Entry to Practice Exam
Candidate Handbook
Revised August 2012
The Massage Therapist Association of Alberta
The Massage Therapist Association of Alberta (MTAA) is a registered, non-profit organization that has a
defined Scope of Practice, Code of Ethics and Standards of Practice. Incorporated since 1953, the
MTAA is a professional association dedicated to Massage Therapists in the province of Alberta.
Mission:
Confident, inspired health professionals dedicated to patient centered care.
Vision:
Build a culture of excellence through leadership and innovation – enabling the profession to
promote the optimal health of the community by delivering quality care within a collaborative
health care system.
Inquiries about the MTAA examination, or any aspect of the Association, should be addressed to:
Massage Therapist Association of Alberta
#201, 4929 – 50 Street
Red Deer, Alberta
T4N 1X9
Phone: (403) 340-1913
Toll Free: 1-888-848-6822
Fax: (403) 346-2269
Email Address: info@mtaalberta.com
Web Site Address: www.mtaalberta.com
About This Study Guide
This Candidate Handbook will give you all of the information you need to register and prepare yourself for
the MTAA Entry to Practice examination. Please read ALL information completely and carefully and
contact the MTAA if you have any questions. KEEP THIS BOOKLET FOR LATER REFERENCE. It is
crucial that all procedures and deadlines in this handbook be carefully followed.
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TABLE OF CONTENTS
The Massage Therapist Association of Alberta
TABLE OF CONTENTS
INTRODUCTION
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Statement of Purpose
The Exam
Composition of the Examination
Question Selection
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Eligibility for Examination
To Apply for the MTAA Examination
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Denial of Exam Registration
Cancellations / Refunds
Special Testing Arrangements
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Exam Security
Exam Fees
MTAA Exam Competency Objectives
Competency Requirements
A. Ensuring Safety of the Patient and Therapist
B. Information Gathering
C. Information Processing
D. Implementation of Treatment Plan
E. Post-Therapeutic Management
Conditions
Orthopedic Tests
Written Examination
Practical Examination / Objectively Structured Clinical Evaluation
Practical Exam General Guidelines
Exam Day Expectations
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General Information for all Practical Sections
Case History Section (15 minutes to complete)
Assessment Section (30 minutes to complete)
Treatment Section (30 minutes to complete)
Landmarking Section (15 minutes to complete)
After the Examination
Getting your Exam Results
Confidentiality of Scores
Appeals Process
Retaking the Exam
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Reference List
Other Important Reference Documents
Frequently Asked Questions
Test Taking Advice
MTAA Exam Candidate Guide
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INTRODUCTION
Statement of Purpose
The MTAA Entry to Practice examination is a test of competency, safety and ethics in the practice of
Massage Therapy. Individuals must meet the minimum standards to be eligible for membership with the
MTAA.
The Exam
The Entry to Practice examination is administered over two separate weekends. The Written Examination
is conducted in synchronized locations around the province (Calgary and Edmonton with additional
stations if demand requires) and the Practical Examination held in Red Deer, usually two (2) to three(3)
weeks afterwards. While an attempt is made to have Written locations in most major centres, this will be
dependent upon the number of candidates in each locale as well as availability of an exam location and
proctor. Re-write Examinations are held within 6-8 weeks of the initial Examination dates for those who
were unsuccessful in their first attempt.
Composition of the Examination
The examination is composed of five sections, of which one is a written examination and four are practical
stations as follows:
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Knowledge
100 multiple choice questions
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Practical skills
1)
2)
3)
4)
Case History
Assessment
Treatment
Landmarking
To the greatest extent possible the questions on all exam sections reflect a clinical, rather than an
academic perspective.
Question Selection
Multiple-choice questions for the written section and scenarios for the practical skills section are based on
the Inter-Jurisdictional Practice Competencies and Performance Indicators for Massage Therapists at
Entry-to-Practice (2012), which have been developed into question banks. Iems are reviewed and
monitored with focus on applicability and a psychometrically defensible exam.
Eligibility for Examination
In order to be eligible for the Entry to Practice examination, a candidate must be able to provide a
Diploma of completion from a Massage Therapy training program of at least 2,200 hours in length or be
deemed eligible via the MTAA Substantial Equivalency Process.
Due to a wide array of Massage Therapy curricula offered in Alberta, the MTAA suggests that each
candidate review the Competency Objectives and evaluate their own readiness to challenge the
MTAA Entry to Practice Exam.
Candidates who are currently enrolled in a 2200-hour training program and wish to challenge the
examination in advance of their graduation date must be within 90 days of completion, provide a
transcript of marks and a reference letter from their educational facility.
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To Apply for the MTAA Examination
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Fill out the application completely. Incomplete applications will be returned UNPROCESSED.
Applications must be received at least three (3) weeks prior to the scheduled written examination
date. No applications for the examination will be accepted after the registration deadline.
Complete application includes:
• Application form with all required supporting documentation attached.
• A cheque, money order or credit card number for the examination fee, made payable to The
Massage Therapist Association of Alberta. Post-dated payments are not accepted.
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Candidates currently enrolled in a 2200-hour training program who wish to challenge the examination
in advance of their graduation date must be within 90 days of completion, provide a transcript of
marks and a reference letter from their educational facility.
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Send all application materials together in one envelope.
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It is suggested that the application and supporting documentation be sent via courier or Express Post
in order that the application package can be traced if it is not received at the MTAA Office. The
MTAA accepts no responsibility for application packages that are lost in the mail or do not arrive at
the MTAA Office prior to the deadline date.
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All candidates will receive a confirmation email once the application has been received and
processed. In the event that you do NOT receive a confirmation email, please contact the
MTAA Office as this may indicate non-receipt of your application.
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It is strongly recommended that you submit your examination application well in advance of the
registration deadline in order that you can receive all pertinent information in a timely manner. The
MTAA accepts no responsibility for delayed mail service by Canada Post.
Denial of Exam Registration
Registration will be denied for any of the following reasons:
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Diploma not received
Falsification of an application or documentation
Misrepresentation
Non-Payment
Cancellations / Refunds
No refunds will be made for cancellations received less than two (2) weeks prior to the written
examination date.
If you wish to cancel your application for the examination, notification must be received in writing at a
minimum of two (2) weeks prior to the scheduled date for the written examination. The request must
include your full name, address and signature. A $150.00 processing fee will be retained from the
examination fee. Refunds will be mailed two (2) to four (4) weeks after the scheduled date for the
practical examination.
In the event that extenuating circumstances prevent you from appearing at the testing location, you must
notify the MTAA at 1-888-848-6822 no later than 24 hours after your scheduled exam appointment and
submit supporting documentation as to the extenuating circumstances that prevented you from attending.
The MTAA will determine whether or not circumstances warrant a refund, minus a $150.00 processing
