Distance Education in Massage

By Les Sweeney

One of the most important current policy questions in massage education is what place, if any, online distance education should enjoy. For Associated Bodywork & Massage Professionals (ABMP), answers to this question have practical implications for two approval decisions: a) what school curricula to approve so a school’s graduates are eligible to join ABMP, and b) which continuing education courses will be recognized, specifically for the purpose of ABMP Certified members meeting their renewal requirements. More broadly, is the movement toward distance education a positive occurrence for the massage and bodywork profession? Following are ABMP’s perspectives on the issue.

As with many issues facing the massage and bodywork profession, neither polar extreme—“distance education is a pariah” versus “online training will become the norm”—seems to reflect thoughtful judgment or be grounded in practical reality. In the messy middle lies the actuality. Our answer to the question at the end of the previous paragraph can be summarized by, “It depends.” Here’s how we get there.

As a general policy, ABMP welcomes curricular experimentation and innovation tempered by a perspective that good reasons underlie certain time-honored approaches to massage instruction. Sound instructional innovation incorporates testing to learn how effectively knowledge is transmitted by a new approach, as compared to learning and retention through traditional instructional methods. In many aspects of massage and bodywork, cerebral mastery of knowledge alone is necessary but not sufficient. True mastery also encompasses a combination of intellectual and kinesthetic abilities to assess a client’s condition, determine an appropriate treatment plan, and then apply skillful, professional touch.

Distance learning, specifically online education, is a form increasingly prevalent in both higher and executive education. It holds considerable potential promise—among the many institutions that offer online education are Ivy League schools and many Fortune 500 enterprises. Online education permits time and location shifting, as well as pacing choices to allow a student to access learning when his/her schedule best permits. It is indisputably a more efficient delivery method. The postings requisite in many online classes require students to organize their ideas on a topic and build writing skills.

In continuing education, such an instructional approach can expand participant access to the most talented, knowledgeable, and communicative instructors. Use of online education modules may reduce the school need for classroom space or make scheduling classes easier. It also saves travel costs as well as travel wear and tear for seminar providers and participants. To reject online education out of hand as an improper fit for massage and bodywork training would be acting like the ostrich with its head in the sand.

Yet online instruction is not a panacea for massage education. A principal goal of core massage school instructional programs is to prepare students comprehensively so they are ready to begin working with clients in an efficient and effective manner, including creating their own practice, if that is the new therapists’ choice.

Part of this process is the development of appropriate communication skills, boundary setting, ethical decision making, personal self-awareness, interactions with other healthcare providers, and the ability to represent the massage profession competently. These skills are often built in day-to-day classroom interactions through moment-by-moment feedback from classmates and instructors. Online educators note that the postings required in their classes increase the interaction and diversity of student opinion because all students get a say in issues, not just the most outspoken students. While online postings may work comfortably for some learners, it’s difficult to believe that these soft skills would develop as effectively or as completely in an exclusively online program.

At an even more fundamental level, while basic strokes can be demonstrated by an instructor online, only the instructor in the room is able to watch a student try the techniques, evaluate that trial performance, and suggest appropriate modifications.

Goals for continuing education in the massage field are likely to be more varied. Professionals seek continuing education to learn a technique not covered during core schooling, become informed about new knowledge pertinent to the profession, sharpen practice-building and client-retention skills, gain knowledge about related health professions, or tend to other relevant aspects of personal or professional development. In this case, participants in online programs have already developed kinesthetic skills and there is less risk that key foundational learning experiences will be missed.

The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) recently announced that training programs it recognizes will be allowed to include up to 300 hours of distance education. The information released by NCBTMB only addressed the proportion of education that could be delivered through distance education, not the related content issues.

In our view, focusing on how much, rather than what and how, seems to miss the point. As many massage educators know, learning takes place in a variety of forms, methods, and subjects that are not always interchangeable. A simplistic fractional approach does not get at the core of the issues in question. This becomes clear when the wide range of online classes available on the Web is sampled. Some are very basic. The participant reads slides that might as well be a textbook page, and then takes a quiz to assess progress. This level of learning can’t compare to the dynamic interaction and quality of information exchange that occurs in a traditional classroom run by a knowledgeable teacher talented at bringing about student participation and interaction.

