Saturday, April 21, 2012

Knowledge Skills and Attitudes

There has been a lot of discussion about what a massage therapist should be able to do after they graduate from massage school.  While I was responding to  some of these discussions I started thinking about what I expect from graduates at my school -Health Enrichment Center. Yes there is a stepped structure to skill acquisition during learning and this process continues forever however this is a necessary level of competence for the new graduate to be able to make enough money to support themselves.  I think of my own students at graduation.  What is it that I can realistically expect they can do?  At graduation my students have completed 700 contact hours, 350 hours of that is hands on skill development and of that 350 hours they have done about 100 full massage sessions while under school supervision. 
I expect that they are able to perform a client history and basic functional assessment including posture, gait and individual joint movement. Then using that information they should be able to develop an individualized massage application plan that targets one or a combination of the following generalized outcomes - relaxation, stress and mood management, local and general pain management, mobility and functional movement related to activities of daily living and specific activities of the client (i.e. job/sport related).
I expect that they are able to do this in an ethical, professional, safe, respectful, intelligent and compassionate manner. 
 I expect that they work toward specific outcomes of clients that can realistically be achieved through massage application by adapting massage to target neurochemical function both autonomic and somatic, fluid movement (blood lymph) various forms of connective tissues and integral  skeletal, joint and muscle function.
 I also expect that they are able to adapt massage position, location, duration, method use to the unique condition of the client (i.e. medical treatment, age, size, mental state ).
 I expect that they are able to read, determine validity and translate research to massage practice using PubMed, especially targeting met analysis such as Cochrane reports which helps them determine validity.
I expect them to conduct literature research using Med Line plus to learn about individual medications and or conditions relevant to individual clients.
 I expect that they can explain and justify what they are doing during a massage and why they are doing the method.
 I expect that they can provide clients with an effective and pleasurable massage experience that target the whole body primarily,  while also specifically addressing client outcomes. 
I expect that they can perform 20-25 massage sessions of this type each week without hurting themselves.
I expect that they can adapt to multiple work environments from the spa/massage franchise to the sport field to the hospital and all points in between.

I know I expect a lot but these are the criteria necessary to pass the final exam.  I do not expect they remember every bony landmark or the individual names of all the nerves but I do expect they know how to look it up . I do not expect that they feel confident working with a client with multiple complex issues but I do expect they know how to refer and work within a team approach.  I do not expect that they know every pathological condition but I do expect that they know how to ask intelligent questions and find additional information to educate themselves.   So how does this become a description of what a massage therapist needs to be able to do?  I can state for myself that a massage that is worth paying for is provided by a massage therapist who has these skills and any massage educational program that allows for less does the student a disservice, is acting unethically, taking student's and maybe federal money under false pretenses and should not be allowed to continue to teach.  I do not expect that an educational program can do this in 500 contact hours but I do a good job in 700 hours. If I had my way I would like to have double that. As it is now I have an entry level program and an advance program. Michigan state licensing is requiring 500 hours and upon reflection I estimate this would put my students at about mid term still level. -about half baked. I considered creating an entry level program at 500 hours but not going to do it because it is wrong to send graduates out into a professional world without the necessary knowledge, skill and attitudes.  A definition of ethics is doing the right thing at the right time and so that is what I am going to do.
Yup, I expect a lot. I present all the necessary information to be able to achieve the knowledge, skills and attitudes in the two entry level textbooks- Mosby's Fundamentals of Therapeutic Massage and Mosby's Essential Sciences for Therapeutic Massage.  There is no excuse for an educational program to not have a curriculum that prepares the graduates for the real world of professional massage. 
I do have the knowledge and continue to learn, I do have the skills and continue to improve and yes today as I write this I have an attitude!

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