Job Task Analysis - FSMTB
Job Task AnalysisPrepared by Meaningful Measurement, Inc.March 2013
Table of ContentsSectionPageExecutive Summary3FSMTB Mission6Job Task Analysis7 Method9 Survey Results: Description10 Survey Results: Group Correlations12 Survey Results: Task Maps17Demographics30 Respondent Profile31 Practice/Modality Profile39 Massage Education Profile44 Employment Profile50Contact Information60Page 2
Executive SummaryThe Federation of State Massage Therapy Boards administers the Massage and Bodywork Licensing Examination (MBLEx), a national licensureexamination. A fundamental requirement for best practices in testing is to conduct a formal Job Task Analysis (JTA) every five to seven years to ensurethat the examination reflects practice. For the purpose of this survey, a massage/bodywork/somatic therapist/practitioner is defined as an expert whouses massage, bodywork or somatic practices to promote, maintain or restore health and wellness. Whenever the term “Massage Therapist” is used inthis report, it encompasses bodywork and somatic practitioners.Massage/Bodywork/Somatic Therapists answered how frequently they personally perform various tasks. Each task was also given a rating ofimportance specific to the Entry-Level Massage Therapist. This information is used to guide examination content and blueprint the test. Thus theexamination will reflect the reality of practice and the knowledge required to perform in a safe and effective manner.The first JTA survey was carefully developed in 2007. In 2012, the survey was reviewed and refined by twenty-two content experts under the guidanceof five testing and psychometric experts.The survey was deployed on-line from June 22, 2012 until August 7, 2012. FSMTB sent invitations to participate in the JTA survey to approximately50,000 individuals who had taken the MBLEx. In addition, invitations were sent to all regulatory boards and agencies to distribute to their licensees. Twomembership organizations, Associated Bodywork and Massage Professionals (ABMP) and American Massage Therapy Association (AMTA), also sentemails to their members with a link to the survey. Nearly 6,100 of the 6,759 respondents hold a massage therapy license. MethodMeaningful Measurement uses the techniques of Item Response Theory (IRT), in particular the Rasch model one parameter logistical model (1PL).The computer program Winsteps 3.74, written by John Michael Linacre, provides the basis for data analysis. Once raw scores are conditioned intomeasures, traditional statistical analyses may be performed. Additional analyses, charts and graphs are produced by SPSS 18.0, Excel, andPowerPoint.The calibrated items (tasks) from each topic area have been mapped on the Importance and Frequency scales. This allows a visual assessment ofthe relative weights of the tasks. The tasks fall into one of four quadrants:High ImportanceHigh FrequencyHigh ImportanceLow FrequencyLow ImportanceHigh FrequencyLow ImportanceLow FrequencyThe map is a useful tool to understand the structure of the discipline of Massage Therapy. It highlights patterns of practice as revealed by the factsof measurement rather than the folklore of opinions.Page 3
OutcomesRespondent CharacteristicsMost respondents were female (80%), Caucasian (77%) and graduated from a Certificate program (86%). The top five primary modalities/approachesused are Swedish (34%); Deep Tissue (22%); Clinical/Medical (7%); Neuromuscular Therapy (5%) and Trigger Point Therapy (3%). The top fivemodalities/approaches used in addition to the primary modality are Deep Tissue (60%); Swedish (53%); Trigger Point Therapy (45%); Myofascial (41%);and Reflexology (40%).A little over half of respondents had 500-800 hours of initial massage education, with 26% receiving more initial education, and 20% receiving less. Theyoverwhelmingly agreed (90%) that their school/education prepared them to practice. Entry level accounts for 43% of the respondents;18% have been inpractice 3-5 years; 14% for 6-10 years and 25% for eleven or more years.Respondents had a broad cross section of professionals. Every state and U.S. territory was represented. Seventy-eight percent of the participantsconsidered themselves Massage Therapists and 16% considered themselves Bodywork Practitioners. They worked in a variety of practice settings andwith special populations.The length of a typical treatment is sixty minutes for 69% of the respondents and 50% treat 1 – 3 clients daily. Thirty-three percent of practitioners chargebetween 60-69 per hour of treatment. Hourly pay for treatment from primary employers is 30-39 for 20% of therapists. Forty-five percent make less perhour and 26% make more.Massage practice is the primary income for 39% of respondents. Sixty-one percent of respondents say it does not provide a livable wage.Respondent OpinionsEighty-two percent of respondents indicated that there should be a minimum of 500 hours of education as a prerequisite for licensure. The minimumhours of formal education that should be required of entry level therapists is 500-749 for 55% of respondents, while 35% thought there should be morehours required, and 10% thought less hours should be required. Additionally, 95% percent of respondents said that they would take continuing educationeven if it were not required and 88% said licensing should be required across the nation.Page 4
