Becca Torns-Barker, LMT, BCTMB, MEd1*, Ann Blair Kennedy, LMT, BCTMB, DrPH2
1Massage Therapy Department, Asnuntuck Community College, Enfield, CT, USA
2School of Medicine Greenville, University of South Carolina, Greenville, SC, USA
Massage therapy education processes, practices, and research are rarely described in the scientific literature, and the Covid-19 pandemic may have caused dramatic shifts in how massage therapists were being educated. To date, findings of the impact of the pandemic pivot on massage therapy education have yet to be reported. This editorial explores the trends in hands-on education of other professions during the pandemic and relates these trends to massage therapy education. Currently, it is unknown how institutions supported massage therapy educators in preparation for the shift to online and hybrid learning.
KEYWORDS: massage therapy education, distance education, Covid-19, faculty, technology, curriculum
Prior to the COVID-19 pandemic that caused most educational institutions to move learning online, massage therapy classes were primarily taught in person. In 2019 prior to the pandemic, only 14% of schools offered online entry-level courses, which was 5% lower than the previous year.(1) Not much has changed since a decade ago when researchers noted that massage therapy educators and schools were slow to adopt online teaching technologies, and that massage therapy educators could not see the relevance of online course design and delivery in the massage therapy field.(2,3) Compared to data from the Education Department’s National Center for Education, statistics show, pre-COVID, that approximately one-third (37%) of students enrolled in fall 2019 took online courses.(4) However, because of COVID, more massage therapy programs moved classes online; nearly half, according to the American Massage Therapy Association (AMTA) 2021 Massage Profession Research Report.(5) Kim et al. noted that COVID-19 required universities, instructors, and students to move to an online educational environment without the needed preparation, planning, or training.(6) It is unclear if online offerings will remain in place in massage therapy education as the global pandemic moves into an endemic period. There exists a distinct lack of research evaluating massage therapy education, particularly related to online and blended learning and andragogical theories. This editorial will explore the trends in hands-on education during the pandemic, specifically the move to hybrid or online learning, and the preparation of educators to deliver course material in this format.
To create a more complete look at how COVID-19 has impacted other hands-on professions, a comparison to physical therapy, as well as nursing education, was undertaken. Similar to massage therapy, physical therapy and nursing involve hands-on, manual therapies. Physical therapy and nursing similarly require critical decision-making skills that can impact a person’s health. Like massage therapy education, physical therapy and nursing education encompass theoretical and practical education. Both professions have traditionally been taught in-person, from lectures to labs to clinical experience.(6–10) Blackinton reported that 90% of physical therapy instruction was face-to-face prior to the pandemic.(9)
With the pandemic, however, in both physical therapy and nursing, it was reported that education content that was typically delivered face-to-face or hybrid went fully online, and the face-to-face course content had to be quickly adapted to online delivery.(6,9,11–13) In fact, 91% of physical therapy programs reported that the Covid-19 pandemic required them to remove their students from the clinical environment or resulted in students being unable to begin their clinical rotations.(12) In addition, of those surveyed, 73% of National Nurses Associations (NNA) reported that undergraduate nursing programs were interrupted by COVID-19.(14) However, more than half (57%) of NNAs reported that COVID-19 had a positive effect on nursing education, with the biggest gains found in the adoption of online learning (International Council of Nurses, 2021).(14)
This move to online education also means educators were quickly making adjustments to accommodate that shift. Unfortunately, many faculty members lack experience with online course design and delivery.(15) This problem was not unique to massage therapy education. In physical therapy education, it was noted that at the program level, there was no scientific literature documenting online, blended, or hybrid physical therapy education.(12) The lack of educational technology use and online delivery of massage therapy education was discussed more than a decade ago(3) and continues to be reported.(10) Furthermore, faculty lack appropriate levels of technical support and theory needed for online teaching.(16) In physical therapy education, Gagnon et al. stated that the pandemic required a quick pivot to hybrid or online learning with minimal to non-existent time to train faculty in technology or online pedagogy.(12) In nursing education, Morin described how faculty were offering online courses without well-considered, reliable, and reproducible plans.(17) For the massage therapy profession, the reluctance to adopt online education prior to the pandemic could be because many massage therapy educators feel that the hands-on nature of the profession is paramount and, therefore, the required instruction disallows for learning in an online environment.(2,3,10)
While other health professional programs have been actively reporting on the educational pandemic pivot, we could find no current research that evaluates this shift to online learning for massage therapy education. Although the IJTMB has twice called for submissions of pandemic massage education papers, currently none have been submitted.(18,19) Research is specifically needed to evaluate in which courses hybrid learning and online learning, both asynchronous and synchronous, are being implemented. It is also important to evaluate massage educator perceptions of online education, educator knowledge for online course design and delivery (andragogy, problem-based learning, and other theories), and what support and professional development educators are receiving to prepare them for online course design and delivery. Although massage therapy has historically been an industry opposed to moving coursework online, despite the growing popularity of the method and the fact that it is supported by andragogy, there is a need to understand the lasting impact that COVID-19 will have on massage therapy education and educators.
