November 13, 2024 • 37 mins
Can the flexibility of a new professional development model for massage therapists change the status quo? Discover how British Columbia’s innovative approach is setting the stage for a shift in how therapists across Canada approach continuing education. We delve into the challenges and triumphs of this flexible professional development model, weighing the benefits of personalized learning against the risks of diminished oversight. Hear firsthand about our experiences and the fervent support we’ve encountered, as well as the critical role that evidence-based practices must play in shaping the future of massage therapy education.
This episode takes us to the American Massage Therapy Association's annual conference in Tampa, Florida, where we shared insights on managing fibromyalgia. This international perspective highlights the gaps and opportunities in Canadian massage therapy professional associations. We reflect on the current climate for Registered Massage Therapists, emphasizing the need for critical thinking and a shift away from outdated traditions to evidence-backed knowledge.
Our conversation culminates in a call to action for therapists to challenge the status quo and embrace a more inclusive approach to learning. By focusing on the integration of manual skills within an evidence-based framework, we champion the need to reduce pseudoscience and foster critical thinking throughout the profession. Listen in to gain a deeper understanding of how massage therapists can redefine their practice to truly benefit their clients, keeping pace with the latest scientific standards and innovations in the field.
Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Eric (00:08):
Hello and welcome to another episode of Purvs Versus.
My name is Eric Purvis.
I'm a massage therapist coursecreator, continuing education
provider, curriculum advisor andadvocate for evidence-based
massage therapy.
This is going to be the lastepisode in the Purvis vs name.
I have taken some time off.
(00:29):
As you probably noticed, I havenot released a new episode in a
few months now.
As I was trying to decide whatis the direction that I want to
take in this podcast.
That I want to take in thispodcast and the more I thought
about it and the more commentsand questions I received from
(00:50):
listeners and from people thathave attended my courses
recently.
They wanted more discussionabout science, they wanted more
discussion about the evidenceand initially I was kind of
thinking there's a lot of otherpodcasts out there that discuss
this.
But after having done somereflection and some deep thought
about what it is that I want todo with this, I figured, yes,
(01:13):
why not, let's talk about thatstuff, because there wasn't
actually anybody out there thatI felt that was talking about
these things from a massagetherapist perspective.
So this episode here I discussthe new professional development
program in BC because that'swhere I live and that's where
most of the listeners come from,but I think that this new
program will be something that'sgoing to be adopted by more
(01:35):
provinces across Canada andpotentially other parts of the
world as well.
So, even if you don't live inBC, I will be talking a lot
about the journeys andexpectations that you should
have as a massage therapist forpursuing your continuing
education, your qualityassurance, your professional
(01:56):
development.
Let me know what you think.
I hope you enjoy this episode.
Well, it feels good to be backand to be recording some more
episodes.
As I mentioned in the intro,it's been a bit of a break for
me, so it feels good.
I got a bunch of new ideas.
I'm feeling refreshed andfeeling like I'm slowly
(02:17):
recovering from the busy fall.
For those of you in BC and Ibelieve, in Ontario as well, the
professional developmentprogram that is a requirement
finishes at the end of October.
I'm recording this episodeearly November and I'm just
taking some more time to justdecompress a little bit the
process of doing the PDP.
(02:38):
I didn't find too difficult,but I'm going to talk a little
bit more about that in thisepisode, about my thoughts and
the direction it's taking us,which is predominantly positive,
but I also wanted to just saythat being a continuing
education provider is always avery busy time of year, so for
me, traditionally, september,october are almost always my
(02:58):
busiest months.
I wanted to start off thisepisode here by just saying
thank you and to express mygratitude to all of the
listeners, all the people thatfollow me on social media or
email, all the people thatsupport me and encourage me and
allow me to do what I do for aliving, which is to teach and
create continuing education.
(03:19):
It is probably I should sayprobably.
It is definitely the mostrewarding job I've ever had.
Feels so good to try to makethe world a better place with
more evidence-based informationout there.
It feels good to help people tomake better clinical decisions,
to think differently about whatit is that maybe they hadn't
(03:41):
been taught before or what theywere doing.
And also it's empowering,because when you can help people
to be better clinicians andthen you get the feedback from
those therapists that say thatthey've applied some of the
things they've learned from mycourses into their clinical
practice, and feedback thatthey're getting from their
(04:02):
patients, their clients, issignificant.
That feels really good becauseit makes me feel like I'm doing
something worthwhile.
I'm not just speaking andteaching and it's not having an
influence.
So I just want to say thank youfor everybody.
This last fall, this last yearactually 2024 was my best year
(04:26):
in terms of all metrics with mycontinuing education, and that's
really encouraging.
That means that people arereally supporting it and
grabbing on to the things I amtrying to do.
So thank you, thank you, thankyou.
I couldn't do this without you.
What I did do this fallsomething that was interesting
and new for me, which I thoughtI would share with you was I was
(04:47):
invited to speak at the AMTA,the American Massage Therapy
Association's annual conferencein Tampa, Florida, in September,
and that was an experience in avery good way.
It was a very, very positiveexperience.
I was honored to be able to godown there and teach for two
days, and I or sorry, teachtwice in one day.
(05:10):
It was a lecture, just a lectureon fibromyalgia management, so
it was basically a topic thatwas very much in line with what
I like to talk about, which ischronic pain, but specifically
to processes involved withfibromyalgia risk factors,
treatment options, what can wedo as a massage therapist and it
(05:34):
was great to be in a completelydifferent location with a
completely different audiencefrom anything I'd ever
experienced before, and theamount of support that Americans
have for their AMTA was quiteoverwhelming in a very positive
way, because the amount ofpeople that went to this
(05:56):
conference was astronomical.
I can't even explain how manypeople were there compared to
what we do in Canada.
I think there's probably 1,500,1,800 people is maybe the
number I heard floating around,but it was in a massive
conference center.
There was multiple courses andpresenters going at the same
(06:17):
time all week long.
Each of these courses wereabsolutely packed, jammed,
packed, filled with people.
I believe for the twofibromyalgia lectures that I did
, we had well over a hundred foreach.
I've never seen anything likethat in BC before, other than at
like a big conference, wherethere's just one thing, one
(06:39):
person, presenting at a time.
So it was really great to seethe support that the presenters
have down there and there wastons of different topics, but
the amount of interesting andintelligent questions and
discussions I had was really,really, really encouraging.
I know oftentimes in ourindustry there's a lot of
(07:00):
division or almost stereotypingof different countries or
different provinces or differentstates about who's better,
who's got more education, who'sgot less education, who's more
into pseudoscience, blah, blahblah.
And I think that is reallyquite a divisive attitude,
because I've been very fortunateenough to teach all over North
(07:20):
America.
I've been in every province inCanada except for Quebec.
I have taught numerous times inthe US.
I've done stuff overseas andwhat I found is that a massage
therapist is a massage therapist.
If you are putting your handson people predominantly.
That's your main intervention,which is for all of us.
Then we're trying to makepeople feel better through touch
(07:42):
.
It doesn't seem to matter whereyou are.
Everyone has the best ofintentions and everyone is
striving to learn, to be betterand try to learn to have more
knowledge and to be a betterclinician.
And it doesn't matter whereyou're from.
And it doesn't matter whereyou're from.
(08:06):
I have not seen a drasticdifference in knowledge really,
whether you came from a 500-hourregulation or a 3,000-hour
regulation.
