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Tuesday, June 6, 2023

What changes would you like to see in how education is delivered?

Brent Brookbush

Brent Brookbush


Panel Discussion: What changes would you like to see in how education is delivered?

  • How we receive information and education is changing fast; thanks in large part to the ease of which we can access information on the internet. How would you personally like to see education change in the next 10 years? This discussion is open for all suggestions, from practical to idealistic to fantastical?


Moderated by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS

This Panel Discussion was originally posted on my facebook page – https://www.facebook.com/brent.brookbush – on January 6th, 2015


Robert Gazso I think that producing high quality on-line courses can be produced where many folks can have access to it. Once you produce a course than it can be updated as necessary. This would be like the AP is to newspapers. Higher volume means the costs could be kept down and keeping the quality of instruction and keeping it up to date as much as possible. - June 6 at 9:39am

Kathy Benson Zetterberg Great question Brent Brookbush.. What other mediums are out there to deliver education other than online, YouTube , social media, the Internet and of course books, CDs etc - June 6 at 9:44am · Edited

Brent Brookbush Online education certainly has its upside, and access to the world and the ease at which edits can occur are two huge pluses. I know we update at least 2 of our posts/lessons/articles (whatever you want to call them) a month, and our courses are taken by individuals all of the world - crazy how the internet has changed things.

Back to the first point… I have been working on my second book off and on, but now that I have been producing content online I have a harder time letting go of a finished product - in essence, "What do you mean I can't go back and edit this when I think of, or read something new?" is constantly streaming in my head - June 6 at 9:45am

Brent Brookbush We could open this to any aspect of education Kathy Benson Zetterberg - including the availability of degree programs to working individuals, the quality of instruction from certain institutions, access to research, etc.. - June 6 at 9:47am

Kathy Benson Zetterberg I will soon find out.. Just as you did…I am starting CalU in July which is completely online and I am very interested how this experience will compare to a traditional university experience with the cost being the same. - June 6 at 9:51am

Steve Middleton I did the Rehab Science track. Great program! - June 6 at 1:01pm

Brent Brookbush I loved it Kathy Benson Zetterberg, although I could add a few dozen criticisms about "Blackboard" from the standpoint of user interface issues.

I think Cal U is a perfect example of using online technology to increase access to formalized post-secondary education to 1000's of working-class individuals. I would not be where I am without them. - June 6 at 9:53am

Kathy Benson Zetterberg You and Rick Richey are two examples and gave me inspiration to continue on with my masters. - June 6 at 10:09am

Brent Brookbush Speaking of "role models" I do have a somewhat controversial change I would like to see -

"Get Real or Get Out!"

What I mean by this is, if you do not have a degree, if your program is not evidence-based, and if you are not devoted to enhancing the delivery of education you should not be allowed to teach a course, lesson or workshop.

I know some will argue the "having a degree" portion of my suggestion, but let me explain… One of the more important aspects of my formal education (BS, MS, DPT) is the giant "B.S. Filter" if has created. A formal education teaches more than just information, it opens you up to more information than you realized existed, shows you how to access that information, and then how to critically evaluate that information. The result is more accuracy in speech and the presentation of information and the ability to filter the "myths and misinformation". Although I see more myths in the fitness industry than the physical therapy community (the two communities I am personally part of and take con. ed. courses in), there is often an unacceptable level of inaccuracy in both.

If you saw my post about "Lower Abs" last week… you know just what I am talking about - June 6 at 10:06am

Ken O'Neill How education is delivered? For languages, immersion and classics. no substitute.