fee.
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Candidates who cancel their application must submit a new application with appropriate documentation
and fees to be registered for the next complete examination date.
Candidates who fail to complete the written examination will be automatically cancelled from the practical
exams unless notification is received in the MTAA office within 24 hours of the written examination as
outlined previously. Candidates will be recorded as unsuccessful on the first attempt of the exam and will
not be eligible for a refund.
No applications, documentation, or fees may be transferred from one examination date to another.
These refund policies are not applicable to those candidates who hold a Provisional Membership status.
Special Testing Arrangements
A candidate who is visually or hearing impaired, has a health problem or learning disability, may request
special accommodations or arrangements. When requesting testing alterations, candidates must submit
a complete assessment by a qualified health professional outlining the history and diagnosis and a
description of the special arrangements required. All requests must be reviewed and approved by the
Examination Committee. Requests must be submitted at the time of application. Please note that we
are not able to accommodate all special testing arrangements, however will do our best to be of service.
No special accommodations or arrangements can be made on the day of the examination without the
Examination Chairperson having prior knowledge and documentation of the candidates’ need.
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Exam Security
The purpose of the MTAA Entry to Practice Examination is to provide a fair and objective measure of a
candidate’s competency, knowledge, skills and ability. Any activity that threatens to compromise this
purpose is seen by MTAA as unacceptable behaviour and will be dealt with accordingly.
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Visitors are NOT allowed into the examination areas.
Candidates may not take books, papers, study aids, translation aids, reference materials, computers,
calculators, tape players, CD players, radios, cell phones, personal electronic devices or anything
similar into the examination room.
Candidates may leave the examination area only after all examination materials, including scrap
paper, have been handed in.
Any candidate who attempts to give, or receive, assistance during the examination will be required to
turn in their examination materials immediately and leave the room.
Securing “cheat sheets” on your person is not allowed.
Recording of items viewed on the examination by any means whatsoever, including memorization
with the intent to disseminate to other parties is prohibited.
Candidates who violate any security aspects will not have their examinations processed and will be
recorded as having been “unsuccessful with security violation”. Those candidates will then be ineligible to
write further examinations with the MTAA.
Exam Fees
The following fees apply to the examination. Payment for the examination must be received with your
application. Payments are accepted by cheque, money order or credit card number made payable to
the Massage Therapist Association of Alberta. An administration fee of 2% will be added to all credit
card transactions.
Entry to Practice Examination Fee:
$350.00 + GST
Rewrite Fees:
Written Exam:
Assessment (Practical):
Treatment (Practical):
Case History (Practical):
Landmarks (Practical):
$ 85.00 + GST
$ 85.00 + GST
$ 85.00 + GST
$ 85.00 + GST
$ 85.00 + GST
*** Maximum Rewrite Fees $350.00 + GST
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MTAA Exam Competency Objectives
Five major categories of competencies have been established for Massage Therapists:
A. Ensuring Safety of the Patient and Therapist
B. Information Gathering
C. Information Assessment
D. Implementation of Treatment Plan
E. Post-Therapeutic Management
The competency requirements in this document have been organized under these five major areas and
sub-classified into the specific field of study.
Competency Requirements
A.
Ensuring Safety of the Patient and Therapist
1.
Contraindications to Massage Therapy
The candidate will be able to:
• Prove understanding of how to identify contraindicated conditions.
• Prove understanding of why a specific condition may be contraindicated.
• Explain and demonstrate modifications to the Massage Therapy treatment to accommodate a
contraindication.
• Explain and demonstrate understanding of the effects and contraindications to Massage
Therapy for patients taking commonly prescribed medications.
2.
Basic Draping, Positioning and Turning Techniques
The candidate will be able to:
• Demonstrate draping proficiency in exposing only the body area to be worked on, while other
areas remain covered.
• Display respect for the personal boundaries, physical and emotional, of the patient and
therapist.
• Demonstrate appropriate bolstering techniques to ensure correct positioning of the patient by
providing purposeful support and comfort to the limbs and joints during a massage treatment.
• Demonstrate proper patient turning procedure during a massage treatment, ensuring that the
patient remains properly draped at all times.
3.
Basic Environment for Practicing Massage Therapy
The candidate will be able to:
• Prove understanding of methods for the preparation and maintenance of a hazard-free and
clinical Massage Therapy environment.
• Demonstrate and prove understanding of practices of infection control, personal hygiene and
attire appropriate for a clinical setting.
4.
Communication Skills
The candidate will be able to:
• Demonstrate how to establish open and professional communication between the therapist
and patient.
• Demonstrate methods to empower the patient to participate in the massage experience
(based on the power differential implicit in the roles "therapist" and "patient").
• Explain procedures, strokes and remedial exercises, in language free of medical jargon.
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5.
Professionalism and Ethics
The candidate will be able to:
• Differentiate between legal and ethical responsibilities of the Massage Therapist.
• Prove understanding of why confidentiality is important and identify behaviour on the part of
the therapist that protects confidentiality.
• Prove understanding of the importance of a patient’s right to refuse treatment and the
therapist’s right to refuse providing the treatment.
• Prove understanding of the importance of zero tolerance for inappropriate sexual behaviour
on the part of therapist and patient.
• Provide understanding of proper intervention responses to inappropriate behaviour on the
part of the patient in the massage setting.
• Prove understanding of the limitations of the massage treatment and when referral to other
healthcare providers is appropriate.
• Prove understanding of the MTAA Standards of Practice and Code of Ethics.
B.
Information Gathering
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Terminology
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The candidate will be able to:
Prove a thorough working knowledge of medical terminology and anatomical structures.
Demonstrate understanding of the Western medically accepted anatomical position of the
body.
Prove understanding of locations of the body’s cavities and their subdivisions.
Prove understanding of descriptive directional terms.
Prove understanding of the various planes of the body.
Contrast the terms clinical "signs" and "symptoms".
Prove understanding of the various movement terms at appropriate joints.
Systems
The candidate will be able to:
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Identify and palpate bones and bony landmarks.
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Identify and palpate joints and joint structures.
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Identify and palpate muscles, fibre directions, origins and insertions, primary action(s).
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Palpate major pulse points in the body.
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Identify, describe and evaluate myotomes, dermatomes and deep tendon reflexes of the
body.
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Explain how to recognize and identify the signs and symptoms of clinically relevant
pathologies of the following systems: articular, cardiovascular, digestive, endocrine,
integumentary, lymphatic, muscular, nervous, reproductive, respiratory, skeletal and urinary.
3.
Assessment
The applicant will be able to:
• Collect and interpret relevant data in a pre-treatment interview.
• Prove understanding of and demonstrate proper sequential orthopedic testing techniques.
• Prove understanding of the normal range of motion of each joint in the body and demonstrate
proper testing of joint range of motion.
