The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Observation of performance in the workplace or a simulated workplace (defined as a supervised clinic)

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Assessment may contain both theoretical and practical components and examples covering a range of clinical situations

Assessment of sole practitioners must include a range of clinical situations and different client groups covering at minimum, age, culture and gender

Assessment of sole practitioners must consider their unique workplace context, including:

interaction with others in the broader professional community as part of the sole practitioner's workplace

scope of practice as detailed in the qualification and component competency units

holistic/integrated assessment including:

working within the practice framework

performing a health assessment

assessing the client

planning treatment

providing treatment

Context of and specific resources for assessment:

An appropriately stocked and equipped clinic or simulated clinic environment

Relevant texts or medical manuals

Anatomical models

Relevant paper-based/video/electronic assessment instruments

Appropriate assessment environment

Method of assessment

Observation in the workplace

Written assignments/projects or questioning should be used to assess knowledge

Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice

Explanations for plan preparations

Oral questioning and discussion

Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting
If successful, a second assessment is to be conducted during workplace application under direct supervision

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Related units:

This unit should be assessed in conjunction with the following related units:

HLTCOM404C Communicate effectively with clients

HLTREM504C Apply remedial massage assessment framework

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Awareness of critical information required for diagnosis and treatment according to massage therapy framework

Community resources and support services

Ethical and legal implications of enquiry and treatment

Indications for massage

Pathology and symptomology

Possible obstacles to treatment

Possible reactions and contraindications for massage

Regional anatomy

Structure and function of anatomical systems

Systems and regions of the body including structure and function of systems, such as:

cardiovascular system

immune system

lymphatic system

nervous system

reproductive system

respiratory system

Technical and practical knowledge of treatment

The endocrine system

The organisation of the body

The principles of human movement and biomechanics

The structure and function of the articular system, classification of joints and types and ranges of motion

Essential skills:

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Comprehend common medical terminology

Demonstrate communication and negotiation skills

Demonstrate communication skills to gain and convey required information

Identify and describe a treatment outcome using accepted medical terminology

Identify bone landmarks, structures and individual muscles through palpation.

Identify prominent bones/structures and major muscle groups through palpation

Identify treatment options and establish treatment regimes

Manage time throughout consultation and treatment

Prepare treatment plans

Read medical reports

Transcribe assessment findings and treatment in a client history using accepted medical terminology

Transcribe assessment findings and treatment in a client history using accepted medical terminology

Use equipment and technology effectively and safely

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Remedial massage principles refers to:

Principles and practices of the remedial massage therapy framework:

relevant code of ethics or code of conduct documents/policies, regulations and guidelines state/territory or local massage therapy organisations and/or associations

relevant national, state/territory or local government regulations and guidelines

accepted preventative practices adopted by self or peers to minimise safety hazards and risks in the same or similar situations

current and past good practice demonstrated by self or peers in the same or similar situation

Contraindications to treatment and possible complicating factors may include:

Massage therapists are not expected to diagnose any conditions but must be able to recognise the indications and contra-indications of conditions

Massage is contra-indicated in all infectious diseases suggested by fever, nausea and lethargy until a diagnosis is received and recommended by a medical practitioner

Always refer for diagnosis when symptoms do not have a logical explanation. Indications for referral include:

pain local, sharp, dull, achy, deep, surface

fatigue

inflammation

lumps and tissue changes

rashes and changes in the skin

edema

mood alterations, eg depression, anxiety

infection

changes in habits such as appetite elimination or sleep

bleeding and bruising

nausea, vomiting or diarrhoea

temperature-hot or cold

Endangerment sites are areas where nerves and blood vessels lie close to the skin and are not well protected:

anterior triangle of the neck

posterior triangle of the neck

axillary area

medial epicondyle

lateral epicondyle

area of the sternal notch and anterior throat

umbilicus area

twelfth rib dorsal body

sciatic notch

inguinal triangle

popliteal fossa

Massage techniques:

To be performed in a variety of positions, ie standing, seated, prone, supine and side recumbent lying, and through clothing as well as conventional table massage. This may include:

Passive joint movement techniques

joints are moved through their range of movement, ie to the point of mild tissue resistance

Passive soft tissue movement

technique is applied with palmer surfaces of the hand, heel of hand and/or fingers

jostling: shaking of the muscle from origin to insertion

Gliding techniques

effleurage: broad superficial strokes using the entire palmer surface of the hands to cover large surface areas of the body are exhibited

longitudinal stroking: deep gliding movement is applied in the direction of the muscle fibres through focal pressure using fingers, palm, heel of hands, forearm and/or knuckles

transverse gliding

cross over stroke: pulling and pushing of the tissue using the hands in a criss-cross manner is exhibited

Kneading

technique is applied with palm surface of the hand, heel of hand and/or fingers

soft tissue is mobilised with rhythmical circular rolling, squeezing or pulling movements

Friction techniques

superficial tissue is moved over an underlying structure in circular, longitudinal or transverse directions

deep repetitive movements of short amplitude are applied usually with thumbs, fingers and knuckles

friction techniques are believed to be beneficial in releasing adherent/scar tissue

Continued:

Massage techniques:

(continued)

Compressive techniques

digital pressure

compression: successive and rapid pressure - a series of short duration compressions, is applied to soft tissue between two structures, ie underlying bone structures and therapist's hand, or hand to hand

percussion: cupping, tapping, hacking, pummelling and flicking are applied rhythmically using the hands

Petrissage

Temperature therapy

conduction, eg heat packs and immersion baths

radiation, eg ray lamps

friction

topical applications

Deep tissue massage techniques

Myofascial tension technique

Techniques conducted on superficial and/or deep tissues to:

lengthen tissue

reduce adhesions

increase range of movement

decrease compartment pressure

restore elasticity

Manual lymphatic drainage

Trigger point release techniques

apply digital ischemic pressure and/or apply stretching after treatment. it incorporates ischemic pressure and stretching

Stretching techniques

contract-relax

dynamic stretching

hold-relax

muscle energy technique

proprioceptive neuromuscular facilitation stretching

static stretching

Client constitution refers to:

Age, fragility

Fitness

Mental attitude

Muscle tone

Tolerance of pain

Client compliance refers to:

Ability to follow instructions or suggestions

Willingness/motivation to follow instructions or suggestions

Discrepancies may include:

Client is unaware of the immediate danger of their condition

Client is over anxious about their condition

Client is unaware of maintaining causes acting on their condition

Practitioner is unaware of some implications of the client's condition

Practitioner and client have different views of what the main problem is

Discussion may include:

Face to face discussion

Electronic communication

Telephone discussion

Practitioner responsibilities may include:

Isolating the sick person

Provide advice on public health matters

Commitment to the treatment plan

Discussing relevant contra-indications or potential complications to treatment

Review of treatment plan

Clientresponsibilities may include:

Following instruction/advice during and post treatment

Advising practitioner of any relevant contra-indications or potential complications to treatment

Advising practitioner of compliance issues

Commitment to the treatment plan

Treatment evaluation strategies may include:

Discussion and review of response to treatment

Reviewing achievement of treatment goals

Monitoring time frame for achieving treatment goals