Before tackling education, however, more salient issues deserve addressing starting with epistemology and its application to research methods and analysis. This is particularly important to consumers of medical services. Under the current 'evidence based medicine' scam introduced by the pharmaceutical monopoly marketing gurus, we have nothing close to health education since the driving metaphor is pathologizing. Risk management presupposes pervasive if not silent illness. And that's just the beginning of a pseudo-science framing itself as medical science. Hence, first things first: solid education for skill development in epistemology, philosophy of science, hermeneutics, research methods and analysis, and history of science. That intro alone should precipitate a much need revolution in health care. - June 6 at 10:08am

Kathy Benson Zetterberg Great points Brent Brookbush. I find the people without degrees are the ones making the arguments about the lack of importance. Many so called experts, especially in the fitness industry have huge followings without science based information being delivered. - June 6 at 10:13am

Brent Brookbush - So true Kathy Benson Zetterberg, and I used to be one of those individuals. Although I would like to think I was a well read, dedicated, fairly intelligent person before I had a degree, the process of getting a degree changes the way you think dramatically. There may be a freak here and there who manages to skip the degree and attain the same level of skill, knowledge and abilities, but… this is a very, very rare occurrence in an information based business/industry/career. - June 6 at 10:15am

Kathy Benson Zetterberg And that is very unfortunate. Sometimes ego and greed get in the way, and for the uneducated it's hard to decipher between factual evidenced based material or somebody's interpretation, idea, or opinion. - June 6 at 10:31am

Robert Gazso In Canada if you want to work in a spa as a massage therapist there is a 700hr requirement. If you would like to do clinical bodywork there is 2000hr requirement and a 3000hr requirement in British Columbia. I would like to see a 2-3000 hr option here in the US. - June 6 at 10:25am

Steve Middleton It's 500 hours in the state I live in (Illinois) and they can basically do whatever they please. The bad thing is the school teaches too many different modalities: kinesiology tape, cupping, tai chi, reiki, hot stone, etc. but no evaluation skills. - June 6 at 1:49pm

Brent Brookbush Hey Robert Gazso, are you saying that the United States requires less or more? - June 6 at 10:48am

Robert Gazso Brent - BC Canada has the highest requirements in the world. In the US it varies by state. In California the requirement is 500hrs. - June 6 at 10:50am

Brent Brookbush Interesting, I would certainly like to see larger education requirement for massage therapists or a reduction/clarification of their scope. I see far too many massage therapists blurring the lines between soft tissue work and treating pain as "therapists". Unfortunately, the lack of education in evaluation, differential diagnosis, joint pathology and nerve issues leads to some very troubling scenarios far more often than I am comfortable with. - June 6 at 10:52am

Robert Gazso I hear what you are saying Brent. I also see PT's who do the minimum con-ed to maintain their license. Many times people come in to me for bodywork and they tell me the PT that they went to did absolutely no soft tissue work. - June 6 at 11:00am

Brent Brookbush Unfortunately Robert Gazso, this conversation is most related to minimum standards. Although it is possible to treat without soft tissue work (See Sahrmann who never touches patients), it is impossible to treat facet joint pain and radiculopathy without joint mobiliation and exercise. Further if that low back pain is actually referred from the kidneys due to a UTI that has spread, not referring them to a physician is detrimental to their health.

In most cases soft tissue work is warranted, but is not always the most needed treatment. - June 6 at 11:04am

Robert Gazso Certainly it is possible to treat without soft tissue work and I am a big fan of Sahrmann's. In fact I spent several hours this week watching her YouTube presentations (there are 2 that are close to an hour long each that I highly recommend). That being said soft it still blows me away that many PTs and Chiropractors do not do soft tissue work. - June 6 at 11:20am

Robert Gazso I am not sure if it is the right answer but I have chosen to go the con-ed route to fortify my education. - June 6 at 11:24am

Kenneth E. Hoover On demand. Visual. Production value remains important. We will all attempt to deliver our work in ways that it are attractive to students. They will lead us to the functional answer to this question and we should deliver information based on the methods they prefer? - June 6 at 11:26am

Brent Brookbush To bring this back to this conversation Robert Gazso, if you intended to treat injury then we have to be completely honest with ourselves, the education we're offered by our professions and the potential limiting factors that preclude us from attaining education.

A license in massage therapy is not the ideal certificate or license for treating injury. A DPT, DC or ATC would have been better education options… and I could make a pretty strong argument for why the DPT is likely the best degree and license of those 3 (but I know I am biased).

The question becomes, why didn't you go for your DPT? and… What could we have done in the "education industry" to make that possible for you?