It seems to be very, veryconsistent and that's been
really encouraging.
This was really encouraging tome.
I wasn't a big surprise becauseI had experienced that before
(08:28):
when I've been to the US, butjust to see so many wonderful
therapists there from numerousstates, it was great.
A national organization thatwould really be able to bring
everybody together once a year.
I think that would be fantasticfor our profession up here in
(08:54):
Canada.
I know we've got the CMTA andthere's all these other
acronymed associations out therethat say they're a national
organization, but there's lotsof parts of the country that are
missed out with those becausesometimes they only involve
regulated provinces or sometimesthey exclude certain ones
because they don't meet aspecific criteria.
Honestly, in my opinion, forour profession to move forward,
we definitely need to have anational, unified association
(09:21):
that we can all be part of,rather than having these
segmented associations spreadout throughout Canada.
And I don't think it's helpfuleither to have multiple
associations in one province.
I understand why they have them.
I understand why there, whythere is a need for them right
(09:42):
now but I'm probably going a bitoff topic here but it the
desire for massage therapists inthis country to be recognized
as a legitimate health careprofession, to be appreciated
for the, the education and thework that we do and the
difference that we can makepeople's lives.
I don't see how that's going tobe very possible If we have so
(10:07):
many different associations alladvocating for only their own
self interests.
We need a unified group and Ihope that in my lifetime in my
career in this profession thatwe will see something and maybe
there is some steps movingtowards that right now.
See something, and maybe thereis some steps moving towards
(10:28):
that right now, but wedefinitely have a lot further to
go, particularly when comparedto our neighbors to the south,
where it seems that they have alot of support and a lot going
on with a massive organizationlike the mta.
So thank you to the mta andthank you to all the American
MTs that came.
It was great to connect withyou and I know a bunch of you
were going to listen to thepodcast.
(10:48):
So I just want to say thank youfor taking the time to say hi
and take obviously, thank youfor taking the time to come
listen to me speak aboutfibromyalgia.
Now, the one thing I reallywanted to focus on with this
episode being the last kind ofmy, of my purpose versus episode
now, the, the new one, the newuh podcast I'm gonna be doing
moving forward.
(11:09):
It's gonna be very it's gonnabe similar in some ways, but
it's gonna be different someways.
In in regards that I'm notgonna be doing as many
interviews.
This will be more uhdiscussions, a little bit more
monologues of me talking aboutspecific topics, particularly
focusing on the science.
So the new podcast movingforward is going to be called
Massage Science, and what I wantto do is I want to talk about
(11:30):
the science of touchmusculoskeletal care and try and
keep that as relevant aspossible to massage therapy, and
I'll talk about, you know,regulatory things.
I'll still talk about topicswith certain individuals that
want to be on or that invite tobe on the on the podcast, but I
want to.
I want to focus more on thescience aspect of things.
(11:51):
Like I said before, massagescience is what it's going to be
called.
It'll still be on the same urland it'll still be on the same
website or the same networks, soit shouldn't be any more
difficult to find, because I'mgoing to try and keep it as
simple as possible.
Just change the name and thelogo a little bit.
Now the thing that we want totalk about, though, today is
(12:13):
let's talk about the newprofessional development program
that is just finished here inBC.
Now, with this new PDP program,it was a complete change from
how things have been doneforever.
The previous program followedthe standard you needed a
certain number of hours ofcredits and you had two years to
(12:35):
satisfy them.
That usually translated to youneeded basically a weekend
workshop, one per year, and thenyou would submit your
certificate and you'd be signedoff and then you'd have to
pursue the thing again the nextyear.
Now this was great forcontinuing education providers
because it created thisconsistent attendance and
(12:55):
consistent interest in yourcourse, because you basically
would teach a course every yearand you could have a couple of
different ones and you wouldjust kind of get this, you know.
You know that you could plan acertain number of weekends to
teach and it was fine.
But as a learner, as atherapist, it wasn't the
greatest system because youwould have to choose
(13:15):
pre-approved courses andsometimes the courses you might
want to take were not convenientfor your schedule.
Or maybe you're interested in atopic and there just wasn't a
course out there that you couldfind that was approved on that
topic, on that topic.
(13:36):
So it almost forced us toattend a weekend just to get
credits, even though it may nothave always been in our own best
interest or in best practice.
And I think it allowed a lot ofthe modality empire courses to
proliferate, because what endedup happening was you were
required to take courses thathad to be hands-on courses that
(13:56):
involve critical thinking orinvolved even things like
biopsychosocial you know, whichwas a big topic, you know, 15
years ago, 10 years ago, wasthere's courses coming out about
that stuff that maybe were moreabout discussion and active
listening, and these type ofthings were not approved.
So you were basically forced totake a hands-on course and that
(14:19):
, like I said before, thatallowed this modality empire
proliferation.
And not saying there's anythingwrong with learning techniques
and some people get me wrong andI think when they listen to to
me, thinking that oh, weshouldn't, we shouldn't learn
techniques, that's useless.
That's not what I'm saying, butI'm saying that we should.
We have to obviously have good,skilled hands.
(14:39):
However, we should be allowedand be encouraged in our
profession to pursue knowledgeacquisition and learning more
about certain pathologies orpatient demographics or, you
know, research or other thingsother than just the hands-on
(15:00):
stuff.
And I'm glad that they got ridof the old system even though
for me as a continuing educationprovider, it was very good.
But with the new system there'sno more hours requirement, you
can.
All you need to do is choosetwo learning outcomes or two
learning goals and then you getto the flexibility to choose how
you want to do those.
(15:20):
You know working adultprofessional who maybe doesn't
want to or can't afford to takea weekend off to travel out of
town If you don't live in amajor urban area, it's very
(15:43):
difficult to you know, you haveto travel and you'd have to stay
in hotels and you have to goout and eat dinner a few times.
There's a lot of extra costsand inconvenience.
So this new program does agreat job of saying, hey, you've
got some flexibility.
Do you want to attend aconference?
Do you want to do some stuffonline?
Do you want to take anin-person course, you know, do
(16:05):
you want to do some study groupsor do you want to do some
research reviews?
There's a lot of otheropportunities now for us to
learn and this is going to bethe way forward, I'm sure, in
most massage therapyassociations and regulatory
colleges across the country.
I know Ontario has a verysimilar program called STRIVE
(16:29):
which is quite a few years aheadof BC's.
I do know that in Saskatchewanthey are with MTAS, they are
moving towards a similar thingand I do know a few of these
smaller associations acrossCanada already have this
self-directed process.
Now the thing is there's thegood and then there's the bad.
(16:51):
So the counter to this is nowthere is no longer any real
oversight of what it is you'relearning.
You can basically say and tryto defend whatever it is you
want to learn and use that tosatisfy your learning goal.
Now there's criteria, there'scertain things that we are
(17:11):
supposed to be mindful of andwe're supposed to use to help us
make these decisions about whatwe learn.
But, based on a lot of theconversations and things that I
see on social media and theconversations I've had with
colleagues, the evidence-basedapproach to how we're supposed
(17:33):
to practice.
The evidence-based approachalso applies to how we're
supposed to pursue and satisfyour professional development
program or a new qualityassurance program isn't really
being followed now.
I understand that this is abrand new thing that just took
effect this year, so I'm hopingto see more guidance and support
(17:54):
moving forward, or maybe evenhaving RMTs audited and in a
safe way.