• Perform and describe the palpation procedures to identify soft tissue lesions.
• Prove understanding of principles and procedures for documentation of assessment and
treatment data.
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C.
Information Processing
1. Pathophysiology
The candidate will be able to:
• Prove understanding of the concept of the homeostatic mechanism at the systemic and
cellular levels, how this is reflected in healthy and unhealthy tissue function and how this
relates to the indication or contraindication of Massage Therapy.
• Prove understanding of how to recognize and identify the signs and symptoms of common
inflammatory, infective and traumatic skin conditions.
• Describe primary and secondary causes of a condition.
• Prove understanding of the inflammatory response and its chronological progression.
• Prove understanding of the role of the immune system in inflammation and repair.
• Prove understanding of the consequences of impaired and excessive inflammatory response
on tissues.
• Prove understanding of the mechanism and presentation of injuries and congenital and
idiopathic diseases and how they can be modified clinically by Massage Therapy.
2. Systems
The candidate will be able to:
• Prove understanding of the structure and function of all systems of the body: articular,
cardiovascular, digestive, endocrine, integumentary, lymphatic, muscular, nervous,
reproductive, respiratory, skeletal and urinary.
• Prove understanding of the physiological effects and limitations of Massage Therapy on all
systems of the body.
• Analyze the muscle involvement on common movement patterns at specific joints.
• Describe the factors involved in the change of normal resting muscle tone to hyper or
hypotonic states.
3. Assessment
The candidate will be able to:
• Formulate a plausible functional hypothesis regarding soft tissue and joint dysfunction, based
on analytical deductions from all the collected data.
D.
Implementation of Treatment Plan
1. Basic Massage Strokes
The candidate will be able to:
• Demonstrate integration of various massage strokes in a logical order based on basic
principles of Massage Therapy.
• Describe the specific physiological effect(s) of each massage stroke based on intended
therapeutic outcomes and goals of treatment.
2. Pathophysiology
The candidate will be able to:
• Explain the primary distinguishing characteristics of the different tissue types and the possible
effects massage may have on healthy and unhealthy tissues.
• Explain and demonstrate understanding of the contraindications of Massage Therapy on the
inflammation and repair processes in soft tissue and joint dysfunction.
• Explain and demonstrate understanding of the effects and contraindications of Massage
Therapy on patients taking commonly prescribed medications.
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3. Systems
The candidate will be able to:
• Describe and demonstrate understanding of each of the following body systems along
with the effects and limitations of Massage Therapy on them: articular, cardiovascular,
digestive, endocrine, integumentary, lymphatic, muscular, nervous, reproductive,
respiratory, skeletal and urinary.
• Explain the possible effects of Massage Therapy on acute and chronic pain perception,
both on a physical and psychological level.
• Describe and demonstrate their knowledge and application of “universal precautions”
when administering Massage Therapy services.
4. Assessments and Treatment
The candidate will be able to:
• Demonstrate and explain the development of a treatment plan based on a hypothesis.
• Demonstrate and explain use of appropriate Massage Therapy techniques for the
treatment of the hypothesized soft tissue and joint dysfunction(s).
• Demonstrate and explain the precautions, principles and purpose of any particular
application of hydrotherapy, with specific reference to hot, cold and contrast applications.
E.
Post-Therapeutic Management
The candidate will be able to:
• Explain and demonstrate safe, effective, relevant and specific post-treatment interventions
including strengthening, stretching, hydrotherapy, lifestyle changes, and as well as postural
and ergonomic adjustments in management of the patient’s condition.
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Conditions
The following conditions, which may be encountered by a Massage Therapist in practice, may be tested
on any of the sections of the examination.
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Headaches – Tension, Sinus, Migraine
Whiplash Acceleration/Deceleration Injury (Whiplash Associated Disorders – WAD Type I and II)
Torticollis
TMJ Dysfunction
Bell’s Palsy
Dislocations
Impingement Syndromes
Adhesive Capsulitis
Lateral and Medial Epicondylitis
Thoracic Outlet Syndrome
Carpal Tunnel Syndrome
Pronator Teres Syndrome
De Quervain’s Tenosynovitis
Dupuytren’s Contracture
Sprain and Strain
Contusion
Piriformis Syndrome
Iliotibial Band Contracture
Iliotibial Band Friction Syndrome
Patellofemoral Syndrome
Meniscus Injury
Periostitis and Compartment Syndromes
Pes Planus
Plantar Fasciitis
Gout
Osteoarthritis
Osteoporosis
Tenosynovitis
Tendonitis (Supraspinatus, Patellar, Bicipital, Achilles, etc.)
Rheumatoid Arthritis and Juvenile Rheumatoid Arthritis
Fractures
Bursitis
Ankylosing Spondylitis
Scoliosis, Hyperlordosis, Hyperkyphosis
Degenerative Disc Disease
Fibromyalgia
Multiple Sclerosis
Peripheral Nerve Lesions
Parkinsons Disease
Cerebral Palsy
Chronic Bronchitis
Emphysema
Asthma
Constipation, Irritable Bowel Syndrome, Inflammatory Bowel Disease
Diabetes Mellitus
Pregnancy
Orthopedic Tests
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The following orthopedic tests may be used when assessing for the above listed conditions, and may be
tested in any section of the examination. Please note that due to varied and diverse curricula of the
Massage Therapy training programs the following is not an exhaustive list, but rather intended to be a
sampling of tests that could be used when assessing a particular condition.
Please note that there is no expectation of the candidate to demonstrate ALL special tests.
Upper Body
Lower Body
Apprehension Test
Valsalva Test
Adson’s Test
Patrick’s (Faber or Fig. 4) Test
Wright’s Test
Lasegue’s (Straight Leg) Test
Eden’s Test
Thomas Test
Drop Arm Test
Trendelenburg’s Test
Painful Arc Test
Gaenslen’s Test
Yergason’s Test
Ober’s Test
Speed’s Test
Kemp’s (or Quadrant) Test
Phalen’s Test
Braggard’s Test
Finkelstein’s Test
Apley’s (Compression and Distraction) Tests
Tinel’s Sign
Patellar Grind Test
Cozen’s (Tennis Elbow) Test
Q-Angle Test
Mill’s Test
Anterior/Posterior Drawer Test
Golfer’s Elbow Test
Varus/Valgus Stress Test
Apley’s (scratch) Test
McMurray Test
Costoclavicular Test
Talar Tilt Test
Upper Limb Tension Tests
Homan’s Test
Vertebral Artery Test
Piriformis Length Test
Supraspinatus Strength
Ballottable Test
Cervical Compression Test
Brush Test
Cervical Distraction Test
McConnell’s Test
Spurling’s Test
Waldron’s Test
Neer Impingement Test
Noble’s Test
Hawkins-Kennedy Test
Written Examination
The written examination section consists of one hundred (100) multiple-choice questions testing general
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overall scientific knowledge, clinical theory, Standards of Practice and Code of Ethics, as well as
understanding of anatomy, physiology and pathophysiology and how to perform competently in a clinical
setting.
A general guideline for the weighting of the written examination is as follows:
Pure Sciences: Anatomy, Physiology, Pathology = 20%
Applied Sciences: Assessments, Clinical Signs and Symptoms, General and Local Contraindications
and Precautions to Massage Treatment, Remedial Exercise, Kinesiology = 30%
Massage and Hydrotherapy: Theory, Technique, Treatments = 30%
Jurisprudence: Code of Ethics, Standards of Practice, Professional Boundaries = 20%
Upon receipt of your written examination booklet, you will notice that it is sealed. Following completion of
the examination, the exam booklet is to be returned to the Proctor with the answer sheet inside the exam
booklet and then the Proctor will reseal it. You will be required to write your initials on the new seal to
acknowledge that the examination booklet was returned with the answer sheet sealed inside.
Notes and textbooks are not to be brought in to the examination room. There will be at least one Proctor
to monitor the examination room at all times. When you have completed this portion of the examination,
you are required to hand in all papers to the Proctor and leave the room quietly.
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Practical Examination / Objectively Structured Clinical Evaluation
The purpose of the practical exam stations is to assess actual clinical skills and competencies relevant to
the practice of Massage Therapy.
This is a performance-based exam where the candidate is required to perform clinically relevant tasks
and skills.