Survey InstrumentThe JTA survey passed all psychometric tests. The calibrated items cover a wide range of the variable - about 400 points. The reliability is very high,and the majority of the items fit along the line of inquiry. When the few misfitting items are examined, it is easy to identify and explain the reasons forvariations in the responses.CorrelationsThe profession is extremely consistent in its view of the importance and frequency of the various tasks associated with the practice of massagetherapy.It did not matter whether respondents considered themselves to be a massage therapist, body worker, or somatic practitioner; were entry level orexperienced; had less than five hundred or more than a thousand hours of training; or worked in a spa or medical office; the responses are highlycorrelated. The assigned importance and frequency of the tasks maintain their order no matter who is responding.The profession is unified in its approach to the basic competencies and is not fractured into subgroups with different perspectives and activities. Thedata confirm that body workers and somatic practitioners perform the tasks with nearly identical frequency as massage therapists. In addition, theirview of the importance of these tasks matches that of massage therapists.This means the data confirmed the previous study and there is no difference between types of practitioner in the practice of massage,bodywork and somatic therapy at entry level. One entry level licensure examination is appropriate and fair for all groups.Test PlanTo comprise the test, Subject Matter Experts use the information from the JTA survey to determine appropriate percentages for each of the topicareas, thus ensuring the examination is an accurate reflection of practice. This snapshot of the profession is used in the development of a fair andappropriate national examination to ensure the entry level Massage Therapist is competent to practice safely and effectively.Page 5
FSMTB MissionThe mission of the Federation is to support its Member Boards in their work to ensure that the practice of massage therapy is provided to the public in asafe and effective manner. In carrying out this mission, the Federation shall: Facilitate communication among Member Boards and provide a forum for the exchange of information and experience. Provide education, services and guidance to Member Boards that help them fulfill their statutory, professional, public, and ethical obligations. Support efforts among Member Boards to establish compatible requirements and cooperative procedures for the legal regulation of massagetherapists, in order to facilitate professional mobility and to simplify and standardize the licensing process. Ensure the provision of a valid reliable licensing examination to determine entry-level competence. Improve the standards of massage therapy education, licensure, and practice through cooperation with entities that share this objective, includingother massage therapy organizations, accrediting agencies, governmental bodies, and groups whose areas of interest may coincide with those ofMember Boards. Represent the interests of its Member Boards in matters consistent with the scope of the Bylaws.Page 6
Job Task Analysis DescriptionA Job Task Analysis (JTA) is a formal process for determining or verifying what people do, under what working conditions, what they must knowand the skills they must have. The analysis can be applied to a set of duties, a group of tasks, a job, a role or a profession, but most people refer tothe process as a Job Task Analysis.Part of the role of the FSMTB is to develop an examination that is appropriate for use in any US jurisdiction and ensure that national standards forentry-level safe practice be scientifically established with the test development process designed to employ best practices and psychometricanalysis at every step. In order to meet the FSMTB goal of creating standards of practice that are applicable to the field, regardless of geographiclocation or business arena (personal services or health care), a JTA must be conducted that addresses all of the issues inherent in establishing asingle set of credentialing standards that can apply to all practitioners.A JTA consists of identifying and defining the components of that occupation or profession that distinguishes it from other occupations orprofessions. It provides data to support the development of performance standards and training. For