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 assessment instruments

Appropriate assessment environment

Skilled assessors

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

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

Examples of assessment notes

Oral questioning on technique or assessment strategy

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

HLTHIR301B Communicate and work effectively in health

HLTIN301C Comply with infection control policies and procedures

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:

Advanced assessment procedures and options allowing complex regional assessments

Atheroma formation and oedema and their effects within the human body

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

Best practice massage therapy principles

Bioenergetic concepts and the cardio-respiratory concepts in relation to exercise

Digestive, integumentary, nervous, urinary, endocrine and reproductive systems

Disease causation, acute and chronic inflammatory processes, wound healing and haemorrhage processes

Environmental physiology and the effects of drugs on the individual

Ethical and legal implications of enquiry

Further testing procedures

History, philosophy and beliefs of massage therapy within a health framework

Indications, possible reactions and contra-indications to treatment

Infectious and immunity process

Main paths of the human respiratory and cardiovascular systems and their physiology

Neoplasms and pathological skin conditions

Normotensive and hypertensive characteristics

Pain and chronic pain syndromes

Physical signs and symptoms of disease

Structure and function of anatomical systems appropriate to massage therapy and the scope of practice

Structure and function of cells, tissues, blood and organs

Structure and function of skeletal, muscular, cardiovascular and lymphatic systems

Symptomatology and pathology

Technical and practical knowledge of treatment

Temperature control, homeostasis, feedback mechanisms, neurological, psychological and psychogenic foundations and issues

Terminology correct to epidemiology and massage practice

The pathological process of thrombosis and embolism

continued ...

Essential knowledge Cont:

The effects of hormones on the body

The processes of ageing

The processes of biological maturation

The situation and referral patterns of trigger points

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

The structure and function of the immune system

Understanding of physiology and anatomy according to massage therapy

Understanding of the fundamental principles of biomechanics and functional anatomy

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:

Communicate effectively with client/other health practitioners

Comprehend common medical terminology

Demonstrate communication skills

Demonstrate observation skills

Demonstrate record keeping skills

Demonstrate skills in applying advanced assessment techniques

Discuss and observe treatment protocols

Gather and interpret information through the tactile senses

Identify prominent bones/structure and phasic and postural muscles

Manage time throughout consultation and treatment

Observe and identify variations of posture

Palpate prominent bones/structure and phasic and postural muscles

Perform testing and assessment procedures

Read medical reports

Read medical test results or documents

Recognise and adjust to contra-indications for treatment

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

Use equipment and resources competently and safely

Use terminology correct to epidemiology and massage practice

Write referrals, appraisal letters for insurance companies and other documentation

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.

Factors likely to have a negative impact on assessment may include:

Language difficulties

Disabilities

Emotional trauma

Lack of privacy or focus due to additional parties being present

Cultural or gender factors

Other health care professional may include:

Podiatrists

Osteopaths

Energy therapists

Physiotherapists

Chiropractors

Medical practitioners

Registered nurses

Social workers

Alternative health practitioners

Counsellors

Other allied health care professionals

Client history may include:

Date of presentation

Identifying personal details

Source of referral (if applicable)

Main presenting complaint or reason for massage

Presenting symptom picture

General state of health

physical

emotional

allergies

dietary picture

sleep pattern

exercise

leisure activities

Childhood and adult illness

Accidents, injuries, operations

Hospitalisations

Occupational history and environment

Other current medical/alternative health care treatment

Medication, supplements and natural prescriptions - current and previous

Previous occurrence of presenting complaint

Social lifestyle including social drug usage

Family history

Potential sensitivities may include:

Gender

Ethnicity

Language

Religious beliefs

Cultural heritage

Sexuality

Ability

Presenting disease state and personal history

Physical assessment will include attention to:

Active movements

Passive movements

Resisted movements

Functional movements

Palpatory findings

Swelling

Instability

Parasthesia

Characteristics of pain

Established assessment procedures may include:

Observation

Discussion

Temperature

Pulse

Palpation

Percussion

Range of motion tests

Muscle strength tests

Orthopaedic tests

Observation of variations of posture

Any other method in which the practitioner has been trained to a competent standard

Procedure which is conducted according to legislative and regulatory requirements

Contra-indications to treatment may include:

Remedial 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

referral 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

oedema

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