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Demands of Regulation on Education

I caught up with Pam Fitch, a professor in the massage therapy program at Algonquin College (Ontario) and author of the upcoming book, Talking Body Listening Hands (Pearson, 2014).

September 27, 2012  By Don Quinn Dillon

Don Dillon, RMT, in conversation with Pam Fitch, BA, RMT

I caught up with Pam Fitch, a professor in the massage therapy program at Algonquin College (Ontario) and author of the upcoming book, Talking Body Listening Hands (Pearson, 2014). Most massage therapists may have only a vague notion of the regulatory and educational changes that have occurred in the last three years, so I asked Pam to tell us in plain language what’s going on and why it’s important. Pam discusses the changing landscape for educators with respect to registration exams, and she presents some important points for massage educators and program administrators to consider in light of expectations surrounding accreditation and a national competency exam.

Inter-jurisdictional Competencies
The Consortium of Massage Therapy Regulators has developed an Inter-Jurisdictional Occupational Profile that describes the work of massage therapists. This document evolved over 10 years and in two phases. Canadian massage therapists in the three regulated jurisdictions (British Columbia, Ontario and Newfoundland) were surveyed to ensure that the competencies reflected the actual work of massage therapists. The results of the survey overwhelmingly supported the new competencies. In Phase 2 of the project, performance indicators were established to explain how each competency should be tested. Educators in each jurisdiction need to become very familiar with this document because within three years, registration exams will test these competencies based on the performance indicators. It is hoped that the occupational profile, competencies and performance indicators may lead the way to national entry-to-practice examinations and massage therapy program accreditation. According to the College of Massage Therapists of Ontario website, “The Performance Indicators will complement the Inter-jurisdictional Practice Competency Standards and enable educators nationally to develop curricula based on the final amalgamated document. This will further assist in creating the inter-jurisdictional standard facilitating common entry-to-practice requirements in each of the regulated jurisdictions, and for other provinces as they become regulated.”1

“This is a big deal,” Pam says. “The performance indicators explain to what degree each competency is tested and whether a student needs to perform a task in a simulated (lab) or clinical environment or whether the knowledge inherent in the competency reflects academic learning. In addition, professional practice comprises one third of the document, articulating significant expectations for professionalism, communication and the therapeutic relationship. That is brand new. These competencies have never been so comprehensively articulated before and the fact that communication and professionalism have been given such weight suggests that RMT educators need to acknowledge that massage therapy represents much more than techniques, modalities and pathology. A clinical process emerges from this document that demonstrates how essential therapeutic communication is to massage therapy.


“But at the same time as our profession recognizes the essential aspects of communication, professionalism and the therapeutic relationship, the immediate burden shifts to educators who have to teach attitudes, values and beliefs. How to teach professional values, communication skills or evaluate a student’s ability to respect the therapeutic relationship? This is a big challenge for all schools, especially where teachers have no experience with aspects of massage therapy other than clinical science.”

Pam suggests these new requirements require dedicated effort on the part of schools to evaluate current practices and map curriculum to the new performance competencies and indicators. “At Algonquin College, we’ve worked hard to understand how our current teaching practices match the new performance indicators and with the future headed towards massage therapy accreditation, this will be the work that all schools will have to do. Evaluating and mapping curriculum represents an enormous task. I really hope that we can work together as educators to figure out how best to prepare for the upcoming changes to registration exams and future accreditation.”

School Accreditation
Donelda Gowan-Moody and Amanda Baskwill, in their report to the Federation of Massage Therapy Regulatory Authorities of Canada (FOMTRAC) write, “Accreditation by an objective third party system ensures that massage therapy programs, and the institutions that provide them, are accountable for providing quality education in accordance with pre-set standard for entrance to practice.”2

