Michael Hamm, LMP, CCST
Instructor, Cortiva Institute-Seattle, Seattle, WA, USA.
Research literacy is an essential and growing component in modern massage school curricula(1,2). There is broad agreement across massage schools on the emerging importance of research training, but significant differences remain in depth of focus and methodology(3). This may be due to the wide variety of professional practice settings(4) or to the differences in public perception, legislation, and curriculum length. However, the rise in usage of massage therapy makes interacting with the larger health care world inevitable.
Massage therapy is an increasingly popular form of care used by patients who are often also being treated by a physician for the same condition. Nevertheless, we found that massage therapists and physicians rarely communicated with each other. Possible barriers to communication include our observation that most patients who see both a physician and a massage therapist for a particular condition were not referred to a massage therapist by the physician. Furthermore, many massage therapists are not trained in charting language familiar to physicians(4).
Whether practicing in spa, medical, or private practice settings, a massage school graduate will find the highest expression of their work if given basic literacy in research. To this end, successful research training gives graduates a reliable skill set in four key domains: evaluating research articles; making informed clinical decisions, communicating with other health care providers; and writing their own clinical case reports.
A new research curriculum was launched and applied over six academic quarters, involving five cohorts totaling 87 massage students and five instructors. The curriculum spanned two quarters for each cohort, beginning with a 30-hour general research course and ending with a 30-hour case report seminar. The general course (RCR 150) was developed collaboratively by the directors of education from each Cortiva school. It was designed to be deployed similarly in each school’s curriculum, as a way to synthesize the information and reasoning skills of students with at least 500 hours of prior training. The case report seminar (RCR 240) was developed in Seattle as part of an additional 250-hour academic quarter for those students choosing 1000 total hours of training. The basic learning objectives were laid out in collaboration with the national leadership, and the 10-week structure was designed and codified by the author and Matthew Sorlie, Cortiva Institute-Seattle’s director of education.
The developers of both courses recognized that, even within a 60-hour span, the space for research literacy training was limited. Emphasis was placed on supporting the information from prior anatomy and technique classes and on spurring participatory learning. The supplemental text for both classes was Making Sense of Research by Menard(5), and the content was also informed by guidelines from the Massage Therapy Foundation.
At the end of each course, students completed questionnaires that charted specific dimensions of their classroom experience (e.g., organization of course content) and solicited open-ended verbal feedback. The courses were refined after each iteration based on student feedback and instructors’ experience. The author compiled data from feedback forms and from interviews with instructors.
Both courses in their original formulation were product oriented, in that they focused on the acquisition of static concepts and the creation of written material. The task of the general research course was also to integrate clinical reasoning information, which created a somewhat disjointed syllabus. Instructors initially reported concern about the disparity and dryness of the content, felt themselves unqualified to teach research literacy, and found it a challenge to grade written assignments in a timely manner. This experience was mirrored by the early students: at the outset, students reported a lack of clarity of learning objectives and of practical application in their massage careers. Students in the case report seminar found the course overly stressful and time consuming, and were divided on whether it was a worthwhile. As both courses were refined, instructors strove to make them more process oriented and more in line with students’ personal interests. Class time incorporated more interactive exercises, more real-time research demonstrations, and more student peer review. Instructors compiled a trove of current and/or compelling research studies to use as examples, and simultaneously felt themselves more qualified to teach literature searching. Students in later courses reported feeling well supported in their work and well equipped to make use of research in their massage careers. There was still concern over the disjointed nature of the content in the first course, and still considerable stress around synthesizing a case report. However, students increasingly reported the case report as transformative of their clinical skills. The most notable change occurred in the students’ perception of the importance of massage research: though their personal interest remained highly variable, there was universal agreement that research is a vital and worthwhile part of the massage profession.
Research literacy remains a challenging subject to incorporate into a massage curriculum. The challenge begins with the faculty, who themselves often lack direct experience with searching the literature, evaluating articles, or synthesizing written material(3,6). This dynamic is perpetuated by the lack of a traditional academia in many massage schools—for example, there is often a lack of full-text access to literature, and a culture uncomfortable with critical skepticism. Students remain varied in their initial interest level, and this makes the enthusiasm of their instructor of critical importance.
The following strategies are recommended for instructors and developers of research curricula:
Portray the research world as permeable, interactive, and fast-changing.
Work frequently from real examples, and engage the class in critical evaluation.
Perform live literature searches, and develop new research questions with the class.
Emphasize process over product, and highlight the potential of research courses to transform students’ massage skills.
Do not expect there to be universal interest from students, but do work to channel their particular interests and aspirations.
Create interconnections between research courses and other components of the massage curriculum.
A well-crafted research curriculum has the potential to enliven every aspect of a massage licensing program. In teaching research, instructors can become more expert in finding literature, evaluating evidence, and integrating new information into their teaching. This can create a more dynamic learning environment for students who witness their teachers in the act of discovery.
As the massage profession becomes more integrated with other health care modalities and more used by the general public, the need for research-literate practitioners becomes increasingly important. While significant hurdles remain in implementation, it is both feasible and worthwhile to enfold challenging research curricula into massage schools.
1. Werner R. The massage therapy foundation: Focus on education. Int J Ther Massage Bodywork. 2010; 3(2):1–2.
2. Grant KE, Balletto J, Gowan-Moody D, et al. Steps toward massage therapy guidelines: a first report to the profession. Int J Ther Massage Bodywork. 2008; 1(1)19–36.
3. Menard MB. Letter to the editor. Int J Ther Massage Bodywork. 2009; 2(2):28–29.
4. Sherman KJ, Cherkin DC, Kahn J, et al. A survey of training and practice patterns of massage therapists in two US states. BMC Complement Altern Med. 2005; 5:13.
5. Menard MB. Making sense of research: a guide to research literacy for complementary practitioners. 1st ed. Toronto: Curties-Overzet Publications; 2003.
6. Smith J, Smith D. Letter to the editor. Int J Ther Massage Bodywork. 2009; 2(3):31.
*This expanded article was submitted and presented at the Highlighting Massage Therapy in CIM Research Conference, held May 13–15 in Seattle, WA. For further detail, please see the supplementary powerpoint file that accompanies this abstract. ( Return to Text )
CONFLICT OF INTEREST NOTIFICATION
No financial support or incentive was received in creating this report.
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Published under the CreativeCommons Attribution NonCommercial-NoDerivs 3.0 License.
INTERNATIONAL JOURNAL OF THERAPEUTIC MASSAGE AND BODYWORK, VOLUME 4, NUMBER 2, JUNE 2011