That's not too scary.
It doesn't mean you're gonnalose your license, but to have
somebody from the college say,hey, let's look at your what
you've done and then giveprovide some guidance on how
they could have done better.
How could you make yourlearning plan more evidence,
better.
How could you make yourlearning plan more
evidence-based?
How could you satisfy theselearning requirements?
(18:16):
By being more evidence-based,because with all these
guidelines that we're supposedto follow, with all these PDFs
and websites that we're supposedto read all the information
from, it's great, but if youdon't actually spend the time to
do that and there's no supportfor you after the fact, then how
are we supposed to learn andhow are we supposed to grow and
(18:37):
how are we supposed to be betterclinicians?
I think it's very difficult.
So there definitely needs to beanother step to this, and the
reason I say there should beanother step to this is because
I see a lot of uses and abusesof the term evidence-based
practice.
The general consensus from alot of the discussions I have
(19:01):
and a lot of things that peoplebring to me is that they think
evidence-based practice is justresearch evidence, it's this
very recipe, prescriptive thing,and that's not true.
Actually, evidence basedpractice is quite flexible If
you use it for the within thespirit of what it is intended.
Now, I've had a bunch of otherepisodes that have explored
(19:23):
evidence based practice and whatthat means and what that looks
like, so we're not going to talkabout that today in specifics,
but the use and abuse ofevidence basedbased practice,
particularly in the continuingeducation world, I feel is
something that definitely needsto be worked on, because,
according to our collegestandards, you know that we have
(19:46):
these practice standards andthis should be the way it is.
You know, every association orcollege across the country is
going to have some level ofpractice standards, which is
basically the minimumexpectation for you as a massage
therapist in terms of how youconduct yourself in practice,
and the definition on ourcollege website is that the
practice standards define theminimum level of expected
(20:07):
performance for registeredmassage therapists and therefore
define what constitutes safe,ethical and competent delivery
of care by RMTs.
The idea is that when we leaveschool, it's entry to practice.
We pass that board exam, it'sthe minimum standard, and we're
supposed to grow from there.
One of the problems that we see, though, is that, because the
(20:30):
entry to practice standards missout on providing RMTs the
knowledge, the skills, theappreciation for evidence and
evidence-based practice and whatthat means, it's very difficult
for a lot of us to then have anevidence-based quality
(20:52):
assurance program or have anevidence-based professional
growth pathway when the basicprinciples of it are missed in
our entry-level practice.
Now, for those of you that areaware or that know, the
inter-jurisdictional competencydocuments which the schools are
supposed to use to teach basetheir teachings from.
(21:14):
It's what the regulatorycolleges use to base their
licensing exams on these.
There is a mention ofevidence-based practice in there
, but that doesn't mean thateveryone's taught it and it
doesn't mean that everyone'staught it and it doesn't mean
that it's incorporated in everysingle school curriculum.
(21:36):
And I've looked at a lot of theschool curriculums and I can
100 guarantee you that most ofthem are not evidence-based.
Now there is a way to includecurrent evidence to make it fit
within the inter-jurisdictionaldocuments and competencies that
practice competencies andpractice indicators but that is
(21:59):
not done by the majority ofschools.
So it's up to us in thecontinuing education world to
try to fill this gap, and that'sone of the things that I try to
do.
Now, the thing that is importantis, if you don't have an
understanding of evidence-basedpractice, is to learn the basics
of what it means, and a lot ofthat comes down to critical
(22:19):
thinking and to critical thoughtand to asking a lot of
questions and to questioningwhat do you know and how do you
know what you know.
Is what you know valid?
Is it based on hearsay?
Is it based on good qualityevidence?
Is it based on what someonetold you?
It's really important for us tostart off by asking ourselves
(22:42):
the questions how do I know whatI know?
Because an evidence-basedpractice is going to require you
to critically assess all theinformation, and this is
outlined again in our practicestandards, focusing on facts and
observations rather thanbeliefs, opinions and traditions
.
Hugely, hugely important tounderstand that the large
(23:03):
majority of the stuff that welearn, not only in school but
also in continuing education,also in our professional
development, quality assurance,whatever terms you want to use
are based usually on opinionsand traditions rather than on
current science.
And there's also a use andabuse of current science or
current anatomical knowledge totry to use that information to
(23:27):
try to influence a tradition orbelief.
So we need to challenge what wethink we know in order to get
better.
That's one of the most basic,fundamental aspects that we need
to appreciate in evidence-basedpractice.
So let's move on and talk aboutthe Quality Assurance Program in
BC.
Now the guiding principles, andthis is, according to the
(23:49):
Complementary HealthProfessionals of BC, which is
our new regulatory college.
Here.
The guiding principles of theredesign of the QA program for
RMTs are it's got to be based oncore competencies, professional
standards and standards ofpractice for safe, ethical and
competent practice.
It supports high practicestandards, supports RMTs and
(24:10):
continued practice improvement,is inclusive and fairly applied
to all RMTs, ensures all RMTsare able to achieve their
requirements in a meaningful way, is based on best available
evidence and is consistent withthe CCHPBC's mandate to protect
the public.
These are great guidingprinciples, but let's look at
(24:31):
how these things can be applied,or how they should be, in my
opinion.
Applied to practice.
So based on core competencies,which makes sense, right, we got
to keep within our scope ofpractice and the professional
standards.
The other point, though, in thisfirst line here says standards
of practice for safe, ethicaland competent practice.
So our standards of practice.
(24:51):
One of our standards ofpractice is an evidence-based
practice standard, which meanswe have to pursue learning
that's based on current bestevidence.
So it is a logical train ofthought for me to say if we have
(25:11):
an evidence-based practicestandard and our new quality
assurance program is based onthese standards of practices,
therefore, our continuingeducation needs to be based on
evidence.
That means that learning thingsthat have no basis in evidence
or are based on conjectureshouldn't actually be allowed.
(25:33):
That means a lot of themodality empire approaches.
If they are still perpetuating1980s, 1990s belief systems,
information, or based on beliefsystems information, or based on
incomplete hypotheses or ideals, that actually shouldn't count
(25:56):
for your quality assurance.
And the difficult thing, though,is how is an RMT supposed to
know whether something doesn'tmeet that evidence-based
practice standard when we're nottaught it in the first place?
If you are somebody that doessay craniosacral therapy, which
is something that's been donefor a long time and it's got a
lot of beliefs around it andthere's a lot of pseudoscience
(26:18):
around it and that's notdisputed the clinical
application of it, sure it canhelp people, sure people might
feel better, but the sciencearound it is, in a lot of cases,
just completely non-existent.
But if you were taught that inschool and previously, if you
had taken courses andcertifications in that, and you
(26:40):
were taught by these people,these con ed instructors that
really believed in it, and maybethey presented some evidence to
you that sounded compelling,then of course it's easy for us
to fall into these traps ofthinking that what we're doing
is evidence-based when it's not.
(27:01):
So there's a lot of use andabuse of evidence.
There's a lot of use and abuseof people passing off really
crappy science and saying it'sgood science and without us
having that support andunderstanding at an entry to
practice level as well asthrough our associations,
regulatory bodies, it's easy forus to miss that.
(27:23):
So I would say that a lot of us, when we were a lot of people,
when they were doing theirprofessional or their PDP
program here, they were notfollowing an evidence-based
development program.
It's not for any fault of theirown.