purposes of licensure, it is also necessary toidentify and analyze the knowledge and skills required for one to be competent to practice the job or profession. This additional step results in apractice analysis which is required for the development and maintenance of licensure testing programs.The first step in any comprehensive test development effort is the completion of a formal and thorough JTA. The results from the JTA define thedomain of relevant knowledge, skills, and abilities needed for competent entry-level practice and form the backbone of the test blueprint. Thus, in avery real and direct sense, the test content itself is defined by the results of the JTA.We are using a combination of both qualitative and quantitative approaches to gather this information for the Federation of State Massage TherapyBoards national licensure examination.For the purpose of the JTA survey, a massage/bodywork/somatic therapist/practitioner is defined as an expert who uses massage, bodywork orsomatic practices to promote, maintain or restore health and wellness. Whenever the term “Massage Therapist” is used in this report, itencompasses massage, bodywork and somatic practitioners.This snapshot of the profession(s) is used to develop a fair and appropriate national licensure examination to ensure the ENTRY-LEVEL MassageTherapist is competent to practice safely and effectively.Page 7
Survey DevelopmentThe first JTA survey was developed in 2007 by over fifty content experts and fifteen testing professionals. In order to maintain the same highquality, a review process was implemented for the 2012 survey.Subject Matter Experts (SMEs) and testing professionals evaluated the 2007 JTA survey. Comments and suggestions were received for refiningthe 2012 JTA survey. After a thorough review of the feedback, the JTA Task Force made revisions to the survey. It was deployed for about sixweeks from June 22 to August 7, 2012.In addition to licensed and certified Massage Therapists, the Subject Matter Expert pool is comprised of Asian Bodywork Therapists, StructuralIntegrators, Energetic Practitioners, Reflexologists, Chiropractors, Naturopaths, Physical Therapists, Registered Nurses, State Regulators,Educators, Psychometricians and Test Development experts.In all, twenty-two content experts and five testing specialists contributed to the review of the Federation of State Massage Therapy Boards 2012Job Task Analysis Survey.Page 8
MethodScientists design, build and calibrate instruments to record physical phenomena. When latent trait variables such as “Importance and Frequencyof Massage Therapy Tasks” are measured indirectly, fundamental objective measures must be constructed with which to measure theunderlying dimension. Unfortunately it is not possible to retrieve a section of attitude or ability and then measure it with a ruler. Therefore,psychometricians must take great care to construct a frame of reference which evokes these objective, standardized measures. Only then candata be interpreted.Objective Measurement requires the following: An underlying trait that can be expressed in terms of more or lessSurvey/test items that are the operational definition of the underlying traitSurvey/test items that can be ordered from easy to hardRespondents that can be ordered from less to more in attitude or abilityRasch/IRT ModelMeaningful Measurement uses the techniques of Item Response Theory (IRT), in particular the Rasch model one parameter logistical model(1PL), which meets the requirements for measurement. This method is widely used in educational testing, certification and licensure, outcomesassessment and many other research applications.P1,0 Advantages of Using Item Response Theory e (ability-item difficulty)1 e (ability-item difficulty)Equal Interval MeasureTest/survey-takers and items are represented on the same scaleItem calibrations are independent of the respondents used for calibrationRespondent ability/attitude estimates are independent of the particular set of items used for estimationMeasurement precision is estimated for each person and each itemData AnalysisThe computer program Winsteps 3.74, written by John Michael Linacre, provides the basis for data analysis. Once raw scores are conditioned intomeasures, traditional statistical analyses may be performed. Additional analyses, charts and graphs are produced by SPSS 18.0, Excel, and PowerPoint.Page 9