I know some DPT programs are now offering mixed online/in-class programs that are opening the doors for working professionals who could never have imagined taking on a DPT previously. What would preclude you from going back for a DPT and how could we address those issues? - June 6 at 11:40am

Kathy Benson Zetterberg Brent Brookbush people can get in to see a massage therapist without a prescription. In the state of California a Dr must refer you to see a DPT which becomes a complicated and costly approach - June 6 at 11:58am

Brent Brookbush That does not mean it's the right way to go Kathy Benson Zetterberg…. if you are in pain there is a good chance that the pain is stemming from joint or nerve, and a lesser but still significant chance it is referral pain from something more insidious. For example, I would be willing to say that acute low back pain is out of the hands of massage therapists until seen by physical therapist, chiropractor or ATC… I have never seen a low back that did not include at least some level of joint and nerve involvement. Now, imagine if that was the law… massage therapy as an industry would fall apart in a matter of months.

In most states PT's have direct access and do not require a referral from a physician. Are you sure it is the state and not your insurance company dictating what they expect for coverage/reimbursement? California is a very liberal state that does not even have legislation in place to prevent individuals from doing manual therapy without a license. - June 6 at 12:05pm

Kathy Benson Zetterberg I am sure Brent Brookbush. A doctor prescription must be in hand to see a DPT. Maybe Mark Jamantoc can chime in on this, but in the past I tried to circumvent my doctor and was refused. - June 6 at 12:10pm

Brent Brookbush I have direct access and I believe Mark Jamantoc has direct access as well in Washington… unfortunately this is a state by state thing Kathy Benson Zetterberg - June 6 at 12:34pm

Kathy Benson Zetterberg Very unfortunate Brent Brookbush - June 6 at 12:36pm

Robert Gazso "A license in massage therapy is not the ideal certificate or license for treating injury." I fully agree with you Brent. This is why I was suggesting we, as clinical massage therapists in the US, go to 2000 or better yet 3000 hours of training such as what they have in Canada. I don't know if I want to go back and do another degree at this point. I take a fair number of con-ed courses including one today. I took a 3 day course last weekend and have a course next weekend. This is currently how I have decided to further my knowledge base. - June 6 at 8:35pm

Brent Brookbush That's my point Robert Gazso - what if we could modify the degree so that an individual like you could progress to a DPT, DC, ATC or OT… That's one of the points I hoped would come up in this conversation. Sorry to say, but continuing education is not enough. It is not techniques that most concern me about LMT's treating pathology… it's the clinical anatomy, pathokinesioloy, differential diagnosis (both subjective and objective), and methodological approach to addressing pain that is my biggest concern… I have yet to see "Con. Ed." in any of these areas. But… what if you could be in class only 10 hours a week and another 10 online, and progress toward a DPT with benchmarks along the way that incrementally increased your scope.

Believe it or not, I am %100 on your side and place the bulk of the blame on the education system. I want professionals to have the freedom to do what needs to be done to best assist a patient/client, and a patient/client to have direct access to the best professional for them. - June 6 at 8:44pm

Robert Gazso Yes Brent - I would be much more likely to consider it. - June 8 at 4:15pm

Jason Erickson It would be a good step to have PTA programs whose classes are accepted as part of PT programs. - June 8 at 4:31pm

Mark Jamantoc I am just catching up and scrolling up to the conversation Kathy Benson Zetterberg and Brent Brookbush. Brent, I actually now live in oregon. There is direct access here and it's completely unrestricted. HOWEVER, certain insurances still require a doctor's order for us to see a patient AND they'll reimburse that. For my cash pay patients, it's completely unrestricted. I love it. The way I market it is when I am on wellness fairs, doing a networking event or even just at a party, I just tell them they do not require a doctor's prescription to see me but it's good to double check with your insurance. I also explain that PTs (we) are the musculoskeletal experts and it takes just one phone call to your MD office if you have, for example, low back pain, and tell them to fax a prescription to my office, telling them that your "back is bothering you and that you would like to see your physical therapist, I would like to try this before coming in for any medication." Most MDs are okay with that but it also depends if you have not seen your MD for ages, then they might require the patient to come in first - then that conversation can just happen face to face with Md and they can ask for that referral. We are big on "low back pain revolution" right now in my clinic and this is how I market to people. - June 8 at 5:57pm

