Massage Therapy Body of Knowledge

Comment

Comment by Bert Davich on October 28, 2009 at 7:36pm

Oh, and I would like to add that I believe that functionality and portability share a direct relationship so far as most working therapist's are concerned.

If I am mistaken, I would like to hear from anyone who has an alternate view regarding this relationship

Comment by Bert Davich on October 28, 2009 at 7:31pm

Mike,
I agree with your comment that Carl's proposal would create more, not less educational requirements.

For example how would you handle KSA's and educational requirements for modalities that use common techniques like cross fiber friction, cross fiber stretching, ROM stretching, traction, compression...... and on and on. This looks to me like a quagmire of title acts and educational requirements, not like a bridge to portability that I believe most of us desire.

Comment by Bert Davich on October 28, 2009 at 6:48pm

Carl,
While I believe that some changes are needed in the BOK, the undertaking you are suggesting seems to be about 'specialty' title acts. Although I did not see it in the beginning, I have come to see the BOK as an entry level basic understanding to perform touch therapy.

I do believe the BOK should clarify the level of understanding expected rather than state knowledge of a specific nature with no limitations on the degree of understanding. This also seems like a relatively simple tweak.
EXAMPLE:
Line 375:
Competency Requirements for a Massage Therapist in Terms of
Knowledge, Skills and Abilities (KSA)
Line 377:
Section 210 Entry Level Massage Therapist KSAs
Knowledge, skills and abilities relating to anatomic structures and their locations along with their functions, interactions and relative medical terminology.

This could be tweaked to read "pass a competency exam testing......."
OR "have a BASIC understanding of....."
OR "shall have training in....."

This would address the lawsuit problem inherent in the assumption that everything known about the specific A&P or other area should be known by the therapist, which we all know is not the case for any of us, but would be assumed by any attorney bringing a lawsuit.

I would also strike 'modality' in line 768 leaving 'appropriate treatment'
Line 768
Assessment
• Process/methods of assessing and reassessing the status of the client/patient using standard techniques and documentation strategies to determine appropriate modality treatment.

The research article, Development of a Taxonomy to Describe Massage Treatment allows a method of clarifying what is or is not touch or massage therapy without defining titles or modalities. The techniques described provide treatment definition irrespective of modality. This is a formula for portability. I will stipulate that there are some missing elements that were proscribed or omitted. These can be appended fairly easily. The KSA's you advocate for any particular modality title can also be appended when someone (maybe you) researches the evidenced based information and proposes a solution based on that research. If we wait for that to happen, we will miss the opportunity to create a platform from which we can work toward portability.

Arguing educational standards and the concept of KSA's at this point really is putting the kart before the horse. I suggest that you research and propose the KSA's for any modality you have in mind rather than just re-iterating your position, which I respect, but is in a stalemate due to lack of an evidenced based proposal for KSA's.

Comment by Mike Hinkle on October 28, 2009 at 6:11pm

Carl, the differences between massage therapists and body workers comes no where near the differences between Italian art historians and chemists, nice try.

Carl, agaain you say "master" and you are the only one saying it. Your determination of something "not being a standard", will not stop what the BOK declare are standards. The BOK will determine what entry levels are needed.

Carl, you have seen the first draft and made your comments to the BOK. Chip Hines has said, changes are being made and you still are stuck at the beginning. The first draft was a great beginning to the BOK. There are no specific KSAs set yet so your issue, to this point is mute. I know you want a finished product, right off the bat, but there are two drafts to go.

You KSAs, in my opinion will increase the hours and do anything but "streamline" the process. It will costs more and take more hours.

The industry stakeholders, (ABMP, AMTA, Council of Schools, FSMTB, NCBTMB and Massage Therapy Foundation) Carl, are not taking this effort on, to hurt this profession. You can keep throwing out this inuendo. It does little to prove any valid opinion.

Comment by Carl W. Brown on October 28, 2009 at 4:53pm

Mike, I believe that realistic standards will in fact help unite an otherwise divided industry in terms of improving the quality and diversity of what we do. It is a win-win situation. But believing that we can design a single standard for education for Italian art historians and chemists makes no sense. Defining KSAs but leaving it open as to where you really need to master them and if so, how well, is not setting a standard. Designing a standard that does not correspond to actual performance in the field is worthless. The whole point of a BOK standard is to model education to produce optimal results with the least cost and effort. Don’t teach too little or too much and make sure that the essential skill levels are met.

What I see in the first draft is not a BOK but a list of skills that may or may not relate to a specific therapist’s needs or how they will eventually practice. A true BOK is like a check list that a person can use to see if they missed something or need additional training to meet the proposed standards. Going down this list one has no idea if the specific KSA is relevant or not.

There is a big advantage to streamlining education and it is not just cost and time but students get a better idea of what is important and are not distracted by nonessential training. The better the focus the better the quality.

