Trends are like ocean waves. The can gently lap up on the shore and recede or they can come inland with a mighty force and dramatically change the landscape. Anyone who has been watching the regulatory landscape in the massage therapy profession in the U.S. in the last several years will clearly recognize that we have been watching a trend that is gathering momentum and increasing in its size. I am of course speaking of the emergence of the Massage & Bodywork Licensing Exam (MBLEx) as an alternative to the National Certification Exam for Therapeutic Massage & Bodywork (NCETMB).

For years the National Certification Board (NCBTMB) has been able to hold their domain as an organization that encouraged the licensing of massage therapists in an increasing number of states. The existence of their exam was a big piece of that puzzle because it meant the states did not have to go to the expense of creating a psychometrically valid exam (an expensive undertaking). But at the same time the NCBTMB was also trying to promote the exam as a certification exam that demonstrated a higher level of knowledge, skill, and ability by practitioners who took this exam. But you can’t have it both ways… The exam can’t be the entry level credential for everyone and also be a more advanced certification exam that is supposed to set you apart from others.

By trying to play both sides of the fence the NCBTMB has lost its focus and in the mean time become a victim of its own success. Out of this turmoil the Federation of State Massage Therapy Boards (FSMTB) has emerged with an exam and a structure that makes very good sense. The initial licensing exam is administered by a group of state licensing boards and they determine its structure, content and handle the logistics of its administration. This exam also helps more with portability of credentials between different states. It just makes sense (as long as it is administered well).

Yesterday the American Massage Therapy Association (AMTA) sent out a press release supporting the use of the MBLEx as the single primary licensing exam for our profession. Because the AMTA gave birth to the the NCBTMB, this is a very significant development. It is another indication that the NCBTMB is losing its hold on the huge revenue stream that is tied to entry level licensure in our profession. With that slipping away, how will the organization re-invent itself? What will become of them? They have reached what Andrew Grove, former chairman of Intel, has called a Strategic Inflection Point– a place that is defined by a major paradigm shift in the way they have to look at their future. They can either re-invent themselves or they may be watching as that huge wave sweeps them back out to sea… My recommendation is that every member of the board and leadership read Grove’s book, Only the Paranoid Survive. Actually the book contains some pretty good messages for all of us in these very challenging economic times.

There is no doubt that some things are better taught in a traditional classroom environment and some are better taught in distance education environments. And, of course, many topics that can be taught well in either environment. In most cases it is far more important to consider the instructional design method used for the course than the medium of course delivery. If the instructional design fits properly you can make a good educational experience in many different subject areas.

One topic that is also talked about in the debate about distance education is the quality of the assessment strategies. Web technologies have made it very easy to create simple multiple choice and true/false assessments. Many people who deploy online learning (e-learning) simply transfer material from a lecture type class (or in a worst case scenario, simply put a bunch of written text online) and then offer a multiple choice test at the end. This is not always bad if you are just trying to get people to memorize information, but hopefully the goals for most educators go beyond simple rote memorization.

In his book, Educative Assessment, Grant Wiggins states that assessment should be more than just a means to attempt documentation of learning. The assessment should be a learning process in and of itself. When designing tests or evaluations, I have always tried to keep that in mind.

I have been spending the last several days working on a comprehensive evaluation for our orthopedic massage certification program. I have become intrigued with the possibilities of the adaptive mode for test questions that is built into Moodle, our learning management system. When a student takes the exam and answers a question correctly they can immediately see that they got the question correct. Immediate feedback like this helps reinforce the learning process. When a question is answered incorrectly there is an opportunity to do the question again for a lower amount of credit and, if desired, see feedback on why the question was wrong. This ability to get immediate feedback about errors has great potential for using the assessment process for enhancing learning and not just measuring it. That kind of immediate feedback and grading option is not possible in a paper-based classroom evaluation test.