These exams are objectively structured clinical evaluations (OSCE).
Examiners are all Massage Therapists with a number of years of ongoing practice experience who are
trained to provide impartial and fair evaluations. They are rigorously trained on specific stations and the
associated evaluation criteria. Examiners assess each candidate according to the predetermined
checklist of criteria based on the exam competencies and Standards of Practice and other approved
references. Examiners do not know the identity of the candidates they evaluate and also do not know
which schools the candidates attended. Examiners will not stop candidates who have gone off course
during a station or are doing something other than what was instructed. Note that examiners will not
respond to questions about the scenario or about how the candidate is doing.
Practical Exam General Guidelines
You should know and be able to answer the following:
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Define conditions
Causes of conditions
Conduct an interview to develop knowledge of case’s history
Form a logical clinical impression based on information gathered
Signs and symptoms of conditions
Anatomical identification of structures involved
Explain special considerations and contraindications
Demonstrate and perform orthopedic tests
Perform active, passive and resisted range of motion (ROM)
Explain short and long term aims of treatment
Demonstrate and perform remedial exercises
Explain hydrotherapy applications
Exam Day Expectations
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Candidates are requested to arrive a maximum of 30 minutes and absolutely no less than 15
minutes prior to the commencement of the written and the practical exam sections as directed in
their registration package.
For registration, the candidate must present government issued picture identification (ID) that is
checked against the exam identification sheet corresponding to the candidate’s ID badge number.
This ID badge along with the Candidate Registration Sheet is then given to the candidate.
ID badges MUST BE worn at all times during the exam process.
Candidates are to present their registration sheet at each section of the exam. The candidate
must receive their registration sheet back when the section is completed.
Candidates wait for their practical exam time in a common candidate's holding room. They are
allowed their personal items including food and beverages. There are NO cell phones, pagers,
electronic devices or any other text messaging type devices allowed in any of the exam areas.
A designated Proctor will escort candidates to an exam room.
Personal belongings must be stored in the candidate’s holding room which is monitored at all
times.
When washrooms are outside the exam area, a Proctor must escort a candidate to the
washroom.
NO CANDIDATE IS ALLOWED TO LEAVE THE EXAMINATION VENUE WITH THEIR ID
BADGE OR REGISTRATION SHEET.
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General Information for all Practical Sections
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Your personal belongings will remain under the care of the candidate holding room proctor.
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You will be tested on up to three different conditions during the practical component. You will
have a different scenario in each of the case history, assessment and treatment stations.
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If you feel the need to introduce yourself to the patient, please do so using either your Candidate
ID number or your first name only.
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You will have time at the beginning of each section of the practical exam to use the paper
provided to make any notes you wish to assist you in completing that section. You may keep this
paper with you to refer to. It will then remain with your score sheet upon completion of the
section. Please note the time you use to make notes is included in the maximum amount of time
you are allotted for that station.
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You MUST verbalize your actions and intentions to the examiners to receive full marks.
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You are expected to receive informed consent in all practical stations to receive full marks.
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There will be 2-3 examiners in each station.
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Please treat the examiner/patient as if you were in your own clinic. That is, as if he/she has no
knowledge of Massage Therapy.
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Be prepared for vague or no answers from the examiner/patient. The case history station will
be the only station in which the standardized patient will be responding directly to your
questions.
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Expect the examiners to move around you and/or the massage table so as to most effectively
observe you while you complete the examination.
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There may be a time when the Examination Chairperson and/or Practical Chairperson enters the
exam room during the time that you are performing a portion of your exam. This is for purposes
of monitoring the examiners, ensuring that they are performing their duties effectively.
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There is more than adequate time for you to complete each section. Should you need a moment
during a section to compose yourself and gather your thoughts, please feel free to do so. Keep in
mind that adjustment to the time allocated for any section of the examination will not be made
under any circumstances.
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Do not feel that you have to use the full time in each exam section if you feel as though you have
adequately completed the section before the time has elapsed.
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Comments by examiners to the candidate are restricted ONLY to clarifying instructions. They
cannot answer questions outside of clarifying the instructions given for the station.
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You will be advised of the time remaining as you near the end of the allocated time for each
section. Announcements will be made at 10 minutes, 5 minutes and 1 minute remaining.
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At the end of each practical section you will be asked if there is anything that you would like to
add or review. This will be done REGARDLESS of your performance.
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At any point in all of the exam stations you are able to go back and correct something previously
demonstrated or stated as long as you are demonstrating and verbalizing what you would prefer
to do.
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In each station of the examination, you are also being examined on your overall presentation of
professionalism which includes such things as verbal and non-verbal communication.
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Once completed all of the practical sections, you will be escorted back to the candidate holding
room and you will have the opportunity to provide input about the examination in the form of a
written questionnaire. Once completed you will be escorted out of the building.
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Case History Section (15 minutes to complete)
This section consists of a standardized patient presenting as if in your clinic. You are presented with a
written description of the patient that includes name, age, height, weight, occupation and main complaint.
You are then instructed to perform a complete case history through interaction with the standardized
patient. This is the only station of the examination in which the standardized patient will be directly
responding to your questions.
Through this portion of the examination, you are judged on your ability to elicit the pertinent information
and develop a clinical impression based on the information obtained from the standardized patient and
overall impression. For example, if the case history shows a 43 year old mechanic with tingling and
numbness in his right forearm and wrist after gathering the appropriate information you will have certain
conditions in mind such as Carpal Tunnel Syndrome, Pronator Teres Syndrome, Thoracic Outlet
Syndrome, etc. The person you see in front of you does not physically represent the patient and you
should concentrate on the standardized patient's responses to you.
You are able to question the standardized patient in all areas of the case history, including, but not limited
to chief complaint(s), character, associated symptoms, aggravating and relieving factors, past history,
family history, previous care, medications and prior treatment.
General Reminders:

