Evidence-Informed Practice and Critical Thinking

Spring 2021

The STRiVE e-learning module, ‘An Introduction to Evidence-Informed Practice’ established a model for evidence-informed practice (EIP) for Massage Therapy. At its core are four domains of knowledge:



  • The domain of RMT knowledge, experience and practice evaluation includes the practitioner’s experience, expertise and clinical judgement which also involves evidence obtained at the practice level through the assessment of outcomes in the practice setting.
  • The client perspective domain combines an awareness and understanding of the client’s values, circumstances, experiences, preferences, expectations and concerns.
  • The domain that addresses work context considers the unique features, characteristics and requirements of the practice setting which is also defined by the individuals operating or seeking services within the setting.
  • The external research domain refers to research activity conducted external to the work context which requires use of the best evidence, based on a hierarchy of study designs, including meta- analysis. Additionally, external research involves the critical review of research literature

Evidence-informed Massage Therapy Practice (EIMTP) is defined as the consistent application and integration of these four domains in practice.

When you are new to EIMTP, the domains are usually thought about separately and with varied importance. As you become more experienced and comfortable applying EIMTP:

  • The domains that are most relevant to you may be applied more frequently and to a greater depth within your practice.
  • Each of the domains becomes consistently considered and incorporated into your decision-making.

Eventually, the goal is to apply this integrative approach where knowledge from all four domains, and the connections between them, informs your day-to-day practice.

Further developing an integrative approach to EIMTP in your practice requires repetition and conscientious effort in regularly considering knowledge from each domain. However, even when all four domains are consistently considered, you will then need to come up with a clinical decision.

Critical Thinking and EIMTP

Critical thinking is a key component of EIMTP. It is the bridge between the diverse information gathered through consideration of all four domains and the development of a treatment plan and/or course of action. Improving critical thinking skills helps all aspects of decision-making but is of particular importance to clinical decisions where there is an ethical responsibility to consider bias, blind spots, and prejudice.

To help think critically, you can ask yourself:

  • Why do I think about things the way I do?
  • Why do I value or emphasize this way of thinking?
  • How can I be more thoughtful, rational, and empathetic in my thinking?

It may be helpful to apply a process of thinking through steps, while keeping the above questions in mind.

Considering and improving the process of critical thinking can lead to better decision-making and more informed clinical decisions and outcomes for clients.

CMTO is developing additional educational tools to help further support the integration of EIP in Massage Therapy practice.

If you have questions about EIMTP, please contact our Practice Specialist at practicespecialist@cmto.com or by phone at 416-489-2626/1-800-465-1933 extension 4124.

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