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  1. 1. Case Report: A Year in the Life of a Massage Research Curriculum Michael Hamm, LMP CCST
  2. 2. Overview <ul><li>Acknowledgements </li></ul><ul><li>Background on Massage Research Education: Goals & Challenges </li></ul><ul><li>Curriculum Description & Outcomes Measures </li></ul><ul><li>Results: Student Perspective & Instructor Perspective </li></ul><ul><li>Discussion: Lessons Learned & Future </li></ul>A Retrospective Case Report on a New Massage Research Curriculum
  3. 3. Acknowledgements <ul><li>The Massage Therapy Foundation (MTF) </li></ul><ul><ul><ul><ul><li>Case Report Contests </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Education Committee </li></ul></ul></ul></ul><ul><li>Cortiva Institute -- Seattle </li></ul><ul><ul><ul><ul><li>Dina Boon (President) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Matthew Sorlie (Director of Education) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Kenneth Pfaff (Librarian) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Faculty & Students </li></ul></ul></ul></ul>
  4. 4. Background: Goals of Massage Research Education <ul><li>Find & evaluate research articles. </li></ul><ul><li>Make evidence-informed clinical decisions. </li></ul><ul><li>Communicate with other healthcare providers. </li></ul><ul><li>Write & submit their own clinical case reports. </li></ul>Graduates of Massage School can reliably...
  5. 5. Background: Challenges to Teaching Massage Research <ul><li>Students have disparate backgrounds & varying interest levels. </li></ul><ul><li>Massage instructors often lack expertise & confidence in teaching research literacy. </li></ul><ul><li>Institutional: Lack of full-text access, lack of emphasis in massage school curricula, few academic research positions. </li></ul><ul><li>Cultural: Unfamiliarity with scientific discourse and/or negative prior association with science education. </li></ul>
  6. 6. Methods: Curriculum Description <ul><li>Cortiva Institute launched a new licensing curriculum in 2007. </li></ul><ul><li>Cortiva -- Seattle offered 750hrs (3 quarters) and 1000hrs (4 quarters). </li></ul><ul><li>Two 10-week (30-hour) courses relating to research: </li></ul><ul><ul><ul><ul><li>RCR 150 (Clinical Reasoning & Research Literacy) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>RCR 240 (Case Report Seminar) </li></ul></ul></ul></ul>
  7. 7. Methods: Curriculum Description <ul><li>Clinical Reasoning </li></ul><ul><ul><ul><li>Review Anatomy/Pathology </li></ul></ul></ul><ul><ul><ul><li>Strategic Assessment & Tx Planning </li></ul></ul></ul><ul><ul><ul><li>Basic Pharmacology </li></ul></ul></ul><ul><li>Research Literacy </li></ul><ul><ul><ul><li>Introduction to Massage Research </li></ul></ul></ul><ul><ul><ul><li>Literature Searching </li></ul></ul></ul><ul><ul><ul><li>Article Critique </li></ul></ul></ul>RCR 150: Clinical Reasoning & Research Literacy
  8. 8. Methods: Curriculum Description <ul><li>Conduct a Treatment Series </li></ul><ul><ul><ul><li>Develop a research question around a specific modality, pathology, or treatment approach. </li></ul></ul></ul><ul><ul><ul><li>A minimum of 5 sessions with 1 patient. </li></ul></ul></ul><ul><ul><ul><li>At least 1 quantitative and 1 qualitative assessment. </li></ul></ul></ul><ul><li>Synthesize a Case Report </li></ul><ul><ul><ul><li>Based on MTF Contest Guidelines </li></ul></ul></ul><ul><ul><ul><li>1500-3000 words. </li></ul></ul></ul><ul><ul><ul><li>Find and incorporate 3+ peer-reviewed sources. </li></ul></ul></ul><ul><ul><ul><li>Display data graphically. </li></ul></ul></ul><ul><ul><ul><li>Present your case to classmates. </li></ul></ul></ul>RCR 240: Case Report Seminar
  9. 9. Methods: Study Duration & Outcomes Measures <ul><li>Data collected from October 2008 through October 2009 (4 quarters) </li></ul><ul><li>87 Massage Students </li></ul><ul><li>5 Instructors </li></ul><ul><li>At the end of each course, students completed standardized feedback forms. </li></ul><ul><li>Both courses (RCR 150 / RCR 240) were refined with each iteration based on student feedback and instructor experience. </li></ul><ul><li>The author compiled open-ended interviews from students & instructors. </li></ul>
  10. 10. Methods: Study Duration & Outcomes Measures <ul><li>Student Feedback Forms focused on: </li></ul><ul><ul><ul><li>Instructor’s performance (Pacing, Communication, Visual Aid) </li></ul></ul></ul><ul><ul><ul><li>Clarity of learning objectives & expectations. </li></ul></ul></ul><ul><ul><ul><li>Quality & fairness of tests/assessments. </li></ul></ul></ul><ul><ul><ul><li>Overall classroom experience. </li></ul></ul></ul><ul><li>Instructor Interviews focused on: </li></ul><ul><ul><ul><li>How prepared did you feel to teach this material? </li></ul></ul></ul><ul><ul><ul><li>What was improved over the first year? </li></ul></ul></ul><ul><ul><ul><li>Specific recommendations for future classes? </li></ul></ul></ul>
  11. 11. Results: First Two Quarters (Fall 2008, Winter 2009) <ul><li>Overview: </li></ul><ul><ul><ul><li>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. </li></ul></ul></ul><ul><ul><ul><li>Mostly unconnected to other massage school courses. </li></ul></ul></ul><ul><ul><ul><li>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. </li></ul></ul></ul><ul><ul><ul><li>A few students produced excellent case reports, but most reports were of low quality. </li></ul></ul></ul>
