In January 2008, at an American Massage Therapy Association Council of Schools meeting, representatives of both the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and Commission on Massage Therapy Accreditation (COMTA) announced they would begin accepting distance learning for massage education. The NCBTMB’s representative said that organization would accept 300 hours of the 500 hours it currently requires. The definition of distance learning was vague, and there were no indications of what standards would be required to assure quality education. This has the potential to become a real mess.

Being an educator for more than 20 years, an author of textbooks for both entry- and advanced-level massage education, and a massage therapist for almost 30 years have given me an interesting view on education. I feel confident in stating that the NCBTMB and COMTA must set standards for distance education, if they are going to consider such education valid.

I am not opposed to distance learning; in fact, I think it is a great concept. I completed my master’s in a hybrid program that used both classroom and computer-based learning. My publisher, Elsevier, has electronic educational products already available with textbooks; as do other publishers. The potential of distance education is fantastic—if care and caution are exercised. Otherwise, the outcome could be terrible.

Obviously this is a huge concern for those beginning education in therapeutic massage. Less obvious is the impact on the massage profession as a whole and those currently working in the profession. The issue is competency—and competency demands are greater for the sophisticated environments of health care, including the medical spa and sports and fitness. Having poorly trained massage professionals affects all of us—and has the potential to become even worse if we do not determine what distance education means for massage education and continuing education.

First, here’s a little data on the idea of distance education. It is not new, as the correspondence courses of the past were a form of distance learning. Electronic delivery of education is not necessarily distance learning, and being at distance from the educational institution is not necessarily a factor either. This can all be very confusing, and confusion is scary and supports misconceptions.

Currently there are three basic models for electronic (computer-based) education: Web enhanced, hybrid and total. Web enhanced means the computer is used during regularly scheduled class hours at the brick-and-mortar (real) school. Hybrid means that some of the education is at the brick-and-mortar school and some is virtual, or via the Internet. Total electronic learning means all education is done at a distance.

The virtual classroom can be a really neat place. The various platforms—programs used to deliver the education—can feature chat rooms, message boards and even whole textbooks. There are entire courses that are interactive and do things a textbook could never do. There can be podcasts and Webinars. The virtual classroom has the potential to be extraordinary.

Yet, the combination of “extraordinary and terrible” is not new to massage education—or to any education, for that matter. I wish I could trust that everyone would strive for extraordinary excellence, but we all know that is not the case.

It is not easy to develop and implement electronic-based education, even if you use pre-developed courses that accompany textbooks. To implement a hybrid learning system at my school, for instance, is going to take about two years.

It is not easy to succeed as a student in the virtual classroom, either. I have done it, and it is much more difficult than face-to-face education. 

Standards are out there to model. The Accrediting Commission of Career Schools and Colleges of Technology, for example, has distance-education standards in place. I would also expect other accreditation organizations have standards in place for distance education. Let’s use these models as places to begin.

I strongly believe we should not allow 300 hours’ distance education at this stage of development. Based on the current 500-hour massage-education standard, this means only 200 hours’ education will be hands on—and that just isn’t enough for students to obtain the degree of confidence necessary for professional success.

Let’s move slowly, with intent and focus—just as when giving a massage—as we make this inevitable shift in education.
Sandy Fritz, N.C.T.M.B., is founder, owner, director and head instructor of the Health Enrichment Center School of Therapeutic Massage and Bodywork ( in Lapeer, Michigan. She coauthored Clinical Massage in the Healthcare Setting (Mosby, 2008) and A Massage Therapist’s Guide to Lower Back & Pelvic Pain (Mosby, 2007), and wrote Fundamentals of Therapeutic Massage (Mosby, 2007), among other titles.