You are expected to receive informed consent in order to receive full marks. Please refer to
the MTAA Standards of Practice for more information.

Examiners are looking for the candidate to follow logical steps in appropriate order, with
attention to indicating a clinical impression at the end of the history taking.

If you do not indicate a clinical impression, the examiner will ask you for one at the
completion of this section.

Be prepared for vague answers from the standardized patient. They will be responding not
as a Massage Therapist, but as you would expect a patient to. If the standardized patient
does not have the information you are requesting their response will be that “that information
is not available.”
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Assessment Section (30 minutes to complete)
This section deals with the evaluation of technical skills and understanding of physical examination
procedures. You are given a completed Health History form and Case History of the standardized patient
as if in the treatment room of your practice. You are provided with the condition that the standardized
patient has. You are expected to verbalize and demonstrate your assessment process that you would
perform on this patient.
Through this section of the examination, you are evaluated on your ability to verbally and technically
demonstrate all components of the assessment procedure including, but not limited to physical
inspection, postural analysis, gait analysis, palpation, range of motion testing (active, passive and
resisted), special testing, joint play, and muscle specific testing, neurologic evaluation (myotomes,
dermatome, deep tendon reflex).
The areas of evaluation include appropriateness of tests done, the sequence in which the assessment
was completed, the skill level demonstrated, ability to identify results that are anticipated given the
information provided, analysis of the results and overall impression. The standardized patient you see in
front of you does not physically represent the information provided. You will not receive any specific
response from the standardized patient.
General Reminders:

You are expected to receive informed consent in order to receive full marks. Please refer the
MTAA Standards of Practice for more information.

Examiners are looking for systematic elimination and or inclusion (rule in/rule out) to arrive at
a conclusion.

This section is intended to test the process of assessment to indicate how the
candidate would arrive at a clinical impression.

This section of the exam will not test a candidate’s ability to perform a case history evaluation
or a Massage Therapy treatment.

Remember that not all patients respond positively or negatively to assessment techniques,
similarly neither will the standardized patient.

It is important in this section to demonstrate safe and logical order of assessment.

It is acceptable to verbalize that you would typically assess the joint above and below the
affected joint, as well as the unaffected side joint.

Candidates are expected to fully explain the purpose of and use a minimum of one applicable
orthopedic test of their choice, performed correctly for and appropriate to the condition. Use
the tests that you were taught in your Massage Therapy program.

Marks are given as to whether the candidate completed the assessments that were indicated
(e.g.: tests, observations, analyses).

Take time at the beginning of this section to familiarize yourself with the various tools of
assessment provided for you in the examination room. These are available for you to utilize,
but you need NOT use all of them to be successful in this portion of the examination.

The standardized patient may not present exactly as the condition may dictate. Be prepared
for no response from the standardized patient.
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Treatment Section (30 minutes to complete)
This section consists of a standardized patient presenting with a specific clinical impression in the
treatment room. You are given a completed Health History form and Case History of the standardized
patient as if in the treatment room of your practice. You are provided with the condition that the
standardized patient has. You are expected to verbalize and technically demonstrate an appropriate
treatment on the standardized patient.
This would include proper draping and bolstering techniques, a general warm-up, the specific treatment,
the cool-down and home care recommendations. You may utilize any equipment provided in the
treatment room. If you would like to have used equipment not found in the treatment room, you must fully
verbalize this to the examiners.
You will be judged on the appropriateness and effectiveness of the treatment, the sequence, draping,
positioning, technical skills, and overall impression made.
General Reminders:

The standardized patient will be seated on the table in a gown when you enter the room.

You are expected to receive informed consent in order to receive full marks. Please refer the
MTAA Standards of Practice for more information.

The standardized patient will follow the instructions given to them, be sure to outline exactly
what you would like them to do.

Candidates are provided a condition and are not tested on case history evaluation or
assessment during this portion of the exam.

Candidates are expected to provide a shortened version of a treatment for this condition. Be
sure to explain what you would normally do in a full treatment for this condition.