I think it's a fault of theentire system.
The stakeholders involved needto step up the game on this, and
I sound like a broken recordbecause I've been saying that a
(27:44):
million times Now.
The other thing that I did likeabout this program though it's
not all bad is it's inclusive.
So it means it doesn't matterwhere you live, who you are.
You have options for you,different learning styles.
You can choose the best way tolearn for you.
(28:05):
This other point says ensuresthat all RMTs are able to
achieve the requirements in ameaningful way.
That's great because, again,that's inclusive.
It allows you to pursue thesethings and it doesn't have to be
that difficult.
It doesn't have to be expensiveeither.
Is it consistent, though, withthe mandate to protect the
public?
I know that the regulatorycolleges have this mandate
(28:25):
that's given to them bygovernment says your job is to
protect the public, but I thinkthere's a very strong argument
that we can make which says thatif you are practicing and
you're in a way that'snon-evidence based, you're not
really protecting the public.
Are you doing them a lot ofharm?
Most know, but are youproviding competent, safe or
(28:48):
ethical care?
Maybe it's safe, but it's notethical or competent if we're
practicing in a non evidencebased way.
So there's there's definitely aneed for improvement.
Now, I know from some of thefeedback I get from people is
they feel that I'm overlycritical, and I'm, you know, can
maybe be not supportive enoughof certain things, but I
(29:08):
strongly believe that, in orderfor our profession to get better
, we need to ask hard questionsand we need to not accept just
the status quo as being okay.
I strongly believe that we needto challenge these beliefs and
we need to challenge a systemwhich is there, which should
look to support us, to moveforward and to be better
(29:31):
clinicians, but there's stillsome big holes there.
Now the PDP program is betterthan the old one.
Yes, I agree with that.
For someone like myself whoteaches predominantly online
whether it's live online orself-directed courses it's great
because I feel that I cancreate content that gives people
lots of options to learn basedon what they want, and try and
(29:51):
have some affordable options.
Some ones are a little moreexpensive but provide things for
them so they can learn whetheryou're in BC or anywhere across
Canada or the world.
But until we really have abetter grasp in our profession
of what evidence-based practiceis and how this applies to what
we do in clinic every day andhow this applies to the learning
(30:12):
that we pursue, I think we'restill going to be left behind.
And when I say things like theuse and abuse of evidence-based
practice, what's that mean?
I'll give you an example here,and this is one that I've seen a
few times and more than a few.
I've seen this a lot Becauseevidence-based practice is a
buzzword.
A lot of people are using it,just like patient-centered care
(30:34):
is a buzzword.
Pain science is a buzzword.
Biopsychosocial is a buzzword.
These are all things thatpeople use and I feel that
oftentimes they get used becauseeveryone's saying them and a
lot of people will use themwithout really understanding
kind of the philosophicalapplications of what these
actually mean.
(30:54):
Anybody can say evidence-basedpractice, but just because you
say it doesn't mean it's true.
And if you just look at, say, acourse description or a website
and someone says I will meetyour therapeutic needs with an
evidence-based approach that'srooted in deep tissue massage
(31:17):
therapy, what does that mean?
What is deep tissue massagetherapy?
Is that evidence-based?
What is deep tissue massagetherapy?
Is that evidence-based?
We all know what deep tissue isin terms of.
It's a term that we use, butit's actually not a defined term
.
It's a feeling and everyone'skind of understanding of deep
(31:40):
tissue is going to be different.
Does that mean you're putting inmore pressure?
Does that mean that you aretreating deeper structures?
How do you know that?
Is that possible?
Is it necessary?
Can you treat deeper tissues?
Where's the evidence on that?
You can't say that you treatdeep tissue without evidence to
(32:04):
support.
So yeah, I'm treating theseother structures here and I I am
because of blah, blah, blah,these papers.
And again we could say do youneed to treat deep?
Whatever that might be right isdeep your perception.
Is it the perception of theperson on the table?
Are you getting a ruler ormeasuring tape and measuring
(32:25):
depth?
Every human, every body isdifferent.
Sometimes light pressure couldfeel like it's really deep on
somebody and vice versa, youcould be putting a lot of
pressure on someone where youfeel like you're squishing and
mashing everything and theydon't feel like it's deep.
So it's those kind of termsthat we use.
We should question those Isthat evidence-based?
(32:46):
If you're going to claim thatyou're evidence-based, well, I'm
an evidence-based practitionerand these are all the techniques
and my favorite modalities blah, blah, blah, blah, blah.
That to me is a red flag,saying that, well, those are
your preferred style, that'syour preferred way of treating.
But you can't say that'sevidence-based, because
(33:08):
everybody has their own uniquestyle.
Everybody has their ownpreferred way of treating people
, whether they like a slower ora pokier or a flatter pressure
or a.
You know?
Do you incorporate movement?
Are you using different bodyparts?
How are you treating somebody?
(33:29):
We all have our own approachesand neither is right and neither
is wrong.
So I don't think that we can sayyou are evidence-based and then
listing all your, listing allyour techniques, because in
order for you to say that thosetechniques are evidence-based,
you'd have to have research tosupport them.
So I think you can say I'm anevidence-based therapist who
(33:51):
likes to treat certainpopulations of people athletes,
pediatrics, chronic pain,whatever that might be.
Or I'm an evidence-basedpractitioner that has a special
interest in orthopedics,evidence-based practitioner that
, like that, has a specialinterest in orthopedics female
health.
But you can't list all yourtechniques afterwards and say
that you're evidence-based,because those two things don't
(34:15):
don't match.
They don't go well together,particularly when the evidence
on all these techniques is allover the place.
There is no one techniquebetter than the other, because
it is not the technique that isevidence-based, it is the
(34:36):
knowledge and how you practicethat should be based on evidence
.
I think the less wrong approach, the more evidence-based
approach would be yeah, like Isaid, to list the populations
that you're interested in andthen say these are some of the
techniques I feel, or these aresome of the techniques that I
like to use, and then you canlist them.
But don't try to sell thosetechniques as being
(34:56):
evidence-based or better thananyone else's.
I don't think it's acompetition.
Anyway, I could go on foreverabout that, but I think I'll
just leave that there so I don'tbeat it to death.
My hope is, as massagetherapists in our profession and
the stakeholders start to adoptmore of these evidence-based
approaches, that what we'llstart to see is less
(35:19):
pseudoscience.
We'll start to see lessmodality empires trying to sell
their fix, start to see lessmodality empires trying to sell
their fix and we'll start to seemore critical thinking and
critical, critical analysis ofwhat is that we think that we
know, because anybody can give,can learn to give, an amazing,
(35:42):
delicious sensory experience ofa massage.
But being able to use yourmanual skills and combine those
into an evidence-based frameworkthat supports somebody and
utilizes everything within ourscope of practice to help them
the best that we can through ourlanguage, through our
(36:05):
communication, through our hands, through the advice we give or
through the advice that theyrequest, requires a deeper
understanding of the evidenceand an appreciation for how that
guides us.
So if you've made it this farin the episode, I'm going to
repeat myself again.
(36:25):
What I would love for you to dois to ask yourself the hard
questions how do I know what Iknow and is what I know valid?