I agree with Keith that we need a BOK that is useful and functional. If not it will only hurt the industry.

Comment by Greg Jones on October 28, 2009 at 4:33pm

Hi Stephen, I don't think your questions are inappropriate at all.

What does the student have by way of direct comparision of the 1 to 12 questions they are being grilled on?

There are over 20 statements they can comment to if they choose, I only included a partial list to spar everyone. I guess the direct comparison would be their past educational experiences. I'm not sure grilled would accurately reflect the process which is meant to enhance the educational experience based on the students input while it is fresh in their minds. It is the instructors review on their performance from the eyes of the student which I find very enlightening and use to improve my skills as an educator.

Does this enhance the education experience of the instructor or additionaly burden?

Yes, I think it does enhance the educational experience for the instructor by pointing out areas that need improvement. After all it isn't what the instructor thinks about the experience that counts, but rather the students perception. It usually takes only about 30 minutes, so I don't see it as a burden.

It just doesn't sound like this system is based on a foundation of trust?

I don't think it is based on trust, it's based on performance. I'm not sure where trust would come into this process at all. We are a community college so who better to judge how we are performing than the students.

Is this a typical modern setup?

I can't speak to wether this is a modern setup. All I know is that all ten campuses use a similar process. All the classes at the college I'm at participate and we get a report showing our performance compared to the entire institution plus the comments that are specific to the prefix we are teaching. I'm sure this was designed as a report for the colleges accreditation also.

Comment by Mike Hinkle on October 28, 2009 at 2:59pm

I accept all valid diagreement but when some have verbally set their intention to divide and conquer, I do not accept their premise. I do believe your intention is to help create a valid BOK. We disagree about how to do that. The research that some are saying has to be in the BOK is not available at the juncture and I do not believe we should hold off this effort until it is available. These "living documents" are adaptable and changeable. Apeendixes can be added and the effort is going forward. But if those in opposition continue to press, I am up to that as well. What you may deem "simplistic", I deem as determination.

The initial BOK will be functional and not simply a "show piece". That is the attitude I have seen thus far and reviewing the therapists choosen to lead this effort, I believe they deserve more. They are contractly bound from speaking and I am not. I will match the tone presented. Very little valid disagreement has been presented other than by you, and I will not abide and sit by as this effort is thwarted.

Comment by Stephen Jeffrey on October 28, 2009 at 2:58pm

Hi Greg, it all sounds a little over the top to me.

This is conducted by a volunteer student and both me and my teaching assistant are not allowed in the room and the volunteer drops the questioner off at the adminastration building in order to get honest feedback.

What does the student have by way of direct comparision of the 1 to 12 questions they are being grilled on?

Does this enhance the education experience of the instructor or additionaly burden?

It just doesn't sound like this system is based on a foundation of trust?

Is this a typical modern setup?

Sorry if my questions seem inappropiate.

Steve

Comment by Keith Eric Grant on October 28, 2009 at 2:44pm

Mike,

I don't see this attribution of intent as being helpful to discussion. At the least, it's far too simplistic. At the worst, it perpetuates an "us" versus "them" worldview that inhibits serious discussion (or at least the listening thereto) of methodology and timescales.

Edzard Ernst was correct in stating that "An uncritical scientist is a contradiction in terms". Critical review, deep discussion, and disagreements are part and parcel of the academic and medical worlds into which massage therapy is entering. It is part of the process of evolving thought and improvement.

Whether or not one separates actual documents is largely a matter of booking. What is more important to me is that, to some resolution, the clustering and structure of knowledge is captured. It is also quite relevant, in my belief, that in defining knowledge we take as tangible a view as was done in the BC profile in terms of objective definition, competencies, and co-morbidities. If, for example, you have no objective basis for something claimed to be knowledge, there is little you can say about negligent practice, omission of treatment indicated, adjustments of practice for existing co-morbidities, indications/trade-offs to treat specific conditions, and what is necessary/unnecessary for adequate competence.

I am not adverse to a body of knowledge, but I want to see one that is functional, not simply put in place to have a show piece. I am also, repeatedly, more than a little dismayed at the simplistic and adversarial tone you keep broadcasting. I got into serious discussions of massage education and regulation over 17 years ago, in large part because I don't well abide such dismissal of disagreement by vilification or attaching of credibility. I am not about to start abiding it at this point. If you want to play in an evidence-based world of health care, then you'll have to get used to the concept of valid disagreement.

Comment by Mike Hinkle on October 28, 2009 at 2:05pm

Hi Bert,

The ones trying to separate these modalities in the BOK (and create a separate BOK foe every modality) are largely the same ones trying to stop the BOK. That speaks volumes. They will fail at both. Separating them will cause confusion to try and stop this effort, that is their ultimate goal. And they will continue to say this is best. It isn't.

You are absolutely correct, it would NOT be in our best interest!

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