Gowan-Moody and Baskwill outline the process: “Firstly, the regulatory body is responsible for establishing scope of practice and professional competencies that dictate the ethics and standards expected by members of the profession. Secondly, the educational institutions/programs are responsible for the creation and delivery of curriculum that will develop the skills and values of their students to enable the graduates of massage therapy programs to be successful at entry-to-practice examinations and in professional practice. There then needs to be an external accreditation institution that is responsible for evaluating the curriculum of the educational institutions against the competencies and scope of practice of the regulatory body. Finally, the provincial government is responsible for approving new massage therapy programs based on their proposed curriculum.”3

Pam hopes that massage therapy institutions will become more proactive in their approach to accreditation. “Massage therapy programs need to discuss how they plan to get on board with school accreditation. Although BC has accredited its schools for years, accreditation has never been established across all three jurisdictions. However, programs in most other professional disciplines view it as an essential way of ensuring educational and professional accountability. If educators ignore the opportunity to discuss how to evaluate and map curriculum to the new inter-jurisdictional competency standards, then they will be unprepared for the dialogue on how best to meet accreditation standards. We don’t know when accreditation will be established for our profession, but it is coming. Taking a long view and preparing in advance for this important step will lessen the burden on schools once this process is in place.”

Need for Two-Way Communication between Educators and Regulators
Pam is adamant that for education to move forward and for accreditation to get past the discussion phase, all stakeholders need to hold dialogues and work collaboratively. “How the Regulator sets the exam and how schools prepare their students for the exam is the point where educators and regulators meet. More than anything, I would like to see educators establish a united voice within the profession and collaborate with the Regulator so that the registration exam becomes a unifying professional force. If the new registration exams reflected the competencies and tested the performance indicators transparently, then educators would use the new document to develop their curriculum maps. That was how these standards were conceived. This type of practice is the norm in other professions like nursing and dental hygiene, where educators are invited to create a registration exam each year.”

The College of Massage Therapist of Ontario historically has not allowed educators to participate in the creation of a
registration exam because they have suggested that the security of the exam might be compromised. Unfortunately this year, the security of the exam was breached despite the fact that no educators were involved. This left educators to answer graduates’ questions about their future and put many teachers in an uncomfortable position of defending the Regulator, without having enough information about future plans. Graduates lost work opportunities, potential income and were delayed in their ability to join the profession, in some cases for up to a year.

Candidates have voiced concern in three Ontario newspapers over the fairness of expecting candidates to write their registration exams more than six months after the initial exam date. The cost of the registration exam is close to $1,000 plus whatever expenses are incurred for travel to the testing site. The Regulator did not offer candidates any compensation and it is expected that some may abandon the profession, work without registration, establish practices in unregulated provinces or try to write their registration exams in British Columbia. Under the current system in Ontario, educators and regulators have no formal consultative process when problems arise or things go wrong with the exam.

“A more transparent process between the Regulator and the Educators would help to unify the profession significantly,” says Pam. If we could have worked together on how to manage the delay in the exam, then schools could have supported the CMTO position more easily. I applaud B.C.’s registration exam process because their College is working diligently to ensure fairness of the registration exam. The CMTBC hires MTs who are trained outside of B.C. to take their registration exam and provide feedback on its fairness. That shows considerable commitment to reducing labour mobility barriers across provinces as well as transparency in process.”

“I hope,” Pam concludes, “that as educators, we can communicate more flexibly between professional stakeholders so that, in moving forward, we are all on the same page. Inter-provincially this is as challenging as it is within Ontario. But an opportunity to dialogue on some of these national and professionally current issues would catch my attention.”

Thanks, Pam, for making this subject matter palatable for the rest of us!




2. Gowan-Moody, D and Baskwill, A: Report on Policy Issues Concerning the Regulation of Massage Therapy in Canada, May 2006. P 16

3. ibid


Don Dillon is the author of Massage Therapist Practice: Start. Sustain. Succeed. and the self-study workbook Charting Skills for Massage Therapists. Don has lectured in seven Canadian provinces and over 60 of his articles have appeared in massage industry publications in Canada, the United States and Australia. Don is the recipient of several awards from the Ontario Massage Therapist Association, and is one of the founding members of Massage Therapy Radio . His website,, provides a variety of resources for massage therapists.

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