resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
April, 2005, Vol. 05, Issue 04
How Should We Teach Assessment?
By Whitney Lowe, LMT
Musculoskeletal disorders (MSDs) are some of the most commonly occurring causes of pain and disability in this country. They are treated by a wide variety of practitioners, and many people with them seek the care of someone other than a physician.Consequently, massage therapy is frequently used to address this wide array of pain and injury problems.
Proper treatment of any MSD begins with identifying the underlying problem. It is only then that we can determine if we should even be working on this client. If the practitioner has determined that a MSD exists for which massage treatment would be helpful, s/he must then determine which techniques or approaches to use with the client that should be helpful. The way to make this determination is through proper and accurate assessment.
Information may be gathered in many different forms, systems or structures yet they all have several elements in common. A thorough assessment includes detailed information from the client history, observable characteristics of the client and his/her condition, as well as specific methods of physical examination.
Some practitioners shy away from any organized framework for their assessment process, stating instead that intuition guides them. Others may state they do assessment solely through what they feel in their hands. While these are very important skills and may work well for basic relaxation massage approaches, they don't provide information necessary to make appropriate clinical decisions about treating MSDs. If I had an illness or injury and went to see a physician, I wouldn't want that doctor to evaluate me based on intuition or palpation alone. Likewise, many MSDs are complex and we must engage in a more comprehensive process when evaluating them.
There are some misconceptions about what assessment entails. Some feel it is just evaluating a client's range of motion. Evaluating range of motion is important, but you must know more than your client has a limitation in a certain motion, such as abduction of the shoulder. You must do what you can to find out why that limitation exists. Others state that assessment is mainly the use of special orthopedic tests like the Phalen's test for evaluating carpal tunnel syndrome. Memorization and use of various orthopedic tests is helpful, but only when used in their proper contexts. Simply memorizing these tests does not make you effective at assessment any more than memorizing the alphabet makes you a writer.
Assessment and Learning Theory
Learning theorists have developed classifications of how we learn that describe increasing levels of complexity. One of the most common classifications still used today is Bloom's Taxonomy of Educational Objectives, first published in the mid-1950s. In this classification, Bloom and his colleagues described six levels of increasing cognitive complexity: knowledge, comprehension, application, analysis, synthesis and evaluation.
The lowest levels, knowledge and comprehension, involve rote memorization. While memorization has its usefulness, it should not be the primary goal of our educational objectives. Unfortunately, most educational environments do not go past this level and assume that "learning" has occurred because an individual is able to achieve a specific score on a test that emphasizes rote memorization and, too often, little else.
The problem with this approach is that it doesn't reflect clinical reality at all. In the clinic room, the practitioner is faced with situations where memorization of facts still leaves you pondering as to what your client's primary complaint really is. In order to get past this point you must use the higher levels of the taxonomy - analysis, synthesis and evaluation. These abilities are developed through practical application of clinical reasoning activities in the learning process. Assessment is a complex procedure of clinical reasoning that has to use these higher cognitive functions in order to be even minimally effective.
Consequently, if we want to teach assessment skills in the way they will be eventually used in practice, we have to radically alter the way they are initially presented. In order to do this we have to get away from trying to have students find the "right" answer all the time. In many cases there isn't one "right" answer. There are several different paths and they each take us in different directions that may produce a good clinical reasoning process. Therefore, to accomplish this goal we must create educational activities that encourage a degree of cognitive uncertainty and encourage the practitioner to go through the reasoning process to figure a problem out. It is only through this kind of practice that these skills are developed.
So, when learning assessment, don't get stuck on trying to memorize a large group of special orthopedic tests or performing range-of-motion evaluations and call that your assessment. You must look at the entire picture of gathering information from the client's story and physical examination, process the importance of what you have found out, and construct a model for explaining your findings. When you can do this, you have moved into the higher levels of cognitive complexity, used advanced assessment strategies, and performed a much more thorough service in seeking care for your clients.
Click here for more information about Whitney Lowe, LMT.
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