Updating Restorative Art

As an educator, I regularly hear from members of funeral service what should and what should not be taught at mortuary school. As instructors, we are beholden to academic standards, deciding what will be valuable practical experience for our students, and of course, what will help them pass the National Board Examination (NBE). Given that we have a finite amount of time with our students, we rely heavily on our community to help aid us in the more practical aspects of the job including embalming and arrangements. This is because in most cases, a student will earn an associate's degree, which is a minimal competency in academia meant facilitate further learning. The American Board of Funeral Service Education (ABFSE) requires students to complete ten embalming cases and five funeral arrangements for graduation. Some schools do more than these, but none do fewer. In this case, the further learning comes during their apprenticeship, as no one should be expected to be a polished funeral director and embalmer after so few cases. We also rely on our community help us to teach the small tasks such as how to properly load a casket or how to close a casket lid. These of course are important pieces of knowledge, but they do not require a mortuary school education. I think it safe to say that at some point all schools give some sort of instruction on these types of things, but more time is spent on required curriculum.  

Speaking of which, many people are not clear on how the curriculum is created and updated. It is not dictated by hooded figures in a cave atop some high mountain, it is created by educators and practitioners. Generally, every five years, a curriculum is reviewed. Sometimes more often than that, sometimes longer than that depending on the subject. For example, the review of our anatomy curriculum is flexible because the human body has not changed in thousands of years, but we did review our embalming curriculum in successive years because of the release of a new embalming textbook.  

When a curriculum is up for review, colleges and member associations such as the National Funeral Directors Association (NFDA), National Funeral Directors & Morticians Association (NFD&MA) and the Cremation Association of North America (CANA) submit candidates for each curriculum that is up for review that year based on their candidates area of expertise to the Curriculum Committee, which is a subcommittee of the ABFSE in charge of managing curriculum. Members of this committee are rotating, so it is regularly refreshed with new eyes and voices. Members of the committee then vote on who should be assigned where. This does not, however preclude someone not selected by the committee from being part of a review. Some years ago, the Hilgenfeld family left a sizeable grant to the ABFSE for curriculum development which in part, is applied to the lodging of selected members. Anyone one who is not selected can attend the reviews either on their own dime or sponsored by their school/ organization. Once that year’s curricula are reviewed, the curricula are sent out to all of the schools and member associations for comments. Then, the curricula are accepted by a vote during the ABFSE’s annual meeting held each April.  

I am a current member of the Curriculum Committee, and in April, I had been named the chair of the Restorative Art Curriculum Review Committe. I am going to share with you the process of reviewing and updating a curriculum in order to help everyone have better understanding of what goes into it. And if there were ever a curriculum that needed updating, it is the Restorative Art Curriculum, and it starts with a little back story;  

In 2019, I served as member of that committee (I know this is longer than five years, but thanks to Covid, the curricula reviewed that year were not voted on until 2021), and I had just completed Creating Natural Form. This was not only a subject I had been teaching for several years, but I also wanted to get my textbook added to the curriculum. At this time, there were only four books on the curriculum; J. Sheridan Mayer’s Restorative Art and Color and Cosmetics both published originally in 1941, and Ralph Klicker’ Restorative Art and Science published in 2002. That’s right, our most recent text was 17 years old at the time. Creating Natural Form was the first RA book written in 17 years. The fourth book was Taber’s Medical Dictionary. I mention the textbooks here because that is the main source of where we can draw new curriculum items from. We must tie any line item on a curriculum to a textbook, so a question for the NBE can be created. The standard I was held to was that a new textbook should offer a new concept or definition. Fortunately, Creating Natural Form had plenty of these and was successfully added. Now if you are a person that calls our curriculum outdated while saying the textbook you used in school in 1970 something is an amazing book, you my friend are suffering from cognitive dissonance. Not to say that old textbooks aren’t great, they just don’t create good updates to modernize curricula. Our second source for updating and writing curriculum is laws. These also drive to keep curricula outdated. I can’t tell you how many times we’ve had to punt the Federal Trade Commission Funeral Rule Curriculum for review because we are waiting on an update ourselves.  

The other goal for the RA curriculum that year was to reduce its content. While that may seem like an odd thing to say, reducing the content on a curriculum serves two main purposes; it encourages instructors to find extra source material in addition to a textbook, it also limits the scope of questions that can be created for the NBE. This allows for more academic freedom and less “teaching to the test” as student populations have different needs based on their geographic location. This was also successfully completed that year.  

Fast forward to this year. Ben Schmidt, Review Chairperson, reporting for duty. This was a unique experience for me. I had sat on these committees, but I had never been in charge of one. This does not mean I had more say than anyone else on the committee, but it was my job to organize everyone and lead the conversation. I had my own goals of course, one of which started as a seed in my mind but was watered and fertilized by two public comments.  

