resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
June, 2009, Vol. 09, Issue 06
Thinking in Practice
By Keith Eric Grant, PhD, NCTMB
"Experts see the world differently. They see things the rest of us cannot. Often experts do not realize that the rest of us are unable to detect what seems obvious to them." Gary Klien, author of Sources of Power: How People Make Decisions.
The world of learning has long fascinated me. I've taken the opportunity to walk it from a number of different perspectives: a physics graduate student; a research scientist; a massage student, practitioner and instructor; a martial arts student and teacher; a music student; and a folk dancer. My experience has thus spanned both the academic and experiential realms; both the conceptual and the kinesthetic. And out of all these experiences, one lesson has become clear (and applied in multiple realms): You cannot just pour information into a student and expect it to become magically useful.
Creating useful skills requires skill practice in context, and requires changing the manner in which the student uses their mind and senses to perceive the world. Without this context, information lies dormant, unconnected and unusable outside of the academic realm. I've had the opportunity to verify in my own experience that "experts see the world differently,"1 just as Gary Klein, senior scientist at Applied Research Assoicates, concluded from his field research. This change in perception is not a result of classroom lectures, but a result of guided participation. If we want to create skilled massage practitioners, we cannot just talk at students or be satisfied when they have memorized definitions and phrases from books. We must encourage and guide them in gaining patterns of tactile memory coupled with active awareness of what they are encountering.
From his research, Klein summarizes what differentiates the novice from the expert into three aspects: a history of experienced patterns; the ability to project the effects of an intervention; and a tuning of sensory discrimination. "These aspects of learning can be tied to the two primary sources of power we have been examining: pattern matching and mental simulation. Pattern matching (intuition) refers to the ability of the expert to detect typicality and to notice events that did not happen and other anomalies that violate the pattern. Mental simulation covers the ability to see events that happened previously and events that are likely to happen in the future. We also encounter some additional sources of power. The ability to make fine discriminations must involve some sort of perceptual learning."1
In a recent book, Think Again,2 authors Sidney Finkelstein, Jo Whitehead, and Andrew Campbell drew on Klein's research and other sources of neurological and cognitive research to better understand failures of decision. One of the things they noted is that experts rarely compare alternative actions. Instead, an expert will move directly to what experience indicates to be a viable solution. This can be both a strength and a weakness: a strength in that it generally produces a correct action quickly, and a weakness because it can also be the cause of occasionally missing alternatives or misidentifying a situation. One interesting aspect of this process is that most of the cognition happens at an unconscious level, as in the following quote taken from Think Again:
"Klein discovered that people with experience do most of their decision making unconsciously. They assess the situation by drawing on similar experiences from their memory, but much of this assessment process happens unconsciously. They then select a course of action from their memories of past actions. Finally, they test the practicality of this course of action by imagining what will happen if the action is taken. The imagining activity is the main conscious work that happens during a decision. What Klein had discovered is that we mostly make decisions unconsciously using experience, intuition, and imagination. We do not normally do much conscious analysis, such as identifying and comparing options or challenging assumptions and initial assessments."2
The conscious level of processing is primarily used only in unfamiliar situations and, for decisions where there is time, for consciously cross-checking the faster, unconscious process. It's fair to ask if this really is the case in health care. The answer provided for nursing, from over a decade of study by Patricia Benner and colleagues is a definite yes. The following is an excerpt from a book written by Benner, et al Expertise in Nursing Practice3:
"As a process, the diagnosis-treatment model was simply not apparent in the narrative accounts provided by nurses at any level, but clearly not in those by nurses practicing at the expert level. The judgments were rather characterized by immediate apprehension of the clinical situation, progressive understanding of the patient's story through his narrative accounts, and the capacity to notice qualitative changes by knowing the patient's pattern of responses; nursing actions were typically response-based, relying on whole intuitions of what had worked in past similar situations, and modified in accordance with this particular patient's responses to it. In this kind of fluid, skillful response, there was virtually no evidence of 'treatment' based on explicit nursing diagnoses."3
The above in no way diminishes the usefulness of anatomical information and abstract knowledge of techniques. What it does indicate is that, like pouring the molten bronze for a cast statue, the usefulness and integrity of the end result is only as good as the containing mold created by practice and experience. Without such a mold, all that is obtained for either statue or learning is a puddle of slag.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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