(May 30, 2012) Members of the Entry-Level Analysis Project (ELAP) released a project description detailing the workings of the group, its planned activities and its goals.
The ELAP work group, a product of Leadership Summit conversations over the most recent eight months, includes eight members expert in massage curriculum development, teaching and research assessment. The ELAP work group will conduct a research project to identify the essential elements of foundational massage curriculum through analysis of a number of massage profession project outputs, surveys and resources. The use of detailed learning outcomes maps will allow for an accurate recommendation of hours related to competent teaching of essential topics.
Entry-Level Analysis Project Project Description
What is entry-level massage therapy education? What should core content encompass? How many hours
of education are necessary for learners to obtain the basic knowledge, skills, and abilities (KSAs) needed
to enter the massage profession and build a viable practice or work successfully as an employee? Many
regulatory agencies have settled on a 500-hour benchmark, but how they and the massage profession arrived
at this number is unclear. Additionally, a variety of topics are taught within or excluded from a 500-hour
curriculum based on the philosophy undergirding each particular training program. As well, the influence of
federal student aid and/or a belief that 500 hours is insufficient to accomplish desired instructional goals has
caused many institutions to set their program length at 650–900 clock hours.
As a result of these diverse decisions and influences, massage education in the United States can be
characterized as inconsistent. While inconsistency in itself is not necessarily harmful in massage education,
it has spawned problematic consequences – notably too many massage school graduates who experience
short, unsuccessful careers and many geographically mobile therapists whose career development is stymied
by barriers to credential portability.
The Massage Therapy Body of Knowledge (MTBOK) document details the depth and breadth of topics
taught in massage programs of 500–1,000+ hours across the country — programs that prepare learners to
sit for credentialing exams and work in a variety of service-oriented and/or health care-oriented settings. It
provides an important piece of the massage education puzzle by capturing a complete set of concepts, terms,
and activities taught in massage training programs. Now, we need to do more work to identify the essential
elements of massage practice that are necessary in an entry-level curriculum; in other words, we need to
identify the key KSAs required to pass a national licensing exam and provide competent, safe massage in an
early massage career.
• To implement an Entry-Level Analysis Project (ELAP) to delineate key learning outcomes schools can be
encouraged to address in their core instructional programs to ensure attainment of KSAs for competent
and safe application of massage in an early massage career.
• To assess how many program hours are needed to attain this KSA goal, assuming capable instruction.
A work group has been formed of eight individuals rich in experience in massage curriculum development,
teaching, and assessment of established research. Working with skilled psychometricians, this group will
develop questions for a companion survey to the FSMTB 2012 Job Task Analysis (JTA) that will allow
segmentation of findings to provide insight into KSAs actually utilized and perceived to be important for
safe and competent massage practice by individual massage therapists. Work group members will also assess
the results of a newly administered employer survey, and the work products of previous profession projects
addressing curricula, competencies, and standards for relevance to the ELAP goals. Knowledge garnered
through these diverse activities will be funneled into the development of learning outcomes maps in each
*Revised May 17, 2012, in response to feedback provided at the Leadership and Work Group Meetings May 1-4, 2012
topic area related to practitioner- and profession-identified important KSAs. Work group members will then
analyze the learning outcomes maps, based on their own experience in curriculum design and teaching, to
quantify estimated training hours necessary for students to become competent in these KSAs.
The new understanding gained through this project is expected to benefit the profession in a number of
ways. The profession’s leadership could make an informed statement regarding what constitutes evidencebased,
minimum educational requirements a student should meet to qualify for a license to practice massage.
Massage schools will have a blueprint of essential topics, key learning outcomes, and appropriate clock hours
on which to base their foundation curriculum. Organizations accrediting massage programs potentially
will gain a consensus view from the massage profession of core education components to factor into their
accreditation expectations for program approval. Project outputs could be used to inform regulatory bodies
about essential curriculum components, which, if broadly adopted, would help ensure greater consistency in
massage education. The Federation of State Massage Therapy Boards (FSMTB) will have a more informed
basis for the education component in its development of a Model Practice Act. Adoption of consistent
core education requirements by multiple states could increase regulators’ confidence and encourage the
portability of credentials long sought by the massage profession. A broadly accepted foundational education
core would allow for a more accurate differentiation of additional expected knowledge and competencies to
qualify for certification and advanced credentialing.
Improving the consistency of massage education is important for the continued health and evolution of
the massage profession; all the major U.S. stakeholder organizations have undertaken projects at various
times that support this vision. With a clearly defined baseline, the massage profession will be in a better
position to determine appropriate next steps, develop resources that help schools and professional therapists
fill education gaps, and provide meaningful and informed leadership to both students and practicing massage
• In March 2012, participating national organizations nominated candidates to participate in an interview
process to populate a work group of six experienced massage educators (minimum requirements: massage
curriculum development experience and at least five years of experience teaching massage-related topics
in a massage therapy program preparing students to become licensed) and two education professionals
holding a master’s degree or doctorate in instructional design or a closely related subject. In fact, the
selected massage educators each have experience substantially exceeding the minimum criteria.