And you may not be able to comeup with a good answer, but I
highly suggest that you askthose hard questions so that way
(36:47):
you can challenge yourself, tounlearn maybe some things or to
relearn how it is what you aredoing is helping people, because
I can promise you this that alot of the stuff that we learned
in schools and that we learnedin non-evidence-based
professional developmentprograms are not consistent with
(37:12):
a current evidence-basedpractice standard, which is a
requirement for our profession.
Thanks for listening.
I appreciate all of you fortaking the time to be here.
If you enjoyed this episode,please give it a five-star
rating and share it on yourfavorite social media platform.
You can always follow me onInstagram or Facebook at Eric
Purvis RMT, and please head overto my website, ericpurviscom,
(37:35):
to see a full listing of all mylive courses, webinars and
self-directed course options.
Until next time, take care.
Hello and welcome to another episode of Purvs Versus.
My name is Eric Purvis.
I'm a massage therapist coursecreator, continuing education
provider, curriculum advisor andadvocate for evidence-based
massage therapy.
This is going to be the lastepisode in the Purvis vs name.
I have taken some time off.
(00:29):
As you probably noticed, I havenot released a new episode in a
few months now.
As I was trying to decide whatis the direction that I want to
take in this podcast.
That I want to take in thispodcast and the more I thought
about it and the more commentsand questions I received from
(00:50):
listeners and from people thathave attended my courses
recently.
They wanted more discussionabout science, they wanted more
discussion about the evidenceand initially I was kind of
thinking there's a lot of otherpodcasts out there that discuss
this.
But after having done somereflection and some deep thought
about what it is that I want todo with this, I figured, yes,
(01:13):
why not, let's talk about thatstuff, because there wasn't
actually anybody out there thatI felt that was talking about
these things from a massagetherapist perspective.
So this episode here I discussthe new professional development
program in BC because that'swhere I live and that's where
most of the listeners come from,but I think that this new
program will be something that'sgoing to be adopted by more
(01:35):
provinces across Canada andpotentially other parts of the
world as well.
So, even if you don't live inBC, I will be talking a lot
about the journeys andexpectations that you should
have as a massage therapist forpursuing your continuing
education, your qualityassurance, your professional
(01:56):
development.
Let me know what you think.
I hope you enjoy this episode.
Well, it feels good to be backand to be recording some more
episodes.
As I mentioned in the intro,it's been a bit of a break for
me, so it feels good.
I got a bunch of new ideas.
I'm feeling refreshed andfeeling like I'm slowly
(02:17):
recovering from the busy fall.
For those of you in BC and Ibelieve, in Ontario as well, the
professional developmentprogram that is a requirement
finishes at the end of October.
I'm recording this episodeearly November and I'm just
taking some more time to justdecompress a little bit the
process of doing the PDP.
(02:38):
I didn't find too difficult,but I'm going to talk a little
bit more about that in thisepisode, about my thoughts and
the direction it's taking us,which is predominantly positive,
but I also wanted to just saythat being a continuing
education provider is always avery busy time of year, so for
me, traditionally, september,october are almost always my
(02:58):
busiest months.
I wanted to start off thisepisode here by just saying
thank you and to express mygratitude to all of the
listeners, all the people thatfollow me on social media or
email, all the people thatsupport me and encourage me and
allow me to do what I do for aliving, which is to teach and
create continuing education.
(03:19):
It is probably I should sayprobably.
It is definitely the mostrewarding job I've ever had.
Feels so good to try to makethe world a better place with
more evidence-based informationout there.
It feels good to help people tomake better clinical decisions,
to think differently about whatit is that maybe they hadn't
(03:41):
been taught before or what theywere doing.
And also it's empowering,because when you can help people
to be better clinicians andthen you get the feedback from
those therapists that say thatthey've applied some of the
things they've learned from mycourses into their clinical
practice, and feedback thatthey're getting from their
(04:02):
patients, their clients, issignificant.
That feels really good becauseit makes me feel like I'm doing
something worthwhile.
I'm not just speaking andteaching and it's not having an
influence.
So I just want to say thank youfor everybody.
This last fall, this last yearactually 2024 was my best year
(04:26):
in terms of all metrics with mycontinuing education, and that's
really encouraging.
That means that people arereally supporting it and
grabbing on to the things I amtrying to do.
So thank you, thank you, thankyou.
I couldn't do this without you.
What I did do this fallsomething that was interesting
and new for me, which I thoughtI would share with you was I was
(04:47):
invited to speak at the AMTA,the American Massage Therapy
Association's annual conferencein Tampa, Florida, in September,
and that was an experience in avery good way.
It was a very, very positiveexperience.
I was honored to be able to godown there and teach for two
days, and I or sorry, teachtwice in one day.
(05:10):
It was a lecture, just a lectureon fibromyalgia management, so
it was basically a topic thatwas very much in line with what
I like to talk about, which ischronic pain, but specifically
to processes involved withfibromyalgia risk factors,
treatment options, what can wedo as a massage therapist and it
(05:34):
was great to be in a completelydifferent location with a
completely different audiencefrom anything I'd ever
experienced before, and theamount of support that Americans
have for their AMTA was quiteoverwhelming in a very positive
way, because the amount ofpeople that went to this
(05:56):
conference was astronomical.
I can't even explain how manypeople were there compared to
what we do in Canada.
I think there's probably 1,500,1,800 people is maybe the
number I heard floating around,but it was in a massive
conference center.
There was multiple courses andpresenters going at the same
(06:17):
time all week long.
Each of these courses wereabsolutely packed, jammed,
packed, filled with people.
I believe for the twofibromyalgia lectures that I did
, we had well over a hundred foreach.
I've never seen anything likethat in BC before, other than at
like a big conference, wherethere's just one thing, one
(06:39):
person, presenting at a time.
So it was really great to seethe support that the presenters
have down there and there wastons of different topics, but
the amount of interesting andintelligent questions and
discussions I had was really,really, really encouraging.
I know oftentimes in ourindustry there's a lot of
(07:00):
division or almost stereotypingof different countries or
different provinces or differentstates about who's better,
who's got more education, who'sgot less education, who's more
into pseudoscience, blah, blahblah.
And I think that is reallyquite a divisive attitude,
because I've been very fortunateenough to teach all over North
(07:20):
America.
I've been in every province inCanada except for Quebec.
I have taught numerous times inthe US.
I've done stuff overseas andwhat I found is that a massage
therapist is a massage therapist.
If you are putting your handson people predominantly.
That's your main intervention,which is for all of us.
Then we're trying to makepeople feel better through touch
(07:42):
.
It doesn't seem to matter whereyou are.
Everyone has the best ofintentions and everyone is
striving to learn, to be betterand try to learn to have more
knowledge and to be a betterclinician.
And it doesn't matter whereyou're from.
And it doesn't matter whereyou're from.
(08:06):
I have not seen a drasticdifference in knowledge really,
whether you came from a 500-hourregulation or a 3,000-hour
regulation.
It seems to be very, veryconsistent and that's been
really encouraging.
This was really encouraging tome.
I wasn't a big surprise becauseI had experienced that before
(08:28):
when I've been to the US, butjust to see so many wonderful
therapists there from numerousstates, it was great.
A national organization thatwould really be able to bring
everybody together once a year.
I think that would be fantasticfor our profession up here in
(08:54):
Canada.
I know we've got the CMTA andthere's all these other
acronymed associations out therethat say they're a national
organization, but there's lotsof parts of the country that are
missed out with those becausesometimes they only involve
regulated provinces or sometimesthey exclude certain ones
because they don't meet aspecific criteria.