Brent Brookbush Agreed Jason Erickson, as well as more reciprocity between DC, ATC, PT and OT programs so that an individual can progress through various programs in mastery of let's say - orthopedic manual therapy. - June 8 at 7:27pm

Brent Brookbush Certainly, Kenneth E. Hoover,

I think another wonderful advantage to well-planned and organized online education platforms is they allow the student to "customize" their education and take what they want "on demand". We have to be careful to make sure that certain, "less fun but mandatory" information still gets in their, but I am all for the change. I think this falls under the "student-centered" learning umbrella. - June 6 at 11:44am

Robert Gazso Excellent Idea Brent! There have been so many courses that I had to take that I know I would never use and if I could have customized my education I would have been able to get the skills for the path I was looking to take. Students would be much more likely to spend time with their coursework if this was the case. - June 6 at 8:02pm

Kenneth E. Hoover It sure does Brent Brookbush. The content is obviously critical. If we miss on the "student centered" point we could have the best content in the world and no audience. Sometimes I don't like that fact, but I do accept it. - June 6 at 11:41am

Tim Henriques A simple solution in my mind would be that all hiring companies require either a degree in a fitness related field or a diploma in personal training and no longer accept certifications as adequate education for new trainers. That would up the standard in a hurry. - June 6 at 12:05pm

Brent Brookbush It would Tim Henriques, it also may decimate the labor force. One thing certifications have accomplished that certificates have not is online access to attain credentialing. As soon as you place the barrier of "you have to stop working, go to school, and not have any income for x number of weeks" in the way of achieving a credential you are going to lose many individuals… some of the great candidates whom we would be very sorry to lose. - June 6 at 12:08pm

Tim Henriques People can still work and go to school, students have been doing that forever - June 6 at 12:09pm

Brent Brookbush It's not easy for the adult with a full time job who is switching careers. Just some thoughts. - June 6 at 12:33pm

Tim Henriques It isn't super easy but I am not sure that should be the goal. I don't think we need more trainers, but better educated ones with a serious passion for the field. Almost all programs have evening and weekend classes available for those that need to maintain their current job. - June 7 at 1:09pm

Brent Brookbush I know NPTI is the exception Tim Henriques, and as long as we are making an effort to draw high level professionals from other fields to our industry I am all for it. I think my original comments in our discussion have more to do with the traditional education model. You are right, it does not need to be easy - there is nothing easy about working a 9 - 5pm and going to class from 6 - 9pm… but, when schools and education programs make the only option courses between 9 - 5 pm Monday through Friday, we are certainly going to a lose a few career individuals who would have made an awesome addition to our field. - June 7 at 10:00pm

Maurice D. Williams What I'd like 2 see is some sort of national standard for fitness professionals. Something that'll weed out those looking to make a quick buck while at the same time allowing us to receive more respect as fitness professionals. So, essentially, I wouldn't be opposed to a national licensure. The major certs: NASM, ACSM, NCSA, & ACE should all come 2 together & really move us forward with this. I know there has been talk & work on this since I was in undergrad (95-99), but, with each year that passes, our industry becomes more focused on the latest & greatest, instead of proven science. A basic licensure of true exercise science principles, written & practical, would do wonders for our field! - June 7 at 1:09pm

Brent Brookbush Great thoughts Maurice D. Williams,

I often remark that "New is not better, better is better" in my courses… and I certainly have my issue with the title "certification" being attached to modality workshops. Although there is nothing inherently wrong with a TRX, Kettlebell, Olympic Lifting, Battle Ropes, etc… workshop… it is an issue when trainers use these courses to adorn themselves with the title of "certified" despite not having a base level CPT where some biomechanics, exercise physiology and basics of program design were taught.

Mastering the fundamentals is what makes you a master of your craft, not the fancy stuff. - June 7 at 9:54pm


© 2015 Brent Brookbush