• With collaborative input from psychometricians with prior experience working with the massage
profession, the work group has begun writing early-career education-specific survey questions to identify
KSAs required for safe, entry-level practice. The questions will help identify what therapists need to know
and to be able to do in order to meet the needs of most clients in a beginning private practice or in early
• Survey questions will be asked within a companion survey to the FSMTB’s 2012 JTA. Demographic
and practice-descriptive information will be collected that permit segmentation and analysis of findings
according to experience and practice success dimensions. One important group will be respondents
who are in the early stages of their careers but who have been “market tested”—that is, who have been
practicing massage from 12 to 48 months and have delivered at least 500 hours of massage during that
time. As shown by their persistence for this time, this group has demonstrated perseverance and the skills
to develop a functional practice or work productively as an employee. Another important group will be
respondents displaying diverse indicia of long-term practice success. These and other methods of analysis
will allow the work group to eliminate the experience bias present in most surveys about massage practice
(veteran practitioners consistently have higher survey participation rates) and to examine the education
foundations of massage therapists trained in different eras.
• Using the results of the education survey, survey data analysis by psychometricians, and a comparison
of findings with other important massage profession resources, the work group will produce a learning
outcomes map detailing learning outcomes, competencies, and learning objectives in the cognitive,
psychomotor, and affective domains related to each early-career job task. Competencies are defined
here in the classic sense as learning objectives written from a behavioral perspective. They are precise
statements that answer the question, “What behavior can the learner demonstrate to indicate that he
or she has mastered the skills specified in the instruction?” Competencies are important starting points,
but to truly understand the needed breadth of entry-level knowledge and skills, the feelings, values, and
attitudes of the learner (not typically addressed by competencies) also need to be captured.
• The profession resources that will be consulted for comparison of findings include an employer survey
about perceived strengths and deficiencies of newly-hired massage employees, results of the current
FSMTB JTA, results of the current NCBTMB JTA, COMTA curriculum competencies, the MTBOK
project and its subsequent analysis by AFMTE, relevant AMTA and ABMP data on liability claims filed
against massage therapists, and the attitudes and experiences of clients as compiled by consumer reports
produced by ABMP, AMTA, and other organizations.
• The best and most useable learning outcomes maps are highly detailed and specific. The learning
outcomes map that will be created in this project will enable the work group to accurately determine the
amount of time needed to teach each identified content component and to recommend core entry-level
education clock hours. To ensure a manageable process, the key outputs will focus on learning within a
brick-and-mortar environment rather than on online or distance education, which is taught differently and
is currently a small proportion of massage therapy foundational education.
• The work group will produce a preliminary project report (targeted for November 2012) detailing the
research findings integrated with other profession resources. The report will review the work group’s
approach, summarize the survey results, summarize the analysis of additional massage profession
resources relevant to the ELAP, defend the learning objectives taxonomy and learning outcomes mapping
references, explain the selection of key KSAs identified from this research, and describe problems,
solutions, research and synthesis of the research, summary of findings, suggested uses and application of
the work group outputs, and conclusions.
• The preliminary project report will be presented to the leadership group for feedback in December
2012. The work group will then complete its task in time to allow a public release of the draft report
for comment in the first quarter of 2013. Public comments will be reviewed by the work group and
incorporated into the final report to be available within 60 days after the public comment period closes.
Scheduled Key Milestones
• April 13, 2012: Project work group members selected.
• May 2, 2012: Work group representatives vet the preliminary project description with the massage
• May 3–4, 2012: Initial project work group meeting to develop survey questions to be administered in
June–July 2012 as a companion survey to the FSMTB Job Task Analysis survey.
• June 14, 2012: Work group webinar to review existing profession resources and assign responsibility for
analyzing specific documents for relevance to ELAP, to report back to the work group at the August
• August 23–25, 2012: Work group meeting: Review and analyze survey results. Report on existing
profession resources and their relevance to ELAP. Participate in activities to ensure appropriate
understanding of the latest thinking and use of learning objectives, learning outcomes mapping, and
instructional design for effective learning. Select appropriate learning taxonomies in the three domains
and the most effective learning outcomes mapping model for this project. Make substantial progress to
create a detailed learning outcomes map of all key KSAs necessary for success in an early massage career.
• November 16, 2012: Completion of the preliminary project report, including the full learning outcomes
map, to be sent to leadership group members.
• December 5, 2012: Live presentation by work group to leadership group for feedback.
• December 6–7, 2012: Work group meeting: Revise report based on leadership group feedback. Complete
second draft of report suitable for public release and comment solicitation.
• 1st Quarter 2013: Draft report to be released for 60-day public comment period.
• 2nd Quarter 2013: Within 60 days of close of public comment period, work group completes final report
and products based on feedback.
We view this project as an important, early foundational step. We have no illusion that successful
completion of this project will by itself transform massage education and the quality of massage being
provided to clients. Other important work, most notably strengthening the teaching abilities of all
instructional personnel, commands parallel attention if this ELAP is to have an opportunity to have
We work group members also understand that our group has no permanent standing. Our job is to
produce a thorough, defensible final report that is sufficiently compelling to motivate diverse national and
local massage therapy organizations to rise to the challenge to ensure the massage profession embraces and
implements the report’s recommendations.
Accepting these caveats, and acknowledging both the opportunity and need for improvement throughout
the massage profession, we believe this project comprises one important foundational step upon which
additional curriculum, teacher preparation, and regulatory standards can build.
The animating spirit of this project is not to criticize, but rather to contribute to the construction of a
more solid and consistent educational foundation that will help those entering the profession to thrive in
their massage therapy careers while ensuring the practice of massage is safe and beneficial for all clients.