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Case Report: A Year in the Life of a

Massage Research Curriculum

Michael Hamm, LMP CCST

Overview

Acknowledgements

Background on Massage Research Education: Goals & Challenges

Curriculum Description & Outcomes Measures

Results: Student Perspective & Instructor Perspective

Discussion: Lessons Learned & Future

A Retrospective Case Report on a New Massage Research Curriculum

Acknowledgements

The Massage Therapy Foundation (MTF) Case Report Contests Education Committee

Cortiva Institute -- Seattle Dina Boon (President) Matthew Sorlie (Director of Education) Kenneth Pfaff (Librarian) Faculty & Students

Background: Goals of Massage Research Education

1. Find & evaluate research articles.

2. Make evidence-informed clinical decisions.

3. Communicate with other healthcare providers.

4. Write & submit their own clinical case reports.

Graduates of Massage School can reliably...

Background: Challenges to Teaching Massage Research

Students have disparate backgrounds & varying interest levels.

Massage instructors often lack expertise & confidence in teaching research literacy.

Institutional: Lack of full-text access, lack of emphasis in massage school curricula, few academic research positions.

Cultural: Unfamiliarity with scientific discourse and/or negative prior association with science education.

Methods: Curriculum Description

Cortiva Institute launched a new licensing curriculum in 2007.

Cortiva -- Seattle offered 750hrs (3 quarters) and 1000hrs (4 quarters).

Two 10-week (30-hour) courses relating to research:

RCR 150 (Clinical Reasoning & Research Literacy) RCR 240 (Case Report Seminar)

Methods: Curriculum Description

Clinical Reasoning Review Anatomy/Pathology Strategic Assessment & Tx

Planning Basic Pharmacology

Research Literacy Introduction to Massage

Research Literature Searching Article Critique

RCR 150: Clinical Reasoning & Research Literacy

Methods: Curriculum Description

Conduct a Treatment Series Develop a research question around a specific

modality, pathology, or treatment approach.

A minimum of 5 sessions with 1 patient.

At least 1 quantitative and 1 qualitative assessment.

Synthesize a Case Report Based on MTF Contest Guidelines

1500-3000 words.

Find and incorporate 3+ peer-reviewed sources.

Display data graphically.

Present your case to classmates.

RCR 240: Case Report Seminar

Methods: Study Duration & Outcomes Measures

Data collected from October 2008 through October 2009 (4 quarters)

87 Massage Students 5 Instructors At the end of each course, students completed standardized

feedback forms. Both courses (RCR 150 / RCR 240) were refined with each

iteration based on student feedback and instructor experience.

The author compiled open-ended interviews from students & instructors.

Methods: Study Duration & Outcomes Measures

Student Feedback Forms focused on: Instructor’s performance (Pacing, Communication,

Visual Aid) Clarity of learning objectives & expectations. Quality & fairness of tests/assessments. Overall classroom experience.

Instructor Interviews focused on: How prepared did you feel to teach this material? What was improved over the first year? Specific recommendations for future classes?

Results: First Two Quarters (Fall 2008, Winter 2009)

Overview: Both courses were product-oriented, in that they

focused on the acquisition of static concepts (e.g. “Define external validity.”) and the creation of written material.

Mostly unconnected to other massage school courses. The case report seminar (RCR 240) was taught from

abstract principles, and in a mostly lecture style. Few real-world examples were used, and in-class collaboration was limited.

A few students produced excellent case reports, but most reports were of low quality.

Results: First Two Quarters (Fall 2008, Winter 2009) Student Perspective:

Learning objectives and practical applications were not clearly understood.

Case report seminar was time-consuming and overly stressful.

Teacher Perspective: Concerned over the dryness and disparity of content. Felt themselves unqualified to teach Research Literacy

-- especially in critical evaluation of research literature. Found it challenging to grade assignments & case

reports in a timely manner.

Results: Last Two Quarters (Spring & Summer 2009)

Overview: As both courses were refined, instructors strove to

make them more process-oriented and more in line with students’ personal interests.

More interactive exercises, real-time literature search demos, student peer-review, and take-home worksheets.

Instructors compiled recent and/or compelling research articles to use as examples.

Baseline quality of case reports improved -- no discernible improvement in top achievers.

Results: Last Two Quarters (Spring & Summer 2009)

Student Perspective: Increasingly reported feeling well-supported in class and well-equipped to access

research later in their careers.

Case report seminar remained time-consuming and stressful, though students described it as transformative of their clinical skills.

Personal interest remained highly variable, but there was universal agreement that research is a vital and worthwhile part of the massage profession on.

Teacher Perspective: Research remained limited in its incorporation in other massage courses.

Felt greater authority in literature searching and critical reading of articles. Expectations for students increased with each iteration.

Grading written material remained difficult and time-consuming.

Results: Selected Quotes

“The class material was a little disjointed at times.” (RCR 150)

“I thought the class dedicated to web research was a bit tedious... a brief overview would have sufficed.” (RCR 150)

“I don’t understand the push for the case report, and wonder why I’ve had to pay for this class... the stress level this added was unnecessary.” (RCR 240)

“Well-paced and very interesting. I appreciated the weekly handouts to keep me on task.” (RCR 240)

“Hard work, but worth it.” (RCR 240)

Discussion: Summary of Results

Incremental Improvements: Students’ perception of clarity, support structure, and

usefulness in their careers. Instructors’ confidence in teaching research literacy. Overall quality of case reports.

Little or No Change: Use of research articles in technique, anatomy, and

other courses. Stress level of students in case report seminar. Quality of the best case reports.

Discussion: Future Study of Massage Research Curricula

Do a prospective study (designed in advance).

Devise more rigorous measures of student experience, including quantitative scales.

Assess for student learning styles (e.g. Visual, Auditory, Traditional).

Conduct follow-up interviews with students 1-2 years after graduation.

Data synthesized by a blinded investigator (not an instructor).

Discussion: Six Strategies for Research Curricula

1. Portray the research world as permeable, interactive, and fast-changing.

2. Work frequently from real examples, and engage the class in critical evaluation.

3. Perform live literature searches, and develop new research questions with the class..

Discussion: Six Strategies for Research Curricula

4. Emphasize process over product, and highlight the potential of research courses to transform students’ massage skills.

5. Do not expect there to be universal interest from students, but do work to channel their particular interests and aspirations.

6. Create interconnections between research courses and other components of the massage curriculum.

Why Focus on Case Reports?

The Classroom

The Library

Working in Groups

Live Literature Searches

Thank You!

Contact:Michael Hamm, LMP CCST

[email protected]