Honestly, in my opinion, forour profession to move forward,
we definitely need to have anational, unified association
(09:21):
that we can all be part of,rather than having these
segmented associations spreadout throughout Canada.
And I don't think it's helpfuleither to have multiple
associations in one province.
I understand why they have them.
I understand why there, whythere is a need for them right
(09:42):
now but I'm probably going a bitoff topic here but it the
desire for massage therapists inthis country to be recognized
as a legitimate health careprofession, to be appreciated
for the, the education and thework that we do and the
difference that we can makepeople's lives.
I don't see how that's going tobe very possible If we have so
(10:07):
many different associations alladvocating for only their own
self interests.
We need a unified group and Ihope that in my lifetime in my
career in this profession thatwe will see something and maybe
there is some steps movingtowards that right now.
See something, and maybe thereis some steps moving towards
(10:28):
that right now, but wedefinitely have a lot further to
go, particularly when comparedto our neighbors to the south,
where it seems that they have alot of support and a lot going
on with a massive organizationlike the mta.
So thank you to the mta andthank you to all the American
MTs that came.
It was great to connect withyou and I know a bunch of you
were going to listen to thepodcast.
(10:48):
So I just want to say thank youfor taking the time to say hi
and take obviously, thank youfor taking the time to come
listen to me speak aboutfibromyalgia.
Now, the one thing I reallywanted to focus on with this
episode being the last kind ofmy, of my purpose versus episode
now, the, the new one, the newuh podcast I'm gonna be doing
moving forward.
(11:09):
It's gonna be very it's gonnabe similar in some ways, but
it's gonna be different someways.
In in regards that I'm notgonna be doing as many
interviews.
This will be more uhdiscussions, a little bit more
monologues of me talking aboutspecific topics, particularly
focusing on the science.
So the new podcast movingforward is going to be called
Massage Science, and what I wantto do is I want to talk about
(11:30):
the science of touchmusculoskeletal care and try and
keep that as relevant aspossible to massage therapy, and
I'll talk about, you know,regulatory things.
I'll still talk about topicswith certain individuals that
want to be on or that invite tobe on the on the podcast, but I
want to.
I want to focus more on thescience aspect of things.
(11:51):
Like I said before, massagescience is what it's going to be
called.
It'll still be on the same urland it'll still be on the same
website or the same networks, soit shouldn't be any more
difficult to find, because I'mgoing to try and keep it as
simple as possible.
Just change the name and thelogo a little bit.
Now the thing that we want totalk about, though, today is
(12:13):
let's talk about the newprofessional development program
that is just finished here inBC.
Now, with this new PDP program,it was a complete change from
how things have been doneforever.
The previous program followedthe standard you needed a
certain number of hours ofcredits and you had two years to
(12:35):
satisfy them.
That usually translated to youneeded basically a weekend
workshop, one per year, and thenyou would submit your
certificate and you'd be signedoff and then you'd have to
pursue the thing again the nextyear.
Now this was great forcontinuing education providers
because it created thisconsistent attendance and
(12:55):
consistent interest in yourcourse, because you basically
would teach a course every yearand you could have a couple of
different ones and you wouldjust kind of get this, you know.
You know that you could plan acertain number of weekends to
teach and it was fine.
But as a learner, as atherapist, it wasn't the
greatest system because youwould have to choose
(13:15):
pre-approved courses andsometimes the courses you might
want to take were not convenientfor your schedule.
Or maybe you're interested in atopic and there just wasn't a
course out there that you couldfind that was approved on that
topic, on that topic.
(13:36):
So it almost forced us toattend a weekend just to get
credits, even though it may nothave always been in our own best
interest or in best practice.
And I think it allowed a lot ofthe modality empire courses to
proliferate, because what endedup happening was you were
required to take courses thathad to be hands-on courses that
(13:56):
involve critical thinking orinvolved even things like
biopsychosocial you know, whichwas a big topic, you know, 15
years ago, 10 years ago, wasthere's courses coming out about
that stuff that maybe were moreabout discussion and active
listening, and these type ofthings were not approved.
So you were basically forced totake a hands-on course and that
(14:19):
, like I said before, thatallowed this modality empire
proliferation.
And not saying there's anythingwrong with learning techniques
and some people get me wrong andI think when they listen to to
me, thinking that oh, weshouldn't, we shouldn't learn
techniques, that's useless.
That's not what I'm saying, butI'm saying that we should.
We have to obviously have good,skilled hands.
(14:39):
However, we should be allowedand be encouraged in our
profession to pursue knowledgeacquisition and learning more
about certain pathologies orpatient demographics or, you
know, research or other thingsother than just the hands-on
(15:00):
stuff.
And I'm glad that they got ridof the old system even though
for me as a continuing educationprovider, it was very good.
But with the new system there'sno more hours requirement, you
can.
All you need to do is choosetwo learning outcomes or two
learning goals and then you getto the flexibility to choose how
you want to do those.
(15:20):
You know working adultprofessional who maybe doesn't
want to or can't afford to takea weekend off to travel out of
town If you don't live in amajor urban area, it's very
(15:43):
difficult to you know, you haveto travel and you'd have to stay
in hotels and you have to goout and eat dinner a few times.
There's a lot of extra costsand inconvenience.
So this new program does agreat job of saying, hey, you've
got some flexibility.
Do you want to attend aconference?
Do you want to do some stuffonline?
Do you want to take anin-person course, you know, do
(16:05):
you want to do some study groupsor do you want to do some
research reviews?
There's a lot of otheropportunities now for us to
learn and this is going to bethe way forward, I'm sure, in
most massage therapyassociations and regulatory
colleges across the country.
I know Ontario has a verysimilar program called STRIVE
(16:29):
which is quite a few years aheadof BC's.
I do know that in Saskatchewanthey are with MTAS, they are
moving towards a similar thingand I do know a few of these
smaller associations acrossCanada already have this
self-directed process.
Now the thing is there's thegood and then there's the bad.
(16:51):
So the counter to this is nowthere is no longer any real
oversight of what it is you'relearning.
You can basically say and tryto defend whatever it is you
want to learn and use that tosatisfy your learning goal.
Now there's criteria, there'scertain things that we are
(17:11):
supposed to be mindful of andwe're supposed to use to help us
make these decisions about whatwe learn.
But, based on a lot of theconversations and things that I
see on social media and theconversations I've had with
colleagues, the evidence-basedapproach to how we're supposed
(17:33):
to practice.
The evidence-based approachalso applies to how we're
supposed to pursue and satisfyour professional development
program or a new qualityassurance program isn't really
being followed now.
I understand that this is abrand new thing that just took
effect this year, so I'm hopingto see more guidance and support
(17:54):
moving forward, or maybe evenhaving RMTs audited and in a
safe way.
That's not too scary.
It doesn't mean you're gonnalose your license, but to have
somebody from the college say,hey, let's look at your what
you've done and then giveprovide some guidance on how
they could have done better.
How could you make yourlearning plan more evidence,
better.
How could you make yourlearning plan more
evidence-based?
How could you satisfy theselearning requirements?
(18:16):
By being more evidence-based,because with all these
guidelines that we're supposedto follow, with all these PDFs
and websites that we're supposedto read all the information
from, it's great, but if youdon't actually spend the time to
do that and there's no supportfor you after the fact, then how
are we supposed to learn andhow are we supposed to grow and
(18:37):
how are we supposed to be betterclinicians?
