We are all biased.
Knowing this we can work really hard to remain open to information and
do our very best to identify bias, acknowledge it and sometimes move beyond it. The scientific method is a process that
attempts to limit bias.
A conflict of interest is a situation where an organization
or individual is involved in multiple interests that might influence the
ability to be objective. I have
conflicts of interest that have impact on what I choose to do or not do within
the massage profession. Because I write
textbooks used to teach both entry level and advanced practice massage I
refrain from organizational board service and instead contribute behind the
scenes on committees or as a subject matter expert. Before I agree to be involved I question my
biases and disclose my conflicts of interest.
With my textbook writing the publisher requires all my work to undergo
extensive peer review that is blinded so individuals can be frank with their
observation and opinions. For last
revision of Fundamentals of Therapeutic Massage I had 17 reviewers and let me
tell you they had no problem telling me about errors, bias, when I was on a “soap
box” and so forth. I depend on this so
that the textbooks are as current and objectively reflective of the massage
profession at the time of publication as possible. However—in spite of all the checks and
balances there are still biases and opinions found in the textbooks— not just mine
but in textbooks in general.
There are two projects that have or are attempting to
describe entry level massage therapy.
The Massage Therapy Body of Knowledge (MTBOK) released in 2010 and
currently the Entry Level Analysis Project (ELAP). As the massage therapy community, we must
analysis for bias and conflict of interest.
To do this we need clear disclosure from all individuals directly
involved with supervision, data collection and interpretation and project
management.
I strongly encourage you to revisit the MTBOK document at
MTBOK.org and specifically read through the vision and information provided in
the FAQ tab. Personally---( and I am biased)
I thought the outcome of the MTBOK was
good in relationship to how entry level knowledge was described and how
a common language used to describe massage was developed. The content was developed
by mining through textbooks used in massage therapy schools all over the
country as well as data from professional organization and state regulators.
There were no surveys or original data collected to my knowledge. There was
opportunity for comment by the massage community. Most of the conflict and push back from the
profession related to the scope of practice statement so I just ignored that (
bias) and concentrated on the knowledge, skills and abilities identified for
entry level massage education. The Alliance
for Massage Therapy Education (aftme.org) did a comprehensive review of the MTBOK entry
level educational recommendations and I served on that committee and we all had our biases which hopefully
evened out the end result, which was reviewed by the Alliance board and then
went out for public comment and remains on the website for review. . I am biased but it is a very good guide for curriculum
development.
I repeatedly recommended
that an objective group of educational experts outside of the massage
profession guide the project. I thought that if the project was conducted in
a specific way that controlled for bias using individuals outside the massage
community, but experts in education, there would be a more accurate outcome and
less suspicion from the massage community.
I suggested that the MTBOK also be part of the data as well as other
information from the various JTA’s (job task analyses.)
My biased little self-
became a pest I think as I pointed out the problems of bias and conflict of
interest. When the original survey came out
(as an add on to the Federation of State Massage Boards JTA relating to the
MBLEX ) I felt uneasy with the way many of
the questions were designed. As I have pointed out before- Swedish massage was
the ONLY term presented for the concept of general relaxation massage. Also it was hard enough to get through the JTA
survey let alone the ELAP add on. I communicated with the work group and the
leadership group about this in my typical pesky biased manner.
Research bias, also called experimenter bias, is a process
where the individuals performing the research influence the results, in order
to portray a certain outcome. (explorable.com/research-bias) . Bias is so
pervasive because we want to confirm our beliefs and the scientific methods are organized around proving itself wrong not
right in an attempt to limit bias.
In my opinion the
ELAP survey process was and continues to be flawed and displayed the following
forms of research bias:
·
Confirmation Bias is the tendency for us to favor
information that confirms our belief about something.
·
Design bias is introduced NOT when the study fails
to control for threats to internal and external validity but rather when the study fails to identify
the validity problems OR when publicity about the research fails to incorporate
the researchers cautions.
·
Measurement bias exists when researchers fails
to control for the effects of data collection and measurement. Often the
problem is not the sample, it's the failure to acknowledge the bias the sample
brings.
·
Procedural bias exists most often when we
administer the research interview or questionnaire under adverse conditions (
the multiple surveys as part of the ELAP as well as not being able to go back
and review content or seeing the project as a whole and or in paper form plus
the videos can be seen as procedural bias in my biased opinion.
·
Bias via assumptions is the failure to
adequately identify more problematic background assumptions. For example, in
the ELAP document there is the assumption that the content is presented by an
effective teacher. There are other imbedded
assumptions in the questions on the surveys.
·
Bias in Survey Sampling: Bias often occurs when
the survey sample does not accurately represent the population. The bias that
results from an unrepresentative sample is called selection bias. A good sample
is representative. This means that each sample point represents the attributes
of a known number of population elements. I contend that The ELAP survey
respondents are not representative of the massage community.
·
Voluntary response bias. Voluntary response bias
occurs when sample members are self-selected volunteers, as in voluntary
samples. The ELAP has problems with this
type of bias. The resulting sample tends to over represent individuals who have
strong opinions. LIKE ME
·
Bias Due to Measurement Error. In survey
research, the measurement process includes the environment in which the survey
is conducted, the way that questions are asked, and the state of the survey
respondents and leading questions. The wording of the question may be loaded in
some way to unduly favor one response over another. I have no idea how the original survey and the
current one on the curriculum map was developed or how they controlled for
bias.
I would hate to see the work of the ELAP group discounted.
To counter this I recommend that the ELAP process be evaluated by experts outside
the massage profession that can identify the inherent biases that have and will
occur. This recommendation in no way
reflects of the integrity and the commitment of the ELAP work group. My bias is that the massage profession is biased,
suspicious and frustrated with projects such as this. For the ELAP project to be useful for the
future of massage therapy it must be valid and if the unintentional biases and
conflicts of interest taint the project it will sit on the shelf along with the
MTBOK and that will be very unfortunate. – My biased opinion.
Bias definitions adapted
from http://stattrek.com/survey-research/survey-bias.aspx
So I did find were the group used an outside consultant ,Donna Tatum. She worked on the MBLEX fit the Federation.I would like to know more about the ext ed by of her involvement.
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