while performing client assessment, planning massage intervention, performing massage, assessing client outcomes, if necessary, planning the next intervention and interacting with clients?
4. Practice "Practical, patient-centered application"?
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what qualification they suggest we consider when deciding if someone is or is not to be presumed competent to
1. Conduct "critical appraisal" of research studies?
It's your own competence that it refers to - not someone elses assessment.
It a therapist is just going to blindly accept someone elses appraisal then they are making a mistake. They need to equip themselves with the skill to make critical appraisals themselves.
As for appraisal of other practitioners, that's something that I don't necessarily do - teachers might, but I'm not a teacher. I continually appraise my own reasoning, trying to keep myself informed. I use research as an information source, which, like all information sources, I should appraise critically. I don't wait on someone saying "This research article carries little weight evidence wise" - I know how to figure it out myself. Also, I'm not going to tell someone else "That research article is junk" - I'll tell them to educate themselves on how to identify junk and *why* it's junk.
That's not to say that things like case studies don't have any merit (even though they carry little evidence). Examining the clinical reasoning done in such studies can be a learning experience and they can provide information that can be useful for further rigorous investigation.
You're waiting on someone saying that *this group of people are the ones qualified to do research and appraise research and these other ones are not*. That is a way of saying that you're waiting on an authority figure coming in to say that. I'm certainly not that authority and I doubt anyone else on here is either.
If they claim to be, it should be questioned.
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if you would describe three seminars that you have attended, that have attracted you by using “evidence-based” words.
I haven't attended any of the seminars in which "evidenced-based" was used in the course description because I thought they were misusing the phrase. When "Evidenced-based Crystal Therapy" starts being advertised on here, you can bet that I won't be attending that either.
That's my point.
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Daniel.Absolutely agree with your post. Critical thinking is necessary in all life prospects including professional. Where is my total disagreement with Vlad’s proposal to differential” good apples from bad apples”. We must to remember that massage therapy in general is scientifically developed as well not scientifically evidence based healing art, where proposed by Vlad “frame” of critical thinking in reality of our industry , will cause harm. In one of the posts Vlad mentioned that I used evidence-based words in promoting my up coming seminar in Las Vegas. Of course would be beneficial for discussion to offer all text . In such a case Every one could find detailed explanation additional to “evidence based”words. I was lucky and as a professional grew up in a much more restricted and controlled by scholars environment, and if this Mongolian doctor was allowed to present to us evidence based procedure then for sure in laboratories he proved to this scholars that it. And no matter if we cannot explain faculty approved his presentation. I believe that at least reading from full text practitioners will understand what I meant. On the other hand Vlad described existing problem that I believe most of us will agree.Vlad also did criticize but in my opinion besides to offering some link with “take it or leave it “definitions of evidence based therapy proposed nothing .
Best wishes.
Boris
Foot Reflexology with Boris Prilutsky
Massage Continuing Education at Northwest Health Careers!
Foot reflexology is evidence-based clinical foot massage.
Chinese medicine includes Chinese massage as well foot reflexology. In principle, foot reflexology is based on beliefs that:
Different areas of the foot will be stimulated by specific techniques that will correspond and have a positive effect on the function of different body parts, including but not limited to internal organs, skeletal muscular system, etc.
Boris has had many years of successfully incorporating foot reflexology with orthopedic massage, stress management massage as well as proposing it as an individual procedure.
After Boris demonstrates you will learn during the first two minutes of observing the foot structure how to create a map and how to choose areas needed for stimulation that correspond with different body components that you target to stimulate, as well as you will learn various hands-on techniques for foot reflexology.
Further discussion and explanations listed below!
COURSE TITLE: Foot Reflexology
LOCATION: Northwest Health Careers, 7398 Smoke Ranch Rd., Las Vegas, NV. 89128 Click Here for driving directions and a map of our location.
DATE and TIME: Saturday, June 25th, 2011. Time: 8 a.m. - 5 p.m.
MASSAGE CE CREDIT: Eight (8) massage CE contact hours with certificate.
TUITION:
SUPPLIES NEEDED: Please bring two (2) bed sheets, personal towel, and lubrication (preferably non-allergenic for all types of skin). Also, please bring a notebook and a writing utensil for note taking.
COURSE DESCRIPTION:
40 years ago at school Boris was introduced to this type of treatment by a Mongolian medical doctor who graduated from a Soviet conventional medical school.
There are many foot reflexology maps out there that show foot zone stimulation in slightly different locations. It would be fair to say that there are hundreds of these maps available on the market which can be pretty confusing. At this seminar Boris will teach you how to choose individual areas for stimulation.
Please keep in mind how similar our feet are, yet they are all different in size and form, including some feet affected with different arthritic and other degenerative changes.
Mongolian and Chinese practitioners for thousands of years considered reflexology and therefore came to the conclusion that no map could be created; yet on each individual foot structure practitioners can choose an area in need of stimulation.
Boris has had many years of successfully incorporating Foot Reflexology with orthopedic massage, stress management massage as well as proposing it as an individual procedure.
After Boris’ theoretical presentation and a hands-on demonstration, most of the time in this seminar you will practice hands on technique with each other, practicing foot reflexology techniques.
Boris has said: "After attending my first presentation on clinical foot massage/foot reflexology I was amazed by the wisdom of creating individual foot maps that only takes two minutes. Lately, utilizing this technique I've been amazed at the results in many different cases including but not limited to, tension headache management, lower back pain, neck and upper back pain, shoulders pain, as well as in cases of internal organ disease."
There are no silver bullets in our occupation, yet foot reflexology is one of the great options we can incorporate in our treatment to assist our clients.
"You will learn during the first two first minutes of observing the foot structure how to create a map and how to choose areas needing stimulation that are corresponding with different body components that you target to stimulate, as well as you will learn various hands-on techniques for Foot reflexology."
Attention: As part of this seminar and as an addition to hands-on techniques Boris will teach you how to incorporate energy work. In Boris' strong opinion each of us have to learn Energy work techniques in order to deliver better results and to protect your self from negative energy influences of clients.
REGISTRATION: Call Kris Kelley at: 702.580.6093 or E-mail at: northwestceu@gmail.com
Daniel Cohen said:
http://calteches.library.caltech.edu/3043/1/CargoCult.pdf Well written and to the point. Critical thinking is what is needed the most. I think if something appears to benefit it should not be thrown out because we can't prove it.Something is happening even if it is a placebo. The only reason to throw out something effective is if we disprove it and have something more effective to replace it with. On the other hand different people respond to different modalities. So if it works for some who might not respond to the replacement, why not use it for them anyway.
I think the general rule should be to allow unless it causes more harm than good. Isn't that how the Pharmaceutical industry operates? Unless it does more harm than good but makes huge profits.
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I'm not going to comment on your post, Boris.
I'm going to wait to see if anyone else does.
If no one has anything to say about it, then I'll not bother posting on this thread anymore.
By the way, I don't have my own *frame* of critical thinking. I'm not in the habit of coming up with my own definition of concepts.
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