Verbalizing both the treatment plan and the treatment itself to the examiners and
standardized patient is VERY important in this section, as you may encounter time
constraints.

Candidates are expected to prepare the patient for treatment, arrange appropriate positioning
and draping, provide appropriate treatment and application of massage strokes/techniques,
safely turn the patient and provide post-therapeutic advice.

For each massage stroke/technique performed it must be fully verbalized and demonstrated
including pre-technique and post-technique protocols to constitute full marks. Please refer the
MTAA Standards of Practice for more information.

Treatment should be demonstrated in a logical and progressive order in accordance with the
principles of massage and the MTAA Standards of Practice.

The standardized patient may not present exactly as the condition may dictate.

The standardized patient is only able to provide feedback with regards to pressure and
comfort during the treatment. The feedback they provide is relative to what they are feeling
individually and , not to the scenario provided. They will not be responding to any other
questions.
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Landmarking Section (15 minutes to complete)
This section consists of 10 separate palpation requirements. There is one (1) myotome, one (1)
dermatome, one (1) pulse point, four (4) muscles and three (3) bony landmarks.
General Reminders:

When palpating muscles the examiners are looking for muscle origin and insertion, fibre
direction, and action.

Be sure to verbally explain and physically demonstrate the above.

Once you have found the required pulse point you are expected to count the pulse out loud.

Dermatomes are to be demonstrated using one finger so the examiners can clearly see the
area you are outlining.

