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Massage Today
December, 2001, Vol. 01, Issue 12

How People Learn

By Keith Eric Grant, PhD, NCTMB

Those students who exhibit the canonical (in our terms "scholastic") mind are credited with understanding, even when real understanding is limited or absent; many people - including at times the author of this book and his daughter - can pass the test but fail other, perhaps more appropriate and more probing measures of understanding.

Less happily, many who are capable of exhibiting significant understanding appear deficient, simply because they cannot readily traffic in the commonly accepted coin of the educational realm.

- Howard Gardner.7

Like those who dress as giant salmon and run the San Francisco Bay-to-Breakers from finish to start, I sometimes find myself going against the accepted flow. The impetus this time was provided by a colleague's statement attributing the growth in the use of massage to a certain "standard of training," and also expressing a fear that all of the "good work" could be undone by a loosening of standards.

While I am a staunch supporter of using marketing and public education to reach out and touch as widely as we can with massage, I believe that both the credit and the fear are unfounded. Even more akin to my symbolic salmon, I believe that much of the current push for "standards of training" is founded on a flawed educational model of how we learn.

The Foundation on which Massage Has Grown

Statistics on sports participation indicate that one of the most important trends to begin in the 1960s was "a new focus on self-fulfillment and a heightened awareness in self-improvement - an outgrowth of which was a budding awareness of personal health and physical fitness."1 This shift in attitude entered the mainstream in the 1970s, resulting in the running boom at the end of that decade with a subsequent spread into other activities. The overall growth of physical activity participation flattened in the 1990s, with activities in health clubs growing at the expense of other venues. In short, during the 1990s there was a shift toward seeking external motivation and facilitation, a shift synergistic with increased utilization of massage. Couple this with the observation that 23% of current health club members are at least 55 years old, a 379% increase since 1987.2

There were two other concurrent cultural themes that I believe changed attitudes in ways that had major positive impacts on massage utilization in the United States. The first was that U.S. athletic organizations were forced to respond, however reactively, to the widespread use of massage by foreign competitors. The second was the dramatic increase in sports participation by girls and women following the 1972 enactment of Title IX.10,11 To a great extent, growth in massage has ridden on the groundswell of the increasing number of women with a positive history of physical activity, and the shift in expectations that they have created.

Teaching for Understanding

There are those who advocate the requirement of a seemingly ever-increasing number of hours of education as a prerequisite to entering the massage profession. If the motivation for this advocacy is to produce corresponding increases in practitioner competency, such requirements are of sadly limited benefit. Educational research over the past 20-30 years compellingly demonstrates that learning in the classroom context often leads not to usable understanding, but only to the ability to successfully answer test questions 3,6,7,8,9. Study after study has found that, by and large, even the best students in the best schools can't take knowledge learned in one setting and apply it appropriately in a different setting.3,4,9

Within the academic setting, students can learn to be successful with short-term memorization and use of "right-answer" cues. In contrast, actual practice requires very limited memorization of facts. The massage practitioner must have the deeper understanding required to find information as needed and then to be able to use it to make therapy decisions in the face of ambiguity. Research indicates that the environment that seems best able to foster the understanding leading to usability has much in common with traditional apprenticeships.7,8 In the modern cognitive apprenticeship, however, it is not just the tasks but the thinking underlying them that must be made "visible" and reflected upon.5

Such apprenticeships can be created within the context of traditional schools. A modular, tiered program can move the student into early practice, while providing resources for the ongoing training and dialog that passes the context of expertise from teacher/mentors to increasingly skillful practitioners. There should be a progression of successively more difficult tasks within the conceptual scaffolding and coaching provided by the mentors. Testing should not be concerned with memorization and regurgitation but with the student's ability, on being presented with the relevant data, to choose between conclusions that can be drawn from it.8 Within the profession of massage, it is time that we base our training requirements on 21st century insights of how people learn.


  1. American Sports Data Inc., 2000: Booming Health Clubs, Slipping Fitness Participation and Healthier Diets All Coexist, in the Overweight Society (
  2. American Sports Data Inc., 2001: Grandparents Fitter Than Grandchildren? (
  3. Ron Brandt: On Teaching for Understanding: A Conversation with Howard Gardner (
  4. John Seely Brown, Allan Collins, and Paul Duguid, 1989: Situated Cognition and the Culture of Learning, Educational Researcher, 18(1), 32-42 (
  5. Allan Collins, John Seely Brown, and Ann Holum, 1991: Cognitive Apprenticeship: Making Thinking Visible, American Educator, winter (
  6. Commission on Behavioral and Social Sciences and Education, National Research Council, 2000: How People Learn: Brain, Mind, Experience, and School: Expanded Edition, National Academy Press (
  7. Howard Gardner, 1993: The Unschooled Mind - How Children Think and How Schools Should Teach, reissue edition, Basic Books; ISBN: 0-4650-8896-1.
  8. Howard Gardner 1998: Low Scores Are No Disgrace: The Limits of Testing, NY Times, March 2, 1998, (
  9. Ted Marchese: The New Conversations about Learning - Insights from Neuroscience and Anthropology, Cognitive Science and Work-Place Studies (
  10. Running Network: State of the Sport, Part III - U.S. Road Race Participation Trends (
  11. University of Iowa: Gender Equity in Sports Project (

Click here for previous articles by Keith Eric Grant, PhD, NCTMB.


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