There are some real obstacles for massage therapy education
such as:
WE DO NOT HAVE AN AGREED UPON ENTRY LEVEL SET OF COMPENTENCIES
AND CURRICULIUM CONTENT AND YES I AM YELLING!
We do have
an excellent start however in the competencies developed by the Commission on
Massage Training and Accreditation and the Massage Therapy Body of Knowledge. The ELAP (Entry Level Analysis Project) is
also supposed to address this issue. In
the meantime educators in the massage community continue to make individual
best guesses about what people need to know and be able to do to be considered
massage therapists. Obviously this is a frustrating
issue for many and it is no secret that I personally am frustrated with the
lack of progress from my peers about laying this foundation, however this is not the topic of this
blog. Ha.
My last blog was about the evolution of the textbook into multidimensional
learning systems. I have had questions
and comments about the blog. This
combined with the many discussion found on the web has prompted me to expand on
this topic.
Being a massage school owner and education almost 30 years
now has made me continue to learn.
Writing textbooks has also made me explore learning theory. I doubt that
many who use my textbooks realize just how much research has gone into how the
information is presented.
First is the audience- Adult learners regardless if they are
baby boomers, generation X or Y or whatever -Adult learners want relevance or:
• Why am I learning this?
• Don’t waste my time?
• What’s in it for me?
In other words, adults will be motivated to learn when they
experience value in the process. They want quality because they are paying for
it. There is a reason/outcome for the learning
as opposed to having to be in school like k-12.
Adults choose to learn.
When I am considering content for a textbook one of the
first questions I ask myself is “What does this information have to do with
actually giving a massage that a client will feel is worth paying for?” This
means that the information in some way is going to help the massage application
be beneficial and not harmful. We all
have had school experiences where the content seemed stupid and have little or no
relevance. Certainly this statement needs
to be qualified based on usage. I recall
having to learn math in K-12 even if I did not actually experience the relevance
until I had to balance a checkbook (do we even have check books anymore?) or sort out statistical meaning in massage
related research. When I am teaching I
will say to students, “Yes you need to know this even though the relevance is
not obvious just yet.” Medical
terminology can sometimes fall into this realm.
I give examples and provide activities that show them the
relevance. In my science text- Mosby’s
Essential Sciences for Therapeutic
Massage-I have practical application boxes strategically place so the
learning knows they will actually use the information they are learning about.
Another process I use in the textbooks is spiral learning
theory and novel repetition. In it’s most basic explanation, spiral learning is
just introducing a topic, touching on it for a short time and then moving on
knowing the content will appear again and again. The premise is that a subject
isn’t learned the first time around and the student can pick up more
information the second third and fourth time. With each learning session, the
student will expand on their skill level and build new understanding. The key
is that each time the content is presented it needs to be presented in a novel
way (different but similar) and with relevance based on the skill set of the
student at the time. For example: The beginning
student will need to know the basics of scientific language and then progress
to using that information to break down work meanings as they read, progressing
to using terms to complete charting and so forth.
Spiral learning is
not a new model of learning and it is especially effective in skill building or
developing competencies. This type of learning can be messy but that is
a good thing. It is harder to develop curriculum
and courses within the curriculum because each part must related to the other
courses. It is much more like playing
with Legos than coloring a picture in a coloring book
I am personally not a
fan of linear or mastery learning methods (coloring book). The linear/mastery
learning model suggest that students learn in a sequential way – they must
master a topic before moving on to the next. The topic will not be “revisited”
as in the spiral learning method.
Often there is a combination. Draping during massage is an example. It is helpful in the beginning for the
student to learn a way to drape. I will
drill in a method until they can do it without being nervous about doing it
right. At the same time I know that draping adaptation is going to show up over
and over through the program. This allows the students to be refreshed in the
key concepts and at the same time expand skills.
I did not create the spiral learning concept. Jerome Bruner put
those pieces together. Jerome S. Bruner (1915- ) is one of the best known and
influential psychologists of the twentieth century. Bruner's model of the
spiral curriculum is an element of educational philosophy suggesting that students
should continually return to basic ideas as new subjects and concepts are added
over the course of a curriculum. The idea behind the method is for students
really to learn, rather than simply memorizing to pass a test. In simpler terms, one learns best through the
repeated experience of a concept. Over the course of development, behaviors and
pieces of knowledge are reinforced by outcomes. The important part of this is
that the information needs to be repeated in novel forms that evolve as the
student evolves.