The examiner will be physically checking the points you are demonstrating.
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After the Examination
Getting your Exam Results
Individual exam results will be emailed within four (4) weeks of the practical examination date. The results
will give you a "Pass" or “Fail” notification ONLY for each station. The results will tell you if you passed all
parts of the examination or what area(s) will be required to be retested.
Every attempt possible will be made to have the exam results sent as soon as possible. This is done in
order to maximize study time prior to the re-write date.
Examination results will be sent out to candidates via fax or email in order to facilitate time sensitivity of
membership activations with a hard copy of the results to be sent by mail. Examination results will NOT
be provided over the telephone under any circumstances.
Confidentiality of Scores
All examination scores are confidential. Educational Institutions are sent only their statistical report on
how the students of their school did on this particular examination. Schools do not receive an attendance
list or any individual marks.
Appeals Process
Candidates are not permitted to review the examination or marking sheets. The MTAA Examination
Committee will accept letters of appeal up to three (3) weeks of the date that the examination results were
distributed by mail. Appeal requests must outline the candidate’s complaints and/or concerns and be
submitted with an Appeal fee of $100.00 + GST. All appeals are reviewed by the Examination Appeals
Committee only with a reply to be sent within four (4) weeks of the appeal being received into the MTAA
Office.
The results of an appeal are FINAL.
Retaking the Exam
In the event that you are unsuccessful in components of the examination, you are required to retake only
the stations that you have failed. Re-writes will be held approximately four (4) to six (6) weeks after
the practical examination date, depending upon venue availability.
The MTAA allows up to two (2) re-writes on any portion of the examination provided that you meet the
eligibility requirements, submit a completed application and proper fees each time. If you are not
successful within these attempts, you may be required to undertake remediation prior to having to retake
the entire exam again.
All rewrites of any portion of the examination must be completed within one year of the last attempt.
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Reference List
The following references, or books of similar content, may be of use as you review for the examination.
The books listed are those that were used in the development of this exam. Candidates should NOT try
to study all of these books in depth. Use them for information about content areas or topics in which you
need review. The books on this list are not available from the Massage Therapist Association of Alberta.
They may be found in library or purchased through a college or regular bookstore.
Biel, Andrew. “Trail Guide to the Body”, Books of Discovery Press, 2001.
Calais-Germain, Blandine. “Anatomy of Movement”, Eastland Press, 1993.
“Canada’s Food Guide to Healthy Eating for People Four Years and Over”, Ottawa: Minister of
Supply and Services Canada, 1992.
Cyriax, J.H. and P.J. Cyriax. “Illustrated Manual of Orthopedic Medicine; 2
Heinemann Medical, 1996.
nd
Edition”, Butterworth-
Fritz, Sandy. “Mosby’s Fundamentals of Therapeutic Massage”, St. Louis: Mosby Lifeline, 1995.
th
Guyton and Hall, “Textbook of Medical Physiology”, 11 Edition, Elsevier Saunders, 2006.
rd
Hole, John W. Jr. “Essentials of Human Anatomy and Physiology”; 3 Edition”, Wm. C. Brown
Publishers, Dubuque, Iowa.
Hoppenfeld, Stanley. “Physical Examination of the Spine and Extremities”, Prentice Hall, 1976.
rd
Kendall, Florence Peterson, and Elizabeth Kendall McCreary. “Muscles: Testing and Function”, 3
Edition. Baltimore: Williams and Wilkins, 1983.
Kisner, Carolyn and Lynn Allen Colbey. “Therapeutic Exercise: Foundations and Techniques”, 2
Edition. Philadelphia: F.A. Davis, 1990.
nd
Lajeuness, Darryl, Carol Edwards and Brenda Grosenick. “Realism, A Study in Human Structural
Anatomy”, Kasterstener Publications, 2003.
Lowe, Whitney W. “Functional Assessment in Massage Therapy: 2
Pacific Orthopedic Massage, 1995.
nd
Edition”, Corvallis, Oregon:
th
Magee, David J. Ph. D. “Orthopedic Physical Assessment; 4 Edition”, W. B. Saunders, 2002.
th
Marieb, Elaine N. “Human Anatomy and Physiology; 6 Edition”, Benjamin/Cummings, 2003.
Nowak, Thomas J. and A. Gordon Handford. “Essentials of Pathophysiology: Concepts And
Applications for Health Care Professionals”, McGraw-Hill, 1998.
Paiva, Cidalia. “Keeping The Professional Promise”, MT Publishing, 2004.
th
Porth, Carol Mattson, “Pathophysiology, Concepts of Altered Health States”, 7 Edition, Lippincott
Williams & Wilkins, 2005
nd
Premkumar, Kalyani. “Pathology A to Z: A Handbook for Massage Therapists; 2
Lippincott Williams & Wilkins, 2002.
Edition”,
Rattray, Fiona S. and Linda Ludwig, “Clinical Massage Therapy, Understanding, Assessing and
Treating Over 70 Conditions”, Talus Inc., 2000.
th
Stone, Robert J. et al. “Atlas of Skeletal Muscles; 4 Edition”, McGraw-Hill, 2002.
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Tortora, Gerard J. et al. “Principles of Anatomy and Physiology; 10th Edition”, Wiley Textbooks,
2002.
Travell, J. G. and D. G. Simons. “Myofascial Pain and Dysfunction: The Trigger Point Manual”,
Baltimore: Williams and Wilkins, 1983.
Travell, J. G. and D. G. Simons. “Myofascial Pain and Dysfunction: The Trigger Point Manual: The
Lower Extremities”, Baltimore: Williams and Wilkins, 1992.
Travell, J. G. and D. G. Simons. “Myofascial Pain and Dysfunction: The Trigger Point Manual: The
Upper Extremities”, Baltimore: Williams and Wilkins, 1992.
nd
Van DeGraff, Kent M., Fox, Stuart Ira. “Concepts of Human Anatomy and Physiology; 2
Wm. C. Brown Publishers, Dubuques, Iowa.
Edition”,
th
Venes, Donald. “Taber’s Medical Dictionary; 19 Edition”, F.A. Davis Co., 2001.
Wistreich, George A. “Medical Terminology in Action”, McGraw-Hill, 1993.
Other Important Reference Documents
MTAA Standards of Practice
MTAA Scope of Practice
MTAA Code of Ethics
MTAA Guidelines for Professional Boundaries
These documents are available on the MTAA Website located at www.mtaalberta.com
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Frequently Asked Questions
Q: Why does the MTAA require proven competency?
A: We qualify our members to provide assurance to the public as well as other health care organizations
and the insurance industry that a member of the MTAA is capable of practicing competently, safely and
according to set Standards of Practice and a prescribed Code of Ethics. The MTAA is registered under
the Alberta Societies Act of Alberta and therefore must develop and maintain bylaws, policies and
procedures, and a complaint and discipline process to effectively govern the organization and define the
profession of Massage Therapy. Massage Therapy is a powerful component of health care with inherent
risks and benefits and must be applied by skilled and knowledgeable clinicians.
We qualify our members because we believe in validating the process of Massage Therapy education by
applying rigorous evaluative standards. We believe in the professionalism of Massage Therapists and
the intrinsic worth of the therapy when applied by demonstrably skilled and knowledgeable therapists.
Q: Why become an MTAA Member?
A: Being a member of the MTAA increases consumer confidence that seeing you will result in safe and
effective health care.
MTAA members gain access to valuable information relevant to the profession. The MTAA works to
promote member services by engaging in efforts to educate the public, other health care providers, and
the government about Massage Therapy. Members are offered discounts on some professional
publications and insurance policies.
Due to advocacy by the MTAA and the members, increasing numbers of consumers recognize that MTAA
members have successfully completed an educational program specific to Massage Therapy and that
they have challenged and mastered a written and oral practical examination that qualifies them to be
known as a Massage Therapist. Many consumers do not know, but are pleased to find out that MTAA
members must earn Professional Development Credits. Additionally, knowing that their therapist
maintains current first aid and CPR also enhances patient safety and patient confidence. The public,
other professionals and peers have additional assurance of quality of care knowing that therapists are
accountable for their conduct and subject to disciplinary procedures within the Association. Consumer
usage of therapeutic massage is continually increasing and users frequently seek only qualified health
care professionals.
Q: Why do the Examiners and Proctors seem so unfriendly?
A: Examiners and Proctors are instructed NOT to engage you in conversation. We are sensitive to the
fact this might be distracting to yourself or others around you, further to this, each candidate is entitled to
a standardized and controlled situation in each of the stations. Any questions you have about the exam
process can be brought forth prior to the examination days via the MTAA office or in the holding room
prior to or after the exam is completed, in which case it will then be directed to the Examination
Chairperson(s). Conversation about any of the exam items is strictly prohibited.
Q: Why do candidates need to show picture ID when they register?
A: Your picture ID will be used as proof of your identity and will be compared to the list of properly
registered candidates. The ID Badge that is issued to you when you initially register is always left behind
when you leave the exam area.
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Q: Why are the Examiners so unfriendly when we leave the examining room?
A: The Examiners cannot offer any encouraging or discouraging words, such as “good job” or “well
done”. This might lead the candidate to think that they had performed well when in fact it is not the
examiners who compile their final score. Expect at best a pleasant “Do you have anything else you would
like to add or revisit”.
Q: What happens if I am late for the exam?
A: The Exam Chairperson(s) carefully schedule examinations to accommodate all candidates, therefore
any exam candidate that reports late to any section of the exam will be unable to write that section and
will receive a fail score for non-attendance. The candidate will be provided an opportunity to write that