Data DescriptionThe FSMTB JTA survey was open from June 22 to August 7, 2012. Responses numbered 6,759. The finalized JTA survey was distributedelectronically to a large cross-section of practitioners and educators who were asked to respond to the list of proposed tasks in terms of both theimportance and the frequency with which the tasks are performed. It is important to note that this sample of respondents includes both entry-level andexperienced practitioners who are drawn from varied practice settings, experience, hours of initial training and diverse geographical areas.Massage/ Bodywork/Somatic Therapists/Practitioners were asked to participate through electronic mailings. FSMTB sent invitations to participate in theJTA survey to approximately 50,000 individuals who had taken the MBLEx. Invitations were also sent to all regulatory boards and agencies to distributeto their licensees. Nearly 6,100 of the 6,759 respondents hold a massage therapy license.In addition, two of the national membership associations, Associated Bodywork and Massage Professionals (ABMP) and American Massage TherapyAssociation (AMTA), sent emails to their members with a link to the survey. It is estimated that in excess of 100,000 Massage Therapy professionals inthe United States were informed of the survey. Due to overlap in the mailing lists, some may have been notified by more than one organization.The first part of the survey was a job task analysis asking respondents for ratings about the frequency and importance of different tasks they perform.This first section was extensive and took approximately 45 minutes to complete. About two thirds (approximately 4,400) completed the JTA portion ofthe on-line survey.The second part of the survey was the Entry Level Analysis Project (ELAP) portion and asked respondents to answer items relevant to the entry leveleducation. This second section took about 25 minutes to complete. Approximately 40 percent (2,650) of respondents completed the ELAP portion ofthe survey. Results are available in a separate report.Respondent Characteristics And OpinionsThis section displays personal characteristics and opinions of the survey respondents and is reported on pages 30 through 59. Respondents reflect thegeneral population of Massage Therapists. There is a broad cross-section of experience, type of practice, work setting and geographical region. Thereis information on who respondents are (gender, age, race) and where they practice. Respondents shared what modalities they use and the type ofpractice in which they engage. Initial massage education and their satisfaction with it, as well as continuing education, are explored.Work statistics are gathered with questions such as how many clients are treated per day; usual length of treatment; how much time is spent per weekgiving treatment and doing administrative tasks; and how many days per week the therapists practice. Additionally, economic questions about costs oftreatment and income are reported by geographical regions.Finally, respondent opinions are solicited concerning the minimum hours necessary to practice and the need for licensure.Page 10
Survey ResultsThe JTA results are important and useful in many ways. Data analysis produces the facts of measurement, thus allowing a deeper understanding ofthe structure of the discipline of Massage/Bodywork/Somatic Therapy/Practice. Output from the analyses is presented in a separate document, theData Analysis Report.The first thing that is done in a Meaningful Measurement data analysis is to “test the test.” The FSMTB 2012 Job Task Analysis Survey passed allpsychometric tests. The calibrated items cover a wide range of the variable - almost 400 points. The reliability is very high and the majority of the itemsfit along the line of inquiry. When the few misfitting items are examined, it is easy to identify and explain the reasons for variations in the responses.Respondents were asked to rate TASKS on two scales, hereafter referred to as “Importance” and “Frequency”. Additionally, KNOWLEDGE was ratedon importance and is hereafter referred to as “Knowledge”.IMPORTANCE: How important is it for an ENTRY LEVEL (within the first two years after completion of training) practitioner to be able to perform thefollowing task?1 Not At All Important4 Important2 Minimally Important5 Very Important3 Somewhat Important6 Extremely ImportantFREQUENCY: How often do YOU perform the task in your practice?1 Never2 Rarely (10% or less)3 Sometimes (11-49%)4 Often (50-89%)5 Almost Always (90-99%)6 AlwaysKNOWLEDGE: How important is it for an ENTRY LEVEL (within the first two years after completion of training) practitioner to have this knowledgeto perform the job?1 Not At All Important4 Important2 Minimally Important5 Very Important3 Somewhat Important6 Extremely ImportantReliability is the degree to which scores for a group of people are consistent over repeated administrations of the same test (or survey), and thereforeconsidered dependable and repeatable for an individual respondent. Reliability reflects the degree to which scores are free of measurement error. Thehigher the value of the index (closer to 1.0), the greater the reliability.Reliability for the JTA survey scales is very high:ImportanceFrequencyKnowledge.92.93.81Page 11