  12. 12. Results: First Two Quarters (Fall 2008, Winter 2009) <ul><li>Student Perspective: </li></ul><ul><ul><ul><li>Learning objectives and practical applications were not clearly understood. </li></ul></ul></ul><ul><ul><ul><li>Case report seminar was time-consuming and overly stressful. </li></ul></ul></ul><ul><li>Teacher Perspective: </li></ul><ul><ul><ul><li>Concerned over the dryness and disparity of content. </li></ul></ul></ul><ul><ul><ul><li>Felt themselves unqualified to teach Research Literacy -- especially in critical evaluation of research literature. </li></ul></ul></ul><ul><ul><ul><li>Found it challenging to grade assignments & case reports in a timely manner. </li></ul></ul></ul>
  13. 13. Results: Last Two Quarters (Spring & Summer 2009) <ul><li>Overview: </li></ul><ul><ul><ul><ul><li>As both courses were refined, instructors strove to make them more process-oriented and more in line with students’ personal interests. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>More interactive exercises, real-time literature search demos, student peer-review, and take-home worksheets. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Instructors compiled recent and/or compelling research articles to use as examples. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Baseline quality of case reports improved -- no discernible improvement in top achievers. </li></ul></ul></ul></ul>
  14. 14. Results: Last Two Quarters (Spring & Summer 2009) <ul><li>Student Perspective: </li></ul><ul><ul><ul><li>Increasingly reported feeling well-supported in class and well-equipped to access research later in their careers. </li></ul></ul></ul><ul><ul><ul><li>Case report seminar remained time-consuming and stressful, though students described it as transformative of their clinical skills. </li></ul></ul></ul><ul><ul><ul><li>Personal interest remained highly variable, but there was universal agreement that research is a vital and worthwhile part of the massage profession on. </li></ul></ul></ul><ul><li>Teacher Perspective: </li></ul><ul><ul><ul><li>Research remained limited in its incorporation in other massage courses. </li></ul></ul></ul><ul><ul><ul><li>Felt greater authority in literature searching and critical reading of articles. Expectations for students increased with each iteration. </li></ul></ul></ul><ul><ul><ul><li>Grading written material remained difficult and time-consuming. </li></ul></ul></ul>
  15. 15. Results: Selected Quotes <ul><li>“ The class material was a little disjointed at times.” (RCR 150) </li></ul><ul><li>“ I thought the class dedicated to web research was a bit tedious... a brief overview would have sufficed.” (RCR 150) </li></ul><ul><li>“ 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) </li></ul><ul><li>“ Well-paced and very interesting. I appreciated the weekly handouts to keep me on task.” (RCR 240) </li></ul><ul><li>“ Hard work, but worth it.” (RCR 240) </li></ul>
  16. 16. Discussion: Summary of Results <ul><li>Incremental Improvements: </li></ul><ul><ul><ul><li>Students’ perception of clarity, support structure, and usefulness in their careers. </li></ul></ul></ul><ul><ul><ul><li>Instructors’ confidence in teaching research literacy. </li></ul></ul></ul><ul><ul><ul><li>Overall quality of case reports. </li></ul></ul></ul><ul><li>Little or No Change: </li></ul><ul><ul><ul><li>Use of research articles in technique, anatomy, and other courses. </li></ul></ul></ul><ul><ul><ul><li>Stress level of students in case report seminar. </li></ul></ul></ul><ul><ul><ul><li>Quality of the best case reports. </li></ul></ul></ul>
  17. 17. Discussion: Future Study of Massage Research Curricula <ul><li>Do a prospective study (designed in advance). </li></ul><ul><li>Devise more rigorous measures of student experience, including quantitative scales. </li></ul><ul><li>Assess for student learning styles (e.g. Visual, Auditory, Traditional). </li></ul><ul><li>Conduct follow-up interviews with students 1-2 years after graduation. </li></ul><ul><li>Data synthesized by a blinded investigator (not an instructor). </li></ul>
  18. 18. Discussion: Six Strategies for Research Curricula <ul><li>Portray the research world as permeable, interactive, and fast-changing. </li></ul><ul><li>Work frequently from real examples, and engage the class in critical evaluation. </li></ul><ul><li>Perform live literature searches, and develop new research questions with the class.. </li></ul>
  19. 19. Discussion: Six Strategies for Research Curricula <ul><li>Emphasize process over product, and highlight the potential of research courses to transform students’ massage skills. </li></ul><ul><li>Do not expect there to be universal interest from students, but do work to channel their particular interests and aspirations. </li></ul><ul><li>Create interconnections between research courses and other components of the massage curriculum. </li></ul>
  20. 20. Why Focus on Case Reports?
  21. 21. The Classroom
  22. 22. The Library
  23. 23. Working in Groups
  24. 24. Live Literature Searches
  25. 25. Thank You! Contact : Michael Hamm, LMP CCST [email_address]