This may come as a surprise to you, but when you want to have input on a particular mortuary school curriculum, you can make a public comment to the committee by emailing the ABFSE. Now, the curricula themselves are not public, as they are proprietary property of the ABFSE, however, many of you are aware of what is being taught in schools and have your own opinions about it and are welcome to share them with us. Now to be clear, the Curriculum Committee is not a reactionary body willing to jump to anyone’s command. As I explained earlier for new ideas to be considered for official curriculum cannon, they must be tied to a textbook. Further, they must be in the scope of that specific curriculum. For example, if you want the embalming curriculum updated with something about casket types, it ain’t gonna happen.  

In this case, we had the chance to do something that surprisingly, had not been done already; define standards of care in funeral service. This is a term we have all used, me included, but there wasn’t an actual definition. Also, beginning with my own independent review, I noticed that this curriculum did not have a section on ethical care. I knew that the embalming curriculum had one, right at the beginning, but why not the RA curriculum? I made a note to discuss it with the rest of the review committee. This also started the wheels turning in my mind; why is there no definition of standard of care for funeral service? As this thought marinated in my mind, some things began to happen that were fuel for the fire.  

 Before the committee was to convene, there were two public comments that we received that made me realize that I wasn’t the only one thinking about these issues.  

On June 4th, I was forwarded an email from Michael Burns, an RA instructor and Dean of Faculty and Students at the Pittsburgh Institiute of Mortuary Science, that had an attachment with the subject line “Proposal for the Inclusion of Restorative Art Ethics in Curriculum.” I thought “oh boy! I am not the only one!” The crux of the letter from Dean Burns was his concern about the public advertisement either on social media or in professional development seminars about the materials that are being used in restorations. He specifically cites the use of discarded materials such as soda bottles, embalming fluid bottles, old newspapers, and other items instead of clean, new materials purchased from appropriate mortuary suppliers or otherwise. I think many of us have this gripe, but the challenge here is the textbook issue. As an author of an RA textbook, I knew in my book I did not address specific bad examples of RA materials and their usage. In Creating Natural Form, I have what I call “RA Dilemmas” where I allude to some specific scenarios and making the best choice, but that is about it. I am not aware of any of the modern textbooks that do this either, as we automatically write about best practices rather than spending time on “do this not that.” Further, the ingenuity for bad ideas is infinite, so it would be difficult to address every possible thing. This thought would later be corroborated by my fellow RA Curriculum Review committee members.  

On June 20th, I received an email from fellow RA Curriculum Committee member Edwin Jackson, that contained a letter from Joél Maldonado, founder of the Multicultural Death & Grief Care Academy addressed to the ABFSE that contained suggestions for objectives that pertained to honoring the cultural practices and phenotypical differences in Black and Black Indigenous and People of Color (BIPOC). I am familiar with Ms. Maldonado as I was fortunate to interview her The Funeralcast episode 56. Diversity in Deathcare with Joél Maldonado and I knew her sentiment represents an important change in funeral service. However, it was not without its own challenges. First, while ceremony is extremely important, the restorative art curriculum is a technical outline, meaning that ceremonies of a specific cultural are not within the scope of the outline. In Creating Natural Form I touch on the responsibilities that we have about correctly dressing a decedent based on their culture but no specifics. The ceremonies textbook doesn’t touch on RA perspectives at all, but rather ceremonial preparations. As I mentioned, the curriculum outline is also specifically designed to be very general to allow for the inclusion of multiple learning resources at the discretion of the instructor, so focusing on a specific culture would be too defined for this curriculum. However, Ms. Maldonado’s requests to incorporate appropriate and relevant language pertaining to cultural awareness as well as taking in the ancestral and phenotypical differences amongst all possible peoples was also already on my radar and as I found out later, everyone on the review committee. Fortunately, both Creating Natural Form and Postmortem Restorative Art are textbooks with updated language that is reflected in modern anthropology.  

I have long said that the availability of information raises our standard of care, and now we had input from Dean Burns addressing information being given out on a technical level and Ms. Maldonado who addresses information being given out on a cultural level, so I had a lot to think about. Fortunately, I only made up one-seventh of the brain power required to make these decisions. I forwarded these letters to the rest of my committee along with some instructions for them to think about.  

One other event helped me consider the meaning of ethics and the Standard of Care. I was delivering a seminar in West Virginia for the West Virginia Funeral Directors and Crematory Operators Association, and one of my fellow presenters was Amanda King. She shared slide from a restorative art textbook from the early 1900’s that had four points;  

• To renew the lifelike appearance of the deceased  
• To restore features 
• To alleviate grief.  
• To improve mortuary standards 

It was this last point that resonated with me when considering defining the standard of care and restorative art ethics. How do mortuary standards need to be improved in the modern era?   