Survey Results: Group CorrelationsCorrelations show if and how strongly pairs of variables are related. For example, height and weight are related - taller people tend to be heavier thanshorter people. The relationship isn’t perfect, but a person who is 5’8" tall is likely to weigh more than someone who is 5’5".The main result of a correlation is called the correlation coefficient (or “r”). It ranges from -1.0 to 1.0. The closer r is to 1 or -1, the more closely thetwo variables are related. If r is close to 0, it means there is no relationship between the variables. If r is positive, it means that both variables aremoving in the same direction, i.e. as one variable gets larger or smaller the other gets larger or smaller. If r is negative it means that variables movein opposite directions, i.e. as one gets larger, the other gets smaller (often called an “inverse” correlation).A correlation report can also show a second result of each test – statistical significance. In this case, the significance level will tell you how likely it isthat the correlations reported may be due to chance in the form of random sampling error. All of the correlations in this report are at the .01significance level, which means there is only a 1% chance that the results are due to error, and a 99% probability that the results are accurate.It is important to examine correlations because they can describe the connections between variables. It is possible to determine structural, functional,or qualitative relationships between comparable groups or variables. The following tables show the way various classifications of Massage Therapistsrespond to the tasks and knowledge statements. A strong positive correlation means there is equivalence between the two variables.Sample Table of CorrelationsCorrelations reflect thecomparison of the topgroup to the group listeddirectly below it.Group 0.93Page 12
Table 1: Correlations: Type of PractitionerTable 2: Correlations: Type of PracticeType of PractitionerImportanceFrequencyKnowledgeMassage TherapistBodywork Therapist.99.98.98Massage TherapistSomatic Therapist.93.90.93Bodywork TherapistSomatic Therapist.94.91.95Type of Conventional Medical.98.97.98Spa/RelaxationAlternative Medical.99.98.98Conventional MedicalAlternative Medical.99.98.98Page 13
Table 3 Correlations: Years in PracticeYears in PracticeImportanceFrequencyKnowledge1 – 2 years3 – 5 years.99.99.981 – 2 years6 – 10 years.99.99.981 – 2 years15 years.98.97.973 – 5 years6 – 10 years.99.99.993 – 5 years15 years.98.98.986 – 10 years15 years.99.99.99Page 14
Table 4: Correlations: Number of Hours Formal Massage EducationHours FormalMassage EducationImportanceFrequencyKnowledge201 – 400401 – 500.98.98.98201 – 400501 – 600.98.98.98201 – 400601 – 800.98.98.98201 – 400801 .97.97.97401 – 500501 - 6001.00.991.00401 – 500601 – 800.99.991.00401 – 500801 .97.99.99501 – 600601 – 800.991.001.00501 – 600801 .99.99.99601 – 800801 .99.99.99Page 15
The fundamental question for the FSMTB to ask is whether it is fair and appropriate to give a commonentry-level licensure examination to those who use massage, bodywork or somatic practicesto promote, maintain or restore health and wellness.The answer is an unequivocal “Yes”.The 2012 JTA survey data confirm results from the 2007 JTA survey. Correlations are remarkably high on every pair of variables. Asdemonstrated in the above tables, it does not matter whether practitioners self-identify as massage, bodywork, or somatic therapists; there is analmost perfect alignment in how frequently they perform tasks, how important they think those tasks are, and the importance of knowledge areasrequired to perform the job.The same holds true regardless of the type of practice, the years in practice, or the number of hours of formal initial massage education. Thepractice of massage is consistent and parallel no matter the circumstances. Thus, it is defensible and practical to develop one examination toensure that all those who perform these tasks are safe and competent to practice.Page 16
Survey Results: Task MapsThe graph below shows a very strong correlation of .85 (significant at the 0.01 level) exists between the frequency and importance of tasks performedby Massage Therapists. This means there is a positive linear relationship between how often a task is carried out and how important it is considered.However, as shown in the graph, some tasks are not in a straight line. In order to take a closer look, Task Maps are valuable.Task CorrelationFigure ance11.512.5The next action is to review the Test Plan for the FSMTB national licensure examination. Guided by the Task Maps, the SMEs will decide uponpercentages of the test to be assigned to the topic areas. Consequently the examination will reflect practice as defined by a large cross section ofprofessionals.Page 17
