Our professor, Kathryn Alexander is a free thinker. She calls herself and 'accidental academic' and also has 30 years of Tarot card reading. She used the Tarot card format for a self reflection. She tells great stories about learning how to navigate through the graduate process. She asks the class thoughtful questions like, "What is the saber-tooth in your field?", "What informs you?" and "What does it mean to be an educated person?"
This term we have begun the exploration of curriculum. How did it come to be? What is the language of curriculum? Who has influenced the interpretation of curriculum? Why does curriculum exist? For whom does the curriculum exist for? What does curriculum mean to me?
The definition of "Curriculum" according to Merriam-Webster is:
1: the courses offered by an educational institution
2: a set of courses constituting an area of specialization
After my first term of my Masters of Education, I have come to appreciate the many readings that our professors assign. For this weekend we were given three articles to review and ponder. The article, "The Saber-Tooth Curriculum" stirred up my mind and emotions.
Briefly, the Saber-Tooth Curriculum, starts with the New-Fist-Hammer-Maker and he observes the children playing randomly. He thinks that he could teach the children to do things which will give more food, shelter, clothing and security. He then asked himself what must tribesmen do in order to have full stomachs, sleep warm and live in a safe environment. New Fist Hammer Maker developed three subjects that were essential in helping him achieve his educational goal. The first subject was “Fish-grabbing with the bare hands”, his second subject was “Wooly-horse clubbing” and his third subject was "Saber-tooth tiger scaring with fire". This education worked well for a while. Then with time and nature, things started to change. The big fish were caught and the smaller faster fish were left behind. The wooly horses wanted to learn to run faster so they left the hunting grounds and little fast antelope moved in. The saber-tooth tigers developed pneumonia with the change in weather. Then some of the old students started adapting their old learned methods to the new situation. Then they began to have success with catching fish, snaring the antelope and digging pits for the new beasts.
The questions that were posed was "Why do the schools teach old methods?" "Why do they not teach the new relevant methods?" "What is the relevance of the old methods?" These questions led me to more questions. "Is education for a final product/outcome or is it a process?" "Does the content of the information mean as much as developing the free thinker or critical thinker?"
These questions are all reflected in the current profession of massage therapy. There are many facebook groups debating these questions. The crux of this debate is based on either keeping the profession status quo or to shift toward a more medical model. Common questions are, "Why do we need to increase education?" and "Why do we need evidence based medicine and research?" Some therapists argue, "Our old methods work fine. Therapists see results." "Increasing evidence based treatment increases the validity and supports the outcomes we claim," argue the others.
Massage therapy is an old profession. The rubbing and kneading of muscles as physical care goes back to the days of the Romans. Most everyone benefits from touch. Most massage therapists enjoy the freedom of their work. Massage therapy has many satisfied clients, support within the communities and success stories. A massage therapy practice can give the therapist the flexibility to choose their own hours, set their own fees, have financial independence and business success. Yet, may beliefs of the physiological effects of massage therapy are based in dogma. Research is consistently de-bunking massage therapy claims. Massage therapy does not increase the uptake of lactic acid. Massage does not increase circulation to the muscles, there is a temporary increase of vasodilation to the arteries of the skin not to the muscles. Massage does help people feel better. No one knows what is the definitive mechanism for this.
This leads us to inquire to the mechanism of why massage therapy works. Understanding requires more research. Research requires people in the field to have more education. Our current education system is a 2 year diploma. The diploma is primarily based on anatomy, physiology, pathology, professional development and techniques. Focus is placed on the outcome and the protocols to get to the outcome. The content is expected to be rhymed off correctly and quickly. In two years, how much critical thinking can occur when students are busy learning the basics? Many new graduates do as they were taught, because they don't know what else to do. They are still mastering the basics. An opportunity to come back to higher education and deepening massage therapy knowledge would allow the time for mastering the basics and then growing within the profession.
To access funding, develop quality questions and understand how to build, implement and interpret the information, our profession needs more critical thinkers. To move forward we need therapists with bachelors, masters and doctorates. These massage therapists will have the language and skill to maneuver through research, apply critical thinking and network with other professions. Massage therapists like their freedom and there is a reason why they chose massage therapy over physiotherapy, occupational therapy or nursing. Many do not want to commit to longer schooling, higher tuition and job insecurity. Many do not wish to work in a hierarchial formation. Many are comfortable with the grey areas of possibilities. Some grey areas are energy work, intention, and the power of interconnectedness and touch. There is a wide spectrum of work places ranging from a clinical practice, spa practice or home practice. Other grey areas include specific modalities and their claims like craniosacral therapy, myofascial treatment and Graston technique. All modalities have cases of improvement, yet there is very little independent research conducted. We surmise what we believe to be true without having the research to back up the hypothesis. Our profession likes to make claims that may or may not be true. It may sound like a logical reason why the work is effective and may have no supporting evidence except that a patient found relief from pain. It can be uncomfortable to command a high hourly rate when we are questioned to why we are effective. The discomfort can increase when we are challenged to why we only have a 2 year diploma. As we learn and face challenges, we are creating more new inquires. That's what good questions do!
To complicate matters of our educational evolution are the various stakeholders. Here in BC, Massage Therapy Education has been taught through privately run colleges. Langara has taken it's inaugural massage therapy class this January. Langara is the only public institution offering massage therapy. All the colleges are concerned about their fiscal security and changes to curriculum either in length, standard or transferability all effect enrollment numbers. Another stakeholder is the College of Massage Therapists of BC (CMTBC). They are the governing body, mandated to protect the public. They are actively working toward a national standard of competencies. Our Massage Therapists Association of BC (MTABC) are mandated to advocate for the massage therapy profession. The MTABC have challenges in maintaining the gains that the profession has earned over the last 20 years. Other stakeholders include the employers and the clients that want strong, effective, well educated and well balanced therapists. The students themselves are stakeholders wanting a relevant education. Students want the facts and know what to do. The crux, is how do you know what to do, if you don't understand the information? Instructors are also stakeholders, striving for a well balanced, relevant, and solid curriculum that is dynamic to the needs of the profession and the student.
From my perspective as an instructor since 1999 and perpetual student, this is the Massage Therapy's saber-tooth. The stalled evolution. This evolution has too many stakeholders. All the stakeholders are focused on their individual outcomes and have lost sight of the collective process. I am concerned that we will get run over by the proverbial glacier. I am concerned that our students will suffer from a lack of quality research and valid knowledge. I am concerned with the safety of the patients and clients that may potentially receive poor quality care. I am concerned with the continuation of storytelling versus truth. Health care is dynamic. All health care fields are moving toward more validity, safety, effectiveness and clarity. The truth can hurt and be uncomfortable. At least with the truth, massage therapists everywhere can begin to build something new.
References:
College of Massage Therapists of British Columbia (CMTBC) www.cmtbc.ca
Curriculum. (n.d.). Merriam-Webster.com. Retrieved January 17, 2014, from http://www.merriam-webster.com/dictionary/curriculum
Massage Therapist Association of British Columbia (MTABC) www.massagetherapy.bc.ca
Saber-Tooth Tiger Curriculum Short. Retrieved January 24, 2014, from http://www.nassauboces.org/cms/lib5/NY18000988/Centricity/Domain/57/TheSaberToothCurriculumshort.pdf
"Stretching and deep and superficial massage do not influence blood lactate levels after heavy-intensity cycle exercise". J Sports Sci. 2013;31(8):856-66. doi: 10.1080/02640414.2012.753158. Epub 2012 Dec 21.
Thompson, Diana. "The Lactic Acid Debate" Massage and Bodywork Magazine March/April 2011
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