Choose Wisely: the Quality of Massage Education in the United States

BACKGROUND Assessing the quality of postsecondary education remains a difficult task, despite many efforts to do so. No consensus or standard definition of educational quality has yet been agreed upon or developed. PURPOSE This study evaluated the quality of massage education in the United States using three closely-related questions to frame the evaluation: 1) Is accreditation improving the quality of education for massage therapy? If not, then what do we need to do to improve it? 2) Does accreditation by COMTA specifically improve quality of education compared to other vocational accrediting agencies that do not require curriculum competencies specific to massage? 3) Would adding competencies at an "advanced" level, or specific degree levels, be helpful in advancing massage therapy in the eyes of other health professions? SETTING United States. PARTICIPANTS Members of a national massage education organization, members affiliated with the educational arm of two national professional associations, and members of two national education organizations in complementary and integrative health care (CIHC). RESEARCH DESIGN MIXED METHODS EVALUATION USING THREE DATA SOURCES: existing gainful employment data from the US Department of Education, analyzed by type of massage program and accreditation agency to determine average and relative value for cost; numbers of disciplinary actions against massage practitioners reported by state regulatory agencies, and a qualitatively developed survey administered to two different groups of educators. RESULTS Average tuition cost across all reporting schools/programs was $13,605, with an average graduation rate of 71.9%. Of the schools and programs that reported student loan data, 84% of students received federal financial aid. Median loan amount was $8,052, with an average repayment rate of 43.4%. Programs in corporate-owned schools had the highest average cost, highest median loan amount, and lowest repayment rate, while community college programs had the lowest average cost, lowest graduation rate, and lowest median loan amount. Repayment rate data were not available for community colleges. Of the five states and the District of Columbia that require school accreditation, there were 208 disciplinary actions from 2009-2011. The remaining 28 regulated states that do not require school accreditation reported 1,702 disciplinary actions during the same period. Seventy-five percent of massage educators and 58% of CIHC educators stated that the current quality of massage education is inconsistent, with only 10% of massage educators and 8% of CIHC educators agreeing that current educational quality is adequate. Fifty-six percent of massage educators and 40% of CIHC educators agreed that educational quality needs to improve if massage therapists want to be considered comparable to other allied health professionals. Both groups suggested specific areas and means of improvement, including raising admission requirements and offering an academic degree. CONCLUSIONS Accreditation appears to improve the quality of massage education; however, more consistent methods for calculating tuition costs, educational outcomes, and classifying severity of disciplinary actions are needed. Both quantitative and qualitative evidence indicates that the current quality of massage education in the US is inconsistent and less than adequate. Specific areas of improvement needed for massage therapists to be perceived as comparable to other allied healthcare providers are described.