Much of the content currently offered online in the massage world seems fairly immature when compared to classes offered in the business and higher education sectors. Examples in these other sectors suggest where it is possible to glimpse the opportunity for meaningful education online. In these online offerings, participants might watch a video, read and respond to postings from classmates, view a slide and audio presentation, build an online portfolio, post a comment on a message board, complete an offline activity and submit it to an instructor, receive feedback, take a live poll and view poll results from participants across the country, and finally take an exam to demonstrate the accomplishment of core learning activities.

How prospective students of a program, or for that matter the massage community at large, might monitor the quality of particular online educational materials is difficult to answer. High-quality online materials are expensive to produce; this may result in more programs opting for a simpler, less robust online experience. In this case, schools could potentially suffer from higher than normal student attrition rates as a result of less than inspiring basic online education.

The question of what also needs careful consideration. Can techniques be taught online? While this might be possible and acceptable in continuing education classes where participants already have core massage skills, we feel it is not optimal for foundational training. When learning new skills that require the integration of body mechanics, palpation, theory, and kinesthetic responsiveness, students rely on direct feedback and coaching from an instructor. Instructors can attest to the amount of direction required to support students learning Swedish massage, let alone advanced treatment techniques.

Part of massage learning comes from books and other printed material. Much comes from instructor knowledge transmitted via both lecture and demonstration. A key part follows in practice opportunities informed by coaching and correction by a knowledgeable instructor. Students also learn a great deal from informal education—face-to-face interaction with classmates, exposure to the needs of different body types, receiving feedback from knowledgeable practice clients, and acceptance of different learning and communication styles. Developing the skills to overcome classroom conflicts teaches interpersonal sensitivity and tolerance. Outside the classroom, other faculty and school leaders model professional behaviors while providing informal advice and counsel.

This doesn’t mean that some topics in foundational training can’t be taught effectively online. Topics that have the potential to function well online include business topics, cautions and contraindications of massage, effects and indications of massage, massage history, medical terminology, pathology theory, personal health and hygiene, research literacy, and sanitation and practice safety.

Additionally, hybrid classes where students use online materials to preview information could prove very effective. For example, students could complete a reading assignment and view an online presentation on the cardiovascular system. A subsequent live class then would deliver more in-depth information and provide opportunities for discussion. A second online class could review the information, require students to post their ideas on the benefits of massage for the cardiovascular system, and complete an online exam to assess progress. Students would spend less time in an actual classroom, but fully engage with the material. Online preparatory classes for massage topics could produce students who are better prepared to absorb live lectures and demonstrations.

ABMP is uncomfortable with NCBTMB’s proclamation that 300 hours of a 500-hour massage training program can be offered online. What facets of massage curricula can effectively be communicated relying principally on online knowledge transmission and which others simply do not fit? NCBTMB has offered no guidance in this area or recommendations on suitable online curriculum design.

To be successful as a massage practitioner one must integrate book knowledge and developed physical skills. In addition, a massage therapist must possess human psychological sensitivity requisite to working comfortably, professionally, and effectively with another human being in intimate, close quarters. Even someone possessing all these skills is unlikely to be successful at solo practice without additional knowledge of and moxie at building and sustaining a professional practice. Carefully articulating these requisite skills seems a useful way first to outline the parameters of sound preparation for a massage career. Only after that process is completed does it make sense to discern and delineate the boundaries of what constructive role online education might play in contributing to this preparation.

ABMP is open to online education delivered in interactive, engaging, and informative formats, especially with respect to continuing education. We are interested in providing support as schools explore online options. At the same time, we view the live classroom setting as vital for building certain skills essential to the practice of massage. The art of massage, at its essence, is about touch and human interaction; learning that art must be based in those elements as well.

 Les Sweeney is president of Associated Bodywork & Massage Professionals and a nationally certified massage therapist. Contact him at les@abmp.com.