Competencies 101 for Massage Therapists
The changing of CE to CC.
Educational competencies are defined sets of knowledge, skills, and abilities that individuals are expected to acquire through their educational experiences. In the context of massage therapy, these competencies outline the essential abilities practitioners must develop to deliver safe, effective, and ethical care to clients.
Importance of Educational Competencies in Massage Therapy
Establishing clear educational competencies in the massage profession serves several critical purposes:
Standardization of Education: They ensure that all massage therapists receive consistent and comprehensive training, leading to uniformity in the quality of care provided.
Public Safety and Trust: Competencies help protect clients by ensuring practitioners are well-prepared to perform treatments safely and effectively.
Professional Recognition: They contribute to the legitimacy and recognition of massage therapy as a credible healthcare profession.
Guidance for Educators: Competencies provide a framework for curriculum development, helping educators design programs that meet industry standards.
Current Resources in the Massage Profession
The massage therapy field has developed several resources to define and promote educational competencies:
Core Competencies for Massage Therapy Educators: Developed by the Alliance for Massage Therapy Education (AFMTE), this document outlines ten standards encompassing the knowledge, skills, and attitudes essential for effective teaching in massage therapy. AFMTE
Commission on Massage Therapy Accreditation (COMTA) Competency Model: COMTA provides a competency model that guides educational institutions in developing curricula that meet accreditation standards.
The Entry-Level Analysis Project (ELAP) was launched by the Coalition of National Massage Therapy Organizations in March 2012 to address critical needs in entry-level massage education. Its primary objectives were to identify the essential knowledge and skills required for entry-level practice and to recommend the minimum number of instructional hours necessary to ensure graduates can practice safely and competently. Completed in December 2013, ELAP resulted in two key publications: The Core: Entry-Level Analysis Project Report (Final Report) and The Core: Entry-Level Massage Education Blueprint (the Blueprint) which are available on their website at www.elapmassage.org
Hospital Based Competencies have been created.
The integration of massage therapy into hospital settings has highlighted the necessity for standardized competencies to ensure safe and effective patient care. Recognizing this need, the Academic Collaborative for Integrative Health (ACIH) established the Hospital-Based Massage Therapy (HBMT) Task Force to develop specific competencies for massage therapists operating in hospitals.
The competencies are categorized into three primary areas:Hospital Environment: This encompasses understanding the unique dynamics of hospital settings, including collaboration with medical staff, adherence to protocols, and effective communication within interdisciplinary teams.
Massage Protocols: Therapists must be adept at adjusting massage techniques to accommodate various medical conditions, recognizing contraindications, and working around medical equipment to ensure patient safety.
Therapeutic Presence: This involves maintaining professional boundaries, demonstrating empathy, and effectively managing the emotional complexities associated with hospitalized patients.
A study conducted at a Midwest medical center emphasized the importance of specialized training for massage therapists in hospital environments. The development of a hospital-based massage therapy course highlighted the need for therapists to acquire skills beyond those taught in standard massage programs, focusing on patient safety and the ability to adapt to complex medical situations.
The establishment of these competencies aims to standardize training, enhance patient safety, and ensure that massage therapists are well-prepared to meet the demands of hospital-based practice. By adhering to these guidelines, therapists can effectively contribute to patient care within the multidisciplinary teams found in hospital settings.
MASSAGE MAGAZINE - Hospital Based Massage Therapy: A Call for Competencies. June 1, 2016Competencies for Hospital Based Massage Therapy MK Brennan MS, RN, LMBT, Dale Healey DC, PhD, Carolyn Tague MA, CMT, Beth Rosenthal PhD, MBA, MPHAcademic Collaborative for Integrative Health Massage Therapy Foundation Poster (PDF)
Development of a Hospital-based Massage Therapy Course at an Academic Medical Center. International Journal of Massage and Bodywork
Academic Collaborative for Integrative Health (ACIH) Hospital Based Massage Therapy (HBMT) Competencies for Optimal Practice in Integrated Environments ACIH.orgProfessional Associations: Organizations like the American Massage Therapy Association (AMTA) and Associated Bodywork & Massage Professionals (ABMP) offer resources and continuing education. The lack of competencies and a clear professional development path are problematic.
Resources Needed in the Massage Profession
Despite existing resources, there are areas where the massage profession could benefit from further development:
Unified National Standards: The establishment of nationwide educational competencies would promote consistency across all states, facilitating license portability and ensuring uniform quality of care.
Enhanced Continuing Education: Developing more advanced and specialized continuing education programs that are based on competency would help practitioners stay current with evolving techniques and knowledge.
Research Integration: Incorporating the latest research findings into educational competencies would ensure that practitioners are informed by evidence-based practices.
Cultural Competency Training: Providing resources that enhance practitioners' abilities to serve diverse populations effectively is essential for comprehensive care.
Our Current CE and Educational System
Our current Licensing requirements, school programs and CE system are based on clock hours to make it easy for scheduling purposes and for tracking time for compliance reasons. The problem though is that time does not equal mastery of a subject or skill.