TASK MAPSTask Maps are useful for visual assessment of the importance and frequency of duties performed by he center vertical line is the scale for the Frequency with which a task is performed.The horizontal line is the scale indicating the Importance for an entry level practitioner to be able to perform the task.The higher the number, the more important or more frequent is the task.Below the maps are tables with measures of Importance and Frequency reported for each task in that topic area.It is essential to note that while some tasks may appear to be very infrequent or unimportant, that is not the case.The lowest average score is 3.26 for Importance and 2.97 for Frequency out of a six-point scale.Task MapLow ImportanceHigh FrequencyHigh ImportanceHigh Frequency12.5Importance11.510.57.5Low ImportanceLow Frequency8.59.59.510.511.512.58.5High ImportanceLow Frequency7.5FrequencyPage 18
Figure 2Anatomy and Physiology12.5Low ImportanceHigh FrequencyHigh ImportanceHigh FrequencyImportance11.510.57.58.512611148759 329.5 9.51010.511.512.58.5Low ImportanceLow Frequency7.5High ImportanceLow 112Use medical terminology in documentationUse medical terminology with other healthcare providersUse reference materialsExplain anatomical concepts to clientsExplain physiological concepts to clientsUnderstand elimination of metabolic wasteIdentify effects of massage on system structureIdentify effects of massage on system functionIdentify origin and insertion of musclesIdentify action of musclesIdentify innervation of musclesUse energetic .679.829.359.08Page 19
Figure 3Kinesiology12.5Low ImportanceHigh FrequencyHigh ImportanceHigh FrequencyImportance11.510.57.58.5263751489.5 9.510.511.512.58.5Low ImportanceLow Frequency7.5High ImportanceLow 45678Palpate soft tissue structuresUse kinesiology concepts to assess muscle healthEducate clients on muscles and their functionsConsider the client's ergonomics and body mechanicsUse knowledge of joint structure and functionMuscular contractions and proprioceptive techniquesDemonstrate stretching and strengthening techniquesEducate clients on ways to avoid 9.7310.069.919.529.889.98Page 20
Figure 4PathologyLow ImportanceHigh Frequency12.5High ImportanceHigh FrequencyImportance11.510.57.58.5236749 8519.5 9.510.511.512.58.5Low ImportanceLow Frequency7.5High ImportanceLow 456789Research client pathologiesResearch client medicationsInterpret info on intake formsDetermine level of contraindicationIdentify pathology-related contraindicationsDetermine best course of treatmentUse adaptive measuresIdentify endangerment sitesAdaptive measures for special e 21
Benefits and Physiological Effects of Massage12.5Figure 5ImportanceLow ImportanceHigh Frequency7.5411.510.52212191615112215242017 5 9.523299.338.59.51025268.5Low ImportanceLow Frequency#123456789101112131415ItemAddress common pathologiesUse various positioning techniquesApply hot or cold treatmentsUse of tools and implementsChoose techniques to affect specific body systemsCommunicate stress reduction aspects of massageUse techniques appropriate for client needsEvaluate effects of treatment during sessionCommunicate with clients on their comfort levelDetoxification techniquesCommunicate benefits for different populations or conditionsRecognize & respond to clients' emotional releaseRecognize effect of touch on abused individualsSelect stroke appropriate for tissue typeUse cross-fiber friction on scar 910.888.529.299.8210.2210.229.46814271 187289High ImportanceHigh Frequency1310.511.512.5High ImportanceLow 181920212223242526272829ItemCirculatory systemDigestive systemMuscular systemNervous systemRespiratory systemLymphatic systemIntegumentary systemEndocrine systemImmune systemReproductive systemUrinary systemUse effects of strokesNotice and respond to changes in client during sessionCommunicate benefits of energetic e 22
Client Assessment and Treatment PlanningFigure 6Low ImportanceHigh Frequency12.5Importance11.57.58.52 3111210.5 81391 107469.5 9.510.55High ImportanceHigh Frequency11.512.58.5Low ImportanceLow Frequency7.5High ImportanceLow 45678910111213Set treatment goalsAdvise client of confidentiality policyAdminister a health history formPerform and interpret a visual assessmentPerform and interpret ROMPost treatment assessmentApply clinical reasoningDocument findings from the sessionTeach client self-care activitiesRefer client when appropriateChoose techniques appropriate to tissue conditionAssess effi
Job Task Analysis A Job Task Analysis (JTA) is a formal process for determining or verifying what people do, under what working conditions, what they must know and the skills they must have. The analysis can be applied to a set of duties, a group of tasks, a job, a role or a profession, but most people refer to the process as a Job Task Analysis.
Federation of State Massage Therapy Boards 7300 College Boulevard, Suite 650, Overland Park, Kansas 66210 MBLEx Service Support Center: 1.866.962.3926 mblex@fsmtb.org FSMTB Executive Office: 913.681.0380 info@fsmtb.org www.fsmtb.org Massage & Bodywork Licensing Examination Candidate Handbook Effective July 2021
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