To learn more check out these reference links: http://www.instructionaldesign.org/theories/constructivist.html
www.infed.org
The spiral approach is a technique often used in teaching or
textbooks where first the basic facts of a subject are learned, without
worrying about details. For example; instead of learning the individual names
of all the muscles that flex the elbow-learn first that the groups are called
elbow flexors. Then as learning
progresses, more and more details are introduced, while at the same time they
are related to the basics which are reemphasized many times to help enter them
into long-term memory. The spiral
learning concept support current discussion on Facebook about the “flipped
classroom” where the emphasis is less on what the teacher has to say especially
in lecture and more about what the students can discover.
I use the spiral model as I create textbooks. Sometimes reviews I get about the books
question the repetition however the spiraled repetition is the point. While the textbooks I write can be used for
individual classes successfully, the imbedded spiral learning is less successful
than when the books are the platform for the curriculum and each chapter is a “course
book”. I think educators make a big
mistake by giving entry level students too many textbooks. It is confusing.
Following is the table of contents from the 5th edition of Mosby’s Fundamentals
of Therapeutic Massage with notation about the imbedded spiral for learning.
Chapter 1 Therapeutic
Massage as a Profession
This is the big picture which briefly presents the need for
knowledge and the relevance for practice
Chapter 2 Ethics,
Professionalism, and Legal Issues
This chapter loops back (spiral) to pick up on the concept
of a service profession and the structure of professional behavior. Critical
thinking and Clinical reasoning is introduced
Chapter 3 Business
Considerations for a Career in Therapeutic Massage
Now the information from chapters 1 and 2 is looped again
but with a very practical practice building outcome—relevance and the critical thinking
process is used for decision about practice building and management.
Chapter 4 Massage
and Medical Terminology for Professional Record Keeping
This chapter introduces the idea of scientific basis of
massage and immediately relates nuts and bolts content to relevance for
documentation. Critical thinking spirals
into how documentation is completed.
Chapter 5 Research
Literacy and Evidence-Based Practice
Chapter five spirals back into content from chapter 1-2-3
and challenge the student to use the content from chapter 4 to read and
analysis the research. The research is
presented in terms of outcomes for massage which loops back to the marketing of
massage or what does the client want and what will they pay for. Critical thinking and Clinical reasoning
spirals into the scientific model and the analysis of research.
Chapter 6 Indications
and Contraindications for Therapeutic Massage
This chapter spirals through all the information of previous
chapters in the novel repetition format that expand on the foundation set
for outcome based massage application
and treatment plan development .
Chapter 7 Hygiene,
Sanitation, and Safety
The nuts and bolts of this chapter are absorbed because the student
understands the relevance based on previous chapters.
Chapter 8 Body
Mechanics
This chapter involves the doing of massage, spiraling into
the concepts of career longevity, adaptation, safe practice and method
application. It also presents ergonomic and biomechanical research to support
methods being taught reviewing previous content.
Chapter 9 Preparation
for Massage: Equipment, Professional Environment, Positioning, and Draping
This nuts and bolts chapter also reviews (spirals) back
through the first 3 chapters based on respect and care of the client
establishing relevance and practical application.
Chapter 10 Massage
Manipulations and Techniques
A nuts and bolts chapter that loops back into all of the research,
indications and contraindications as well as critical thinking and clinical
reasoning of the previous content.
Chapter 11 Assessment
Procedures for Developing a Care/Treatment Plan
Again this chapter, by teaching assessment, reinforces critical
thinking, clinical reasoning, and the importance of research, client expectations
and experience. The end result is the
foundation for individualized massage application based on client outcomes that
can be justified and documented within a multi -disciplinary heath profession.
Chapter 12 Complementary
Bodywork Systems
Building on all previous content this chapter presents
bodywork methods that are typically part of the massage approach but called different
names and presented as unique systems.
Additionally ,true adjunct methods such as hydrotherapy review the importance
of relevance, research, safety and documentation
Chapter 13 Massage
Career Tracks and Practice Settings
This chapter loops all previous content in the platform of
where the learner wants to practice massage and how massage is framed in the
various practice settings.
Chapter 14 Adaptive
Massage
Again Adaptive massage is the same material from previous
chapters in the novel presentation of clusters of populations and the individual
adaption of professional integration, assessment, treatment planning,
justification and massage application.
Chapter 15 Wellness
Education
Building on massage as part of the larger system of health
and wellness this chapter loops back through the textbook content by indicating
that massage is supportive of and supported by a broader scope of experience.
Chapter 16 Case
Studies
This chapter presents 20 stories and pulls it all together
in a final spiraling process toward competence.
Hopefully those reading this blog can identify the broader
based of a well-designed textbook as more of a learning experiences than an efficient
collection of facts. This is hard to do
and take time and a team of developers.
Not just me.
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