Home-Study Conundrum

Comment

Comment by Erik Dalton on August 15, 2009 at 3:33pm

Excellent comment coming from an excellent "ole-timer". Check out these on-line programs from Michigan State College of Osteopathic Medicine: http://hal.bim.msu.edu/cmeonline/start.html

This program has been around for a decade. I took it when I was going to school there in 1998. Best learning experience of my life....thx Doug~Erik

Comment by Doug Alexander on August 15, 2009 at 3:22pm

Thanks for opening up this issue, Erik! I'm a firm believer that good massage theray is more than a good massage, but often includes one.

I have denied massage therapy care for two clients on the basis of academic knowledge and their clinical presentations. The first client was complaining of right calf pain that he (and his chiropractor) wanted me to firmly wring out. Orthopedic assessment revealed that the "tight" calf was actually longer than the "normal" calf in both his gastrocnemius and soleus muscles. I palpated his calves carefully and I couldn't find higher tone in the tight feeling side than the more normal one. I suggested that he seek further evaluation from his doctor, since the feeling of tightness wasn't of a myofascial origin. It is not up to me to state that he might have deep vein thrombosis, but I is up to me to know when I'm treading water where I don't belong.

In another case, I refused to massage a doctor (in hospital) who had given birth a day before by cesarian. She adamantly maintained that she had strained her sartorius muscle. The sartorius overlies the femoral nerve, artery and vein. Due to the surgery, which activates clotting factors systemically and the bed rest that she was on, it was certainly a possibility that she had deep vein thrombosis of her femoral vein (a not uncommon complication of pregnancy). Since we were in the hospital I suggested that she need to have her vasculature cleared by ultrasound. She refused and I refused to treat her. Thankfully, my supervisor (a physiotherapist/massage therapist) stood with me on this issue, stating that safety may be more important than client satisfaction sometimes.

In both of these situations, the provision of safe massage therapy relied on knowledge more than hands on skills and ... all of this knowledge could readily be taught in a home-study and/or online form.

Similarly, we may be facing a swine flu pandemic this fall if the virus undergoes an antigenic shift. Knowing what an antigenic shift is versus an antigenic drift makes us knowledgeable health care professionals. And we can learn about this and the various plans of government health agencies by reading and being tested on this information.

So I feel that there is no end to the very important knowledge that can be learnt in homestudy programs and online.

And it doesn't stop with cognitive knowledge. I recently heard from a group of yoga instructors in India that have learnt how to recruit their transversus abdominus and multifidus muscles via an online traing program I offer. I have similarly heard from a tmj sufferer a thousand miles away from where I practice who learnt how to quiet her tmj hypermobility problem through simple but precise exercise and changed body use habits.

It is time that massage therapists free themselves from the idea that we are valuable per-square-inch rubbed or per kilocalorie of energy we expend on our clients. We have a unique knowledgebase that reflects itself in how we interact with clients, seek information from them and interpret that information. The somatic expression of our knowledge and caring in our hands-on care is truly precious and important; in fact vital. But, some of that can be taught or extended through home-study and/or online training.

Hands on skills are often taught face to face, but I can't imagine the number of times I've craned my head and neck around in a seminar to see more clearly (or at all) the manipulation being demonstrated. With video clips of key hands-on performances one gets a front-row seat (and can review the performance as many times as they like).

While it is true that some techniques really need to be felt to be replicated, this is frequently over-emphasized. If a therapist has a good repetoire of techniques, then video instruction is often sufficient to help them see how fundamental techniques can be applied in new regions or in new ways. For many of us, our visual sense is closely tied in with our kinesthetic sense, so we often "feel" when we watch video.

All that being said, I can still feel the hands of many masterful therapists that touched me over the last 20 years. I have learnt so many important things somatically by being touched and by touching others. However, the assertion that practical skills can ONLY be learnt in a face-to-face setting is patently not true.

Wow, I guess I have been storing that up for a while! Thanks for listening. I look forward to everyone's point of view on this!

Doug

Comment by Erik Dalton on August 15, 2009 at 3:17pm

In addition to Tom Myers, Art Riggs and Whitney Lowe, Cliff Korn has also been instrumental in reporting on the plight of NCBTMB's home-study ruling. In fact, in the April, 2007 edition of Massage Today, Cliff was the first to report on NCBTMB's shocking announcement. Please visit this link and read half way down the page: http://www.massagetoday.com/mpacms/mt/article.php?id=13576

Comment by Carl W. Brown on August 14, 2009 at 5:57pm

Before we can answer the question we need to understand the purpose of CEs. They are designed to insure that a professional stays current with skills and knowledge to perform that job properly. For example do you want to use a CPA who last studied the tax law in 1986? No because the tax law has changed in ways that are essential to giving beneficial advise.

We first have to ask ourselves what changes in the massage profession that is essential to the wellbeing of our clients. Then we can see if home study or hands on teaching can teach it properly. If the only purpose of CEs to insure that peole are continuing to get some sort of educations on an ongoing bases then neither the content or form is important.

Currently I am working on combining EBT and emphatic perception and don’t know how right-brained thinking and learning fits into the educational picture. I think the problem is broader that video or not. How to I learn and of do you test extra-rational work? Or in the case of EBT which I think is more of an attitude and discipline.

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