I think it's very difficult.
So there definitely needs to beanother step to this, and the
reason I say there should beanother step to this is because
I see a lot of uses and abusesof the term evidence-based
practice.
The general consensus from alot of the discussions I have
(19:01):
and a lot of things that peoplebring to me is that they think
evidence-based practice is justresearch evidence, it's this
very recipe, prescriptive thing,and that's not true.
Actually, evidence basedpractice is quite flexible If
you use it for the within thespirit of what it is intended.
Now, I've had a bunch of otherepisodes that have explored
(19:23):
evidence based practice and whatthat means and what that looks
like, so we're not going to talkabout that today in specifics,
but the use and abuse ofevidence basedbased practice,
particularly in the continuingeducation world, I feel is
something that definitely needsto be worked on, because,
according to our collegestandards, you know that we have
(19:46):
these practice standards andthis should be the way it is.
You know, every association orcollege across the country is
going to have some level ofpractice standards, which is
basically the minimumexpectation for you as a massage
therapist in terms of how youconduct yourself in practice,
and the definition on ourcollege website is that the
practice standards define theminimum level of expected
(20:07):
performance for registeredmassage therapists and therefore
define what constitutes safe,ethical and competent delivery
of care by RMTs.
The idea is that when we leaveschool, it's entry to practice.
We pass that board exam, it'sthe minimum standard, and we're
supposed to grow from there.
One of the problems that we see, though, is that, because the
(20:30):
entry to practice standards missout on providing RMTs the
knowledge, the skills, theappreciation for evidence and
evidence-based practice and whatthat means, it's very difficult
for a lot of us to then have anevidence-based quality
(20:52):
assurance program or have anevidence-based professional
growth pathway when the basicprinciples of it are missed in
our entry-level practice.
Now, for those of you that areaware or that know, the
inter-jurisdictional competencydocuments which the schools are
supposed to use to teach basetheir teachings from.
(21:14):
It's what the regulatorycolleges use to base their
licensing exams on these.
There is a mention ofevidence-based practice in there
, but that doesn't mean thateveryone's taught it and it
doesn't mean that everyone'staught it and it doesn't mean
that it's incorporated in everysingle school curriculum.
(21:36):
And I've looked at a lot of theschool curriculums and I can
100 guarantee you that most ofthem are not evidence-based.
Now there is a way to includecurrent evidence to make it fit
within the inter-jurisdictionaldocuments and competencies that
practice competencies andpractice indicators but that is
(21:59):
not done by the majority ofschools.
So it's up to us in thecontinuing education world to
try to fill this gap, and that'sone of the things that I try to
do.
Now, the thing that is importantis, if you don't have an
understanding of evidence-basedpractice, is to learn the basics
of what it means, and a lot ofthat comes down to critical
(22:19):
thinking and to critical thoughtand to asking a lot of
questions and to questioningwhat do you know and how do you
know what you know.
Is what you know valid?
Is it based on hearsay?
Is it based on good qualityevidence?
Is it based on what someonetold you?
It's really important for us tostart off by asking ourselves
(22:42):
the questions how do I know whatI know?
Because an evidence-basedpractice is going to require you
to critically assess all theinformation, and this is
outlined again in our practicestandards, focusing on facts and
observations rather thanbeliefs, opinions and traditions
.
Hugely, hugely important tounderstand that the large
(23:03):
majority of the stuff that welearn, not only in school but
also in continuing education,also in our professional
development, quality assurance,whatever terms you want to use
are based usually on opinionsand traditions rather than on
current science.
And there's also a use andabuse of current science or
current anatomical knowledge totry to use that information to
(23:27):
try to influence a tradition orbelief.
So we need to challenge what wethink we know in order to get
better.
That's one of the most basic,fundamental aspects that we need
to appreciate in evidence-basedpractice.
So let's move on and talk aboutthe Quality Assurance Program in
BC.
Now the guiding principles, andthis is, according to the
(23:49):
Complementary HealthProfessionals of BC, which is
our new regulatory college.
Here.
The guiding principles of theredesign of the QA program for
RMTs are it's got to be based oncore competencies, professional
standards and standards ofpractice for safe, ethical and
competent practice.
It supports high practicestandards, supports RMTs and
(24:10):
continued practice improvement,is inclusive and fairly applied
to all RMTs, ensures all RMTsare able to achieve their
requirements in a meaningful way, is based on best available
evidence and is consistent withthe CCHPBC's mandate to protect
the public.
These are great guidingprinciples, but let's look at
(24:31):
how these things can be applied,or how they should be, in my
opinion.
Applied to practice.
So based on core competencies,which makes sense, right, we got
to keep within our scope ofpractice and the professional
standards.
The other point, though, in thisfirst line here says standards
of practice for safe, ethicaland competent practice.
So our standards of practice.
(24:51):
One of our standards ofpractice is an evidence-based
practice standard, which meanswe have to pursue learning
that's based on current bestevidence.
So it is a logical train ofthought for me to say if we have
(25:11):
an evidence-based practicestandard and our new quality
assurance program is based onthese standards of practices,
therefore, our continuingeducation needs to be based on
evidence.
That means that learning thingsthat have no basis in evidence
or are based on conjectureshouldn't actually be allowed.
(25:33):
That means a lot of themodality empire approaches.
If they are still perpetuating1980s, 1990s belief systems,
information, or based on beliefsystems information, or based on
incomplete hypotheses or ideals, that actually shouldn't count
(25:56):
for your quality assurance.
And the difficult thing, though,is how is an RMT supposed to
know whether something doesn'tmeet that evidence-based
practice standard when we're nottaught it in the first place?
If you are somebody that doessay craniosacral therapy, which
is something that's been donefor a long time and it's got a
lot of beliefs around it andthere's a lot of pseudoscience
(26:18):
around it and that's notdisputed the clinical
application of it, sure it canhelp people, sure people might
feel better, but the sciencearound it is, in a lot of cases,
just completely non-existent.
But if you were taught that inschool and previously, if you
had taken courses andcertifications in that, and you
(26:40):
were taught by these people,these con ed instructors that
really believed in it, and maybethey presented some evidence to
you that sounded compelling,then of course it's easy for us
to fall into these traps ofthinking that what we're doing
is evidence-based when it's not.
(27:01):
So there's a lot of use andabuse of evidence.
There's a lot of use and abuseof people passing off really
crappy science and saying it'sgood science and without us
having that support andunderstanding at an entry to
practice level as well asthrough our associations,
regulatory bodies, it's easy forus to miss that.
(27:23):
So I would say that a lot of us, when we were a lot of people,
when they were doing theirprofessional or their PDP
program here, they were notfollowing an evidence-based
development program.
It's not for any fault of theirown.
I think it's a fault of theentire system.
The stakeholders involved needto step up the game on this, and
I sound like a broken recordbecause I've been saying that a
(27:44):
million times Now.
The other thing that I did likeabout this program though it's
not all bad is it's inclusive.
So it means it doesn't matterwhere you live, who you are.
You have options for you,different learning styles.
You can choose the best way tolearn for you.
(28:05):
This other point says ensuresthat all RMTs are able to
achieve the requirements in ameaningful way.
That's great because, again,that's inclusive.
It allows you to pursue thesethings and it doesn't have to be
that difficult.
It doesn't have to be expensiveeither.