So, on June 27, at Arapahoe Community College the RA Curriculum Review Commitee convened and was comprised of:  

• Dominick Astorino (Professor at Wayne State and Worsham College, textbook author, and presenter) 
• Ally Cabrera (Professor at Arapahoe Community College)  
• Jennie Fredrickson (Program Director at Lake Washington Technical Institute)  
• Edwin Jackson (Professor at Baltimore County Community College)  
• Rachel Mackey (Representing The Conference)  
• Ben Schmidt (the author)  
• Dan Shea (Program Director at Cape Cod Community College)  
• Jacob Smith (Professor at Brightpoint Community College, forensic anthropologist)  

At the beginning of the review, I went around the room and asked everyone what their goals for the curriculum were. As a group we decided that we would: 

• Add new available textbooks. In this case we had Dominick's Postmortem Restorative Art and John Fritch’s Restorative Art Foundation and Practice as well as updating to the latest editions of Embalming: History, Theory and Practice by Sharon Gee and Creating Natural Form 
• Remove outdated textbooks, specifically the J. Sheridan Mayer texts. Before anyone gets after me, I want you to consider this; first, the book was originally published in 1941, and the last edition comes from the late 1990’s. Second, he is dead, and there won’t be any more updates. Finally, on the latest textbook survey (list of books being used by schools) released by The Conference, his books were not on it. This was also bolstered by the Item Writers (educators and practitioners who volunteer to write NBE questions) in the group who said they had specific instructions not to use those books anymore. Now keep in mind, removing it from a curriculum does not prevent instructors from pulling material from it, just simply that it is no longer testable. If you still aren’t sold, I would invite you to open the book up and read the language in it and consider if you would use it when referring to someone’s family members.  
• Update the language dealing with ancestry and ethnicity to match science and modern anthropology.  
• Create an ethics section and define standard of care.  

We all had a chance to review the curriculum beforehand, and I had received some specifics from my group for particular sections and how they should be organized. In addition to the above listed goals, we have the responsibility of making sure those are all organized, and the glossary terms match those from related curricula. For example, we had definitions for types of sutures for incision closures, so we had to make sure those matched the recent updates to the embalming curriculum. After about two days, we reorganized several sections (boring), removed unnecessary alternative terms for things, added to the Munsell Color Wheel for teaching Color Theory, and a few other things. I am proud to say that we were able to add three new textbooks, update two of them, and remove the vestigial ones. Sorry I can’t be more specific, but I am being conscientious about violating the ABFSE’s copyright.  I will say this; we did a lot to move Restorative Art forward to meet both scientific standards and modern culture. Fortunately, we had Jacob Smith’s expertise in anthropology and Edwin Jackson’s knowledge of culture and history to help guide us.  

Now back to the main point of the story. We had discussed the idea of ethics and standard of care at the beginning of our group review, but we did not complete it until the very end. Perhaps it was important to all of us and wanted as much time as possible to discuss it and where to put it. Here are the concepts that we added based on our own thoughts we could tie to a textbook and the public comments we received.  

•   Respect and reverence for the dead- this references a section in Embalming: History, Theory, and Application that compares our duty to care for the deceased to that of the Hippocratic Oath taken by doctors, and addresses our Standard of Care by requiring future funeral directors to ask themselves if their choices are ethical and meet what would be our version of a “bedside manner” meaning are we treating the family with care.  
• Maintain professional standards- another section from Embalming: History, Theory, and Application that addresses the treatment and dignified care of the deceased but also carrying out the wishes of the family without comment and maintaining competence in professional practice. Not just as required by law but to better display as Ms. Maldonado put it in her letter “cultural humility, curiosity, and other cultural intelligence considerations that impact the embalmer’s presence, performance, and ability to serve diverse communities with dignity and honor.”  
• Materials best practices- this references all textbook citations for appropriate practice to address Dean Burns concern about the use of appropriate materials in restoration and to address Ms. Maldonado’s objective of tools and specific products related to culture and ancestry to provide dignified and respectful restorative arts.  
• Standard of care- here we had the unique opportunity to do something that had never been done before; come up with an actual definition of standard of care for funeral service. But we needed a reference to tie it to. In 2016, Jzyk Ennis published a book being used in mortuary schools as supplementary embalming material entitled Embalming Standards of Care and in fact, chapter 1 is called Standards of Care. In it he gives us the Merriam Webster dictionary definition of standard of care as “the degree of care or competence that one is expected to exercise in a particular circumstance or role” he also provides us with a list of what sets the standard of care in funeral service. So, from that list and the dictionary definition we arrived at the following:  

“Standard of care- a degree of competence and care in embalming and restorative art that is a set by a combination of prudent judgement, mortuary science textbooks, funeral service curriculum, experts in the field, trade or technical publications, case law, and legal regulations.” 

So, there it is, for the first time to the best of my knowledge, a definition of standard of care for funeral service. It is very basic indeed, but it illustrates the birth of new curriculum. It started with the DNA of existing material and was shaped by public sentiment and the experience of faculty members. It will be the responsibility of those who come after us to grow and direct these concepts to meet modern demand. This goes for all of the curricula. Tearing them all down and starting over doesn’t make sense any more then tearing your whole house down and rebuilding does. But change is possible, and I believe the work we did reflects that. However, none of what we did is official yet. It still must be reviewed by our peers and accepted by vote in April.  

If you’d like to learn more about mortuary science education, we are happy to have you. Many of the ABFSE’s meetings are public and done over the Internet. Simply keep an eye on the ABFSE website for upcoming events and adopted meeting minutes. We are, after all, educators and we deal in information.