section at the next sitting of the exam with an associated re-write fee. Please note that if you are not
registered for the Practical portion a minimum of fifteen (15) minutes prior to your appointment
time you will be considered late.
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Test Taking Advice
Due to a wide array of Massage Therapy curricula offered in Alberta, the MTAA suggests that
each candidate review the Competency Objectives and self–evaluate their readiness to challenge
the MTAA Entry To Practice Exam.
There is an art to writing multiple-choice exams. Below are some suggestions that we hope you will find
helpful when completing the written portions of the MTAA Entry to Practice examination.
Study Tips
Time must be spent in preparation for the Exam. When reading texts, most sources suggest
that it takes a reader at least three passes through a chapter to reach an understanding of the
material. Try:
(1) reading the chapter for "sense" and searching for the overview;
(2) a second read drawing out the important points; and
(3) a final review pass in which you actively question yourself about the important points raised
in the material. The use of flash cards, study guides, groups of classmates in
discussion, and a wide range of other possible activities can help, but are never a
substitute for careful, active, and systematic reading.
Scheduling Study Time and Rewarding Yourself for Good Study Behavior
1. Make appointments with yourself for study time (i.e., in your day timer), so that it is clear to you
when you're meeting or shirking your study responsibilities.
2. When possible, plan to study even if only briefly before scheduled pleasant events (e.g., parties,
trips, visits). Over time, this will tend to "fool" your nervous system into believing that studying is
fun because it seems to lead to a positive outcome. It will also allow you to enjoy positive events
more fully because your conscience is less likely to intrude on them to remind you about the need
to study.
3. It is a lot easier to study hard if you know that you'll get a break before too long. Frequent short
breaks also reduce interference between different aspects of new information while allowing for
its "consolidation." For these reasons, you might try to study very hard for 20-25 minutes at a time
followed by a 5-minute break for a scheduled positive event (e.g., a snack, an exercise break, call
a friend, etc.).
4. After every 3 such study/short break cycles, take a 15-minute break, repeating this overall
procedure until your study time or tasks are completed. Of course, the actual schedule that is
best for you or any other individual varies--work out the study periods and cycles over which you
can best apply yourself on a sustained basis.
5. Studying is much more effective and efficient if it is spread out over time, rather than done all at
once (e.g., as in cramming the night before). Spreading it out also allows for reviewing those
things that you need to work on the night before and still get a good rest, which is important for
peak performance.
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Use Active Study Techniques
1. Process the material deeply. Studying is much more effective if you mentally manipulate (i.e.,
play with) the information that you're reading. This in one argument against using highlighters.
"Painting" your book with a highlighter gives you an illusory sense of progress through your
reading without any guarantee that you've actually processed any information at all. It's better if
you use a coloured pen or pencil to underline "key words" (e.g., terms, concepts) and underline
"connecting words" (e.g., the "ands", "nots", "greater than", etc.) that are critical to understanding
the context for the key words.
This will greatly reduce what you have to attend to when it is time to review (just read the circled
and underlined words). It also makes you process the material more deeply the first time through
because you have to actively divide all the words into 1 of 3 categories: key words, connecting
words, and unnecessary words (most words fall into this latter category).
2. Material is more likely to be remembered if it is associated with an emotional reaction. For
example, give a "dramatic reading" from the text material in front of a mirror. Or make up rhymes
or use other memory tricks to organize the material--they will help your later memory of it.
3. Creating vivid images of the material helps later recall. Develop interesting concrete visual
images of the material in your head--they are much easier to recall at the exam than are abstract
concepts. For example, if you were studying the parts of a neuron for the first time, you might
imagine a neuron as a tree, its "branches" are the dendrites, its "trunk" the axon, the "bark" the
myelin sheath, the "roots" the axon endings and the sap the transmitter substance. Alternatively
you could imagine that you're a neuron and reaching for information with your "dendrites" (arms)
and so on.
While Studying - Practice What Tests Demand of You and Study What You Don't Know
1. Exams demand that you retrieve information from your "knowledge warehouse". Therefore, if all
you do is read, you're not practicing what you'll have to do on the test. Retrieval, like any other
skill, must be practiced. After carefully and actively reading over a section, try to recover what you
know about it by writing down the main points on a piece of scrap paper. This makes you practice
retrieval and it also diagnoses whether or not you know the topic. In this way you also reward
yourself for understanding the material. This will increase the likelihood that you will pay active
attention to what you're reading the first time through. You'll also try to finish your studying
sooner.
2. Multiple-choice exams ask you to discriminate between very similar alternatives, typically
between a correct answer and several incorrect "foils". The foils are usually taken by the
instructor from the same or nearby sections of the book as was the correct answer. Learning the
subtle differences between the alternatives in each question is another reason that you should
study your readings section by section (i.e., often 2 or 3 pages at a time), never going on to the
next section until you can retrieve the full contents of the section on your scrap paper.
3. After your initial studying is complete, diagnose you knowledge of assigned readings using
sample multiple choice questions or even items that you make up to share with each other. If you
get any of the answers incorrect on the sample questions, restudy those sections from which the
item(s) came using the techniques suggested above, including the practice of retrieval.
4. In the final study review the assigned reading by going over the circled and underlined words,
using them to reconstruct the contents of the section. Practicing retrieval by recalling the
information in each topical section as soon as up finish reading it over.
5. Get a good night’s sleep before taking any examination!
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Writing the Multiple Choice Portion of the Exam......
The information on Test Taking Advice was adapted from the University of Calgary Department of
Psychology.
There are several approaches you can take to answering multiple-choice questions. While there are a
number of variants, the major distinction appears to be between:
1. reading the stem, deriving the answer in your mind, and then actively trying to find the answer
within the available alternatives--we'll call this the answer-search method; and
2. another approach, called the elimination method, involves crossing off the clearly incorrect
alternatives and then making judicious selections from among the remaining possibilities.
The answer-search method has an intuitive component, as you are able to capitalize on your very
impressive recognition memory. Did you know that you would be correct in excess of 95% of the time if you
were shown a 1,000 slides and then shown these 1,000 intermixed with 1,000 new ones and asked to
indicate which ones you'd seen before? Our recognition memories are very impressive and many students
like multiple-choice questions because they allow them to use this very powerful cognitive tool.
However, recognition memory has a non-verbal, intuitive character that makes it difficult to analyze and, for
some, very difficult to depend upon. When researchers, teachers, or students make assertions about
anxiety being a problem on multiple-choice exams they are often referring to this component of memory, as
tension can interfere with recognition. It seems that being relaxed and confident (perhaps not overanalyzing) helps recognition memory do its best.
Many students indicate that they use a combination of the answer-search and elimination methods. They go
through the questions first using the answer-search strategy. To capitalize on recognition memory, some
students indicate that they try to keep fairly relaxed and "distant" from the items--waiting for the correct
answer to "jump out" at them. If a clearly correct answer doesn't emerge easily, they move on to the next
question. After this first pass, they then go through the items again using elimination. They spend more time
properly rejecting the incorrect alternatives and maximizing the chances of picking the correct answer. In
cases where they can't reject all but one alternative, many students will make their best educated guess at
this point.
With some students, creating multiple-choice questions based on course material helps them to improve
their test taking skills. This role-reversal forces the student to look at the text material from the perspective
of developing questions from it. In some cases, this gives the student considerable insight into how to
prepare for multiple-choice questions. Soon, as they are working through material, they are saying to
themselves: "This is a natural multiple choice question--I should be sure to remember this stuff...."
A note of caution though, you should try to bring your approach to answering multiple-choice questions into
concert with your natural ways of doing things. To impose a foreign approach onto your already wellestablished approaches to exam writing could cause problems. The only sure antidote here is "practice,
practice, practice." Do everything you can to work with the material, and try out different strategies. Enter
the exam with confidence and focus on the questions rather than your strategy.
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