Is it consistent, though, withthe mandate to protect the
public?
I know that the regulatorycolleges have this mandate
(28:25):
that's given to them bygovernment says your job is to
protect the public, but I thinkthere's a very strong argument
that we can make which says thatif you are practicing and
you're in a way that'snon-evidence based, you're not
really protecting the public.
Are you doing them a lot ofharm?
Most know, but are youproviding competent, safe or
(28:48):
ethical care?
Maybe it's safe, but it's notethical or competent if we're
practicing in a non evidencebased way.
So there's there's definitely aneed for improvement.
Now, I know from some of thefeedback I get from people is
they feel that I'm overlycritical, and I'm, you know, can
maybe be not supportive enoughof certain things, but I
(29:08):
strongly believe that, in orderfor our profession to get better
, we need to ask hard questionsand we need to not accept just
the status quo as being okay.
I strongly believe that we needto challenge these beliefs and
we need to challenge a systemwhich is there, which should
look to support us, to moveforward and to be better
(29:31):
clinicians, but there's stillsome big holes there.
Now the PDP program is betterthan the old one.
Yes, I agree with that.
For someone like myself whoteaches predominantly online
whether it's live online orself-directed courses it's great
because I feel that I cancreate content that gives people
lots of options to learn basedon what they want, and try and
(29:51):
have some affordable options.
Some ones are a little moreexpensive but provide things for
them so they can learn whetheryou're in BC or anywhere across
Canada or the world.
But until we really have abetter grasp in our profession
of what evidence-based practiceis and how this applies to what
we do in clinic every day andhow this applies to the learning
(30:12):
that we pursue, I think we'restill going to be left behind.
And when I say things like theuse and abuse of evidence-based
practice, what's that mean?
I'll give you an example here,and this is one that I've seen a
few times and more than a few.
I've seen this a lot Becauseevidence-based practice is a
buzzword.
A lot of people are using it,just like patient-centered care
(30:34):
is a buzzword.
Pain science is a buzzword.
Biopsychosocial is a buzzword.
These are all things thatpeople use and I feel that
oftentimes they get used becauseeveryone's saying them and a
lot of people will use themwithout really understanding
kind of the philosophicalapplications of what these
actually mean.
(30:54):
Anybody can say evidence-basedpractice, but just because you
say it doesn't mean it's true.
And if you just look at, say, acourse description or a website
and someone says I will meetyour therapeutic needs with an
evidence-based approach that'srooted in deep tissue massage
(31:17):
therapy, what does that mean?
What is deep tissue massagetherapy?
Is that evidence-based?
What is deep tissue massagetherapy?
Is that evidence-based?
We all know what deep tissue isin terms of.
It's a term that we use, butit's actually not a defined term
.
It's a feeling and everyone'skind of understanding of deep
(31:40):
tissue is going to be different.
Does that mean you're putting inmore pressure?
Does that mean that you aretreating deeper structures?
How do you know that?
Is that possible?
Is it necessary?
Can you treat deeper tissues?
Where's the evidence on that?
You can't say that you treatdeep tissue without evidence to
(32:04):
support.
So yeah, I'm treating theseother structures here and I I am
because of blah, blah, blah,these papers.
And again we could say do youneed to treat deep?
Whatever that might be right isdeep your perception.
Is it the perception of theperson on the table?
Are you getting a ruler ormeasuring tape and measuring
(32:25):
depth?
Every human, every body isdifferent.
Sometimes light pressure couldfeel like it's really deep on
somebody and vice versa, youcould be putting a lot of
pressure on someone where youfeel like you're squishing and
mashing everything and theydon't feel like it's deep.
So it's those kind of termsthat we use.
We should question those Isthat evidence-based?
(32:46):
If you're going to claim thatyou're evidence-based, well, I'm
an evidence-based practitionerand these are all the techniques
and my favorite modalities blah, blah, blah, blah, blah.
That to me is a red flag,saying that, well, those are
your preferred style, that'syour preferred way of treating.
But you can't say that'sevidence-based, because
(33:08):
everybody has their own uniquestyle.
Everybody has their ownpreferred way of treating people
, whether they like a slower ora pokier or a flatter pressure
or a.
You know?
Do you incorporate movement?
Are you using different bodyparts?
How are you treating somebody?
(33:29):
We all have our own approachesand neither is right and neither
is wrong.
So I don't think that we can sayyou are evidence-based and then
listing all your, listing allyour techniques, because in
order for you to say that thosetechniques are evidence-based,
you'd have to have research tosupport them.
So I think you can say I'm anevidence-based therapist who
(33:51):
likes to treat certainpopulations of people athletes,
pediatrics, chronic pain,whatever that might be.
Or I'm an evidence-basedpractitioner that has a special
interest in orthopedics,evidence-based practitioner that
, like that, has a specialinterest in orthopedics female
health.
But you can't list all yourtechniques afterwards and say
that you're evidence-based,because those two things don't
(34:15):
don't match.
They don't go well together,particularly when the evidence
on all these techniques is allover the place.
There is no one techniquebetter than the other, because
it is not the technique that isevidence-based, it is the
(34:36):
knowledge and how you practicethat should be based on evidence
.
I think the less wrong approach, the more evidence-based
approach would be yeah, like Isaid, to list the populations
that you're interested in andthen say these are some of the
techniques I feel, or these aresome of the techniques that I
like to use, and then you canlist them.
But don't try to sell thosetechniques as being
(34:56):
evidence-based or better thananyone else's.
I don't think it's acompetition.
Anyway, I could go on foreverabout that, but I think I'll
just leave that there so I don'tbeat it to death.
My hope is, as massagetherapists in our profession and
the stakeholders start to adoptmore of these evidence-based
approaches, that what we'llstart to see is less
(35:19):
pseudoscience.
We'll start to see lessmodality empires trying to sell
their fix, start to see lessmodality empires trying to sell
their fix and we'll start to seemore critical thinking and
critical, critical analysis ofwhat is that we think that we
know, because anybody can give,can learn to give, an amazing,
(35:42):
delicious sensory experience ofa massage.
But being able to use yourmanual skills and combine those
into an evidence-based frameworkthat supports somebody and
utilizes everything within ourscope of practice to help them
the best that we can through ourlanguage, through our
(36:05):
communication, through our hands, through the advice we give or
through the advice that theyrequest, requires a deeper
understanding of the evidenceand an appreciation for how that
guides us.
So if you've made it this farin the episode, I'm going to
repeat myself again.
(36:25):
What I would love for you to dois to ask yourself the hard
questions how do I know what Iknow and is what I know valid?
And you may not be able to comeup with a good answer, but I
highly suggest that you askthose hard questions so that way
(36:47):
you can challenge yourself, tounlearn maybe some things or to
relearn how it is what you aredoing is helping people, because
I can promise you this that alot of the stuff that we learned
in schools and that we learnedin non-evidence-based
professional developmentprograms are not consistent with
(37:12):
a current evidence-basedpractice standard, which is a
requirement for our profession.
Thanks for listening.
I appreciate all of you fortaking the time to be here.
If you enjoyed this episode,please give it a five-star
rating and share it on yourfavorite social media platform.
You can always follow me onInstagram or Facebook at Eric
Purvis RMT, and please head overto my website, ericpurviscom,
(37:35):
to see a full listing of all mylive courses, webinars and
self-directed course options.
Until next time, take care.
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