Little research exists regarding the formatting choices of massage education as a result of COVID-19. While other programs are reporting the effects of COVID-19 on education programs, none can be identified in the massage therapy industry. It is unknown how institutions support educators in preparation for formatting changes, as well as massage educators’ knowledge of andragogy and other related adult learning theories. Research on these topics is sorely needed for necessary pivots caused by future pandemics. This future research can also be used to inform decisions regarding moving coursework to an online or hybrid format outside of a pandemic situation. Lastly, this future research can inform professional development choices for educators.
1 American Massage Therapy Association. AMTA 2020 Massage Profession Research Report. 2020. Accessed June 21, 2020. https://www.amtamassage.org/globalassets/documents/publications-and-research/2020-amta-research-report-professional-version.pdf
2 McQuillan DJ. Massage therapy education online: student satisfaction and achievement, Part I. Int J Ther Massage Bodywk. 2010;3(2):3–13..
3 Schwartz J. Faculty perception of and resistance to online education in the fields of acupuncture, chiropractic, and massage therapy. Int J Ther Massage Bodywk. 2010;3(3):2–31.
4 Lederman D. Detailing last fall’s online enrollment surge. Inside Higher Ed. Published September 16, 2021. Accessed May 24, 2022. https://www.insidehighered.com/news/2021/09/16/new-data-offer-sense-how-covid-expanded-online-learning
5 American Massage Therapy Association. AMTA 2021 Massage Profession Research Report. 2022. Accessed June 21, 2020. https://www.amtamassage.org/documents/2021-massage-prof-research-report/Document/?assetType=pdf
6 Kim SY, Kim SJ, Lee SH. Effects of online learning on nursing students in South Korea during COVID-19. Int J Environ Res Public Health. 2021;18(16):8506.
7 Baskwill A. Changing the culture of clinical education in massage therapy. Int J Ther Massage Bodywk. 2011;4(4):33–36.
8 Baskwill A, Sumpton B, Shipwright S, Atack L, Maher J. A Canadian massage therapy education environmental scan. Int J Ther Massage Bodywk. 2020;13(4):12–24.
9 Blackinton M. The Future of DPT Education Post COVID-19. APTA. Published June 1, 2021. Accessed May 24, 2022.
10 Gray AC, Steel A, Adams J. A critical integrative review of complementary medicine education research: key issues and empirical gaps. BMC Complement Altern Med. 2019;19(1):73.
11 Agu CF, Stewart J, McFarlane-Stewart N, Rae T. COVID-19 pandemic effects on nursing education: looking through the lens of a developing country. Int Nurs Rev. 2021;68(2):153–158.
12 Gagnon K, Young B, Bachman T, Longbottom T, Severin R, Walker MJ. Doctor of Physical Therapy Education in a hybrid learning environment: reimagining the possibilities and navigating a “new normal.” Phys Ther. 2020;100(8):1268–1277.
13 Plummer L, Belgen Kaygısız B, Pessoa Kuehner C, Gore S, Mercuro R, Chatiwala N, et al. Teaching online during the COVID-19 pandemic: a phenomenological study of physical therapist faculty in Brazil, Cyprus, and The United States. Educ Sci. 2021;11(3):130.
14 International Council of Nurses. Nursing Education And The Emerging Nursing Workforce in COVID-19 Pandemic [ICN Policy Brief]. 2021. Published online April 2021. Accessed May 24, 2022. https://www.icn.ch/sites/default/files/inline-files/ICN%20Policy%20Brief_Nursing%20Education.pdf
15 DeVaney J, Shimshon G, Rascoff M, Maggioncalda J. Higher Ed needs a long-term plan for virtual learning. Harv Bus Rev. Published online May 5, 2020. Accessed May 24, 2022. https://hbr.org/2020/05/higher-ed-needs-a-long-term-plan-for-virtual-learning
16 Rapanta C, Botturi L, Goodyear P, Guàrdia L, Koole M. Online university teaching during and after the Covid-19 crisis: refocusing teacher presence and learning activity. Postdigital Sci Educ. 2020;2(3):923–945.
17 Morin KH. Nursing education after COVID-19: same or different? J Clin Nurs. 2020;29(17–18):3117–3119.
18 Kennedy AB. Trends of publication in the Education and Practice sections of the IJTMB: a call to action. Int J Ther Massage Bodywk. 2021;14(2):1–4.
19 Kennedy AB. A year in review for the IJTMB. Int J Ther Massage Bodywk. 2022;15(1):1–3.
Published under the CreativeCommons Attribution-NonCommercial-NoDerivs 3.0 License.
INTERNATIONAL JOURNAL OF THERAPEUTIC MASSAGE AND BODYWORK, VOLUME 15, NUMBER 3, SEPTEMBER 2022