1. What is a Carnegie Credit Unit?
Since its inception in 1906, the Carnegie Unit, or “credit hour,” has been the foundational measure in education, quantifying student engagement in terms of time spent learning a subject. I have found various definitions of the amount of time that one CEU equals:
The Carnegie Credit Unit (CEU) is a standard measure of academic credit that represents one hour of class instruction and two hours of student work per week over a semester (typically 15 weeks). For instance, one credit usually equates to 45 hours of student engagement.
One "unit" of credit is earned after completing 120 hours of instruction in a subject.
Why do we use Carnegie Units?
Standardization: They provide a consistent framework for comparing educational achievements across institutions.
Administrative Ease: Simplifies course scheduling, transcripts, and student workload management.
Historical Norm: Developed in 1906 by the Carnegie Foundation to standardize educational experiences.
2. Time Does Not Equal Mastery
The traditional focus on clock hours—how much time is spent in class—does not guarantee that students have truly mastered the material. Competency-based learning shifts the focus from "time spent" to "skills learned," emphasizing outcomes rather than inputs.
Why is this important?
Students learn at different paces; some may achieve mastery faster than others.
Clock hours encourage rote learning to meet time requirements rather than deeper understanding and skill acquisition.
In professions like massage therapy, mastery of techniques and knowledge is crucial for client safety and satisfaction.
3. Different Levels of Competencies
Educational competencies can be categorized into levels, reflecting increasing depth and complexity of knowledge and skills:
Foundational Competencies:
Basic knowledge and skills needed for entry-level practice.
Example: Understanding anatomy and physiology, basic massage techniques.
Intermediate Competencies:
Application of foundational knowledge in real-world contexts.
Example: Customizing massage approaches for specific client needs.
Advanced Competencies:
Specialized skills and in-depth understanding for complex scenarios.
Example: Proficiency in medical massage or pain management techniques.
4. Why Should We Change from Clock Hours to Competencies?
Relevance: Competency-based systems ensure practitioners can perform essential skills effectively.
Flexibility: Recognizes and accommodates individual learning paces.
Outcome-Focused: Prepares students better for real-world practice by emphasizing demonstrable skills over time spent in class.
Portability: Facilitates license portability by creating clear, standardized benchmarks across jurisdictions.
5. What is Clock Hour Creep, and Where Do We Find It in the Massage Profession?
Clock hour creep refers to the gradual increase in required hours of education without a corresponding increase in educational quality or outcomes.
In the Massage Profession:
Some states or schools may add hours to meet regulatory requirements or to appear more rigorous.
This can lead to unnecessarily long and expensive programs that do not necessarily improve the quality of graduates.
Example: States requiring 1,000+ hours for licensure, while others require only 500. The added hours does not necessarily mean increased competency (knowledge, skills, abilities).
6. Mastery Learning/Competency-Based Learning vs. Continuing Education
Mastery learning (or, as it was initially called, "learning for mastery"; also known as "mastery-based learning") is an instructional strategy and educational philosophy, first formally proposed by Benjamin Bloom in 1968.
Mastery learning maintains that students must achieve a level of mastery (e.g., 90% on a knowledge test) in prerequisite knowledge before moving forward to learn subsequent information. If a student does not achieve mastery on the test, they are given additional support in learning and reviewing the information and then tested again. This cycle continues until the learner accomplishes mastery, and they may then move on to the next stage. In a self-paced online learning environment, students study the material and take assessments. If they make mistakes, the system provides insightful explanations and directs them to revisit the relevant sections. They then answer different questions on the same material, and this cycle repeats until they reach the established mastery threshold. Only then can they move on to subsequent learning modules, assessments, or certifications. Wikipedia
Mastery Learning:
Focuses on achieving specific competencies or learning goals.
Time is flexible; the goal is mastery, not hours completed.
Often used in foundational education.
Continuing Education (CE):
Time-based, often measured in clock hours or CEUs (Continuing Education Units).
Emphasis is on acquiring additional knowledge, not necessarily mastering it.
Commonly used for maintaining licensure.
Key Difference:
Competency-based systems focus on outcomes and demonstrable skills, while CE often emphasizes exposure to new topics without necessarily assessing proficiency.
7. What is the Future of the Massage Profession When Moving from CE to Continuing Competence?
Shift to Competence-Based Systems: Transitioning from clock hours to a system that requires proof of ongoing competence (e.g., practical assessments or peer reviews).
Improved Practitioner Quality: Ensures therapists maintain and improve their skills throughout their careers.
Public Trust: Demonstrates accountability and commitment to high professional standards.
Flexible Licensing: Competence-based systems could facilitate national or even international portability of licensure.
Challenges:
Resistance from institutions or individuals accustomed to traditional systems.
Need for consensus among massage organizations, state boards, and educators.
Development of reliable and fair methods to assess competence.
Conclusion
Shifting from a clock-hour-based system to competency-based education and continuing competence represents a transformative opportunity for the massage profession. It aligns education with real-world demands, ensures practitioners remain highly skilled, and raises the profession's credibility. Collaborative efforts from associations, educators, and regulatory bodies will be essential for success.
Resources:
ABMP Podcast: Ep 467 – Getting Off the Clock with Whitney Lowe