In the short time that continuing competence programs have been in existence, health regulators’ understanding of different programming strategies has changed.

Physiotherapy Alberta’s Continuing Competence Program, in its current design, has been in place since 2011.  We’ve learned a lot during the last six years. Council has had numerous conversations about the future of the program, we held an Imagineering Event last fall (as the name suggests to “Imagine” what our Program can and should be), and most recently conducted a survey to collect data from members about their experience with the current Program. All this work and data led to Council’s decision to modernize the Program by increasing the range of options for members to demonstrate competence and incorporating emerging evidence on risks and supports to competent practice in health professionals.

While the Program is being re-designed from top to bottom, some of it will seem familiar as we are recycling some strategies from the existing Program that work.

All members on the General Register must continue to participate in the current Program activities (Reflective Practice Review and Jurisprudence) until the new Program is launched which we anticipate to be October 2018.

Physiotherapy Alberta recognizes that competent, quality practice requires a partnership between itself and member physiotherapists. We cannot re-design the Continuing Competence Program without input from members. Re-designing the Program will take several months and will be done in stages. This webpage is dedicated to keeping physiotherapists informed of the Program re-design and gathering feedback on the proposed changes as they unfold.

Visit this webpage often. The timeline below outlines when information will be added to the website and when we will be asking for member feedback. Because of the compressed timeline, to launch the Monitoring and Development component in October 2018, sometimes there may be short timelines for member feedback, but never less than 30 days.

Program elements form the foundation of a program. Not only do they guide program development, they are also the yardstick used when an organization wants to evaluate what it did and why. The following elements will guide the Continuing Competence Program’s re-design. Revised September 2017 based on member feedback.

Program Philosophy: vision for the Program

The Continuing Competence Program promotes, supports and monitors the delivery of quality physiotherapy practice by supporting healthy1 physiotherapist practice. 

1 Healthy practice means practice risks and support. Risk and support factors are aspects of a physiotherapist's environment or personal features that make it more likely (risk factor) or less likely (supportive factors) they will develop a problem with competent practice.

Assumptions about our member Physiotherapists: beliefs ‘assumed’ to be true in the future

  • Physiotherapists are self-directed, motivated adult learners.
  • Physiotherapists can self-monitor and participate in activities to support healthy, competent practice.
  • Physiotherapists continually seek out current evidence to evolve practice and improve the quality of their practice.
  • Physiotherapists use results from both self and externally administered assessments to evolve and improve practice.
  • Physiotherapists strive to achieve improvements in their individual professional skills but also in patient care and practice environments.
  • Physiotherapists are accountable for participating in continuing competence reporting and assessment activities to Physiotherapy Alberta.
  • Physiotherapists are expected to evolve their practice competence through ongoing learning and participation in activities that assure competence.

Assumptions about Physiotherapy Alberta: beliefs ‘assumed’ to be true in the future

  • Physiotherapy Alberta is expected to regulate its members in the public interest.
  • Competence is multifaceted and multidimensional and therefore no one Continuing Competence Programming strategy alone is sufficient to ensure all domains of professional competence are addressed.
  • Physiotherapy Alberta must work with a broad number of stakeholders including other regulators, employers, educators, government and member physiotherapists to ensure quality and competent physiotherapy practice.
  • There is shared responsibility for competent professional practice between member physiotherapists and Physiotherapy Alberta.
  • Standards, competency profiles and external criteria are important benchmarks for quality physiotherapist practice and physiotherapy service delivery.
  • Physiotherapy Alberta leads in being a knowledge creator and curator about Alberta physiotherapy practice standards, rules and regulations and physiotherapy best practices.
  • The Continuing Competence program is applicable to all physiotherapists regardless of geographical location and job role.
  • The Continuing Competence Program supports quality practice across the continuum of a physiotherapist’s career, monitors and assesses competencies and practice.
  • Quality is demonstrated through safe, effective and ethical practice.

Guiding Principles: norms, rules and values that help guide the development of the Continuing Competence Program

  • Quality Focused - designed to mitigate risks to competent physiotherapist practice and to support physiotherapists’ healthy practice and healthy physiotherapy practice environments. Supports improvements in practitioner knowledge, patient care and health systems.
  • Flexible – provides a variety of choices and evidence-informed tools to meet the needs of Physiotherapy Alberta and physiotherapists working in diverse practice areas and settings.
  • Streamlined - expectations are clearly laid out and communicated using a variety of strategies to enable physiotherapist accountability for meeting requirements.
  • Standards and Evidence-Informed – acknowledges that standards of practice, competencies and emerging evidence are pillars to quality patient practice. Relies on data to inform program improvements.
  • Educational and Practice Relevant – assists physiotherapists to self-monitor, learn and enhance their individual competence and professional practice. Provides evidence-informed tools to enhance physiotherapist competence and the provision of safe and effective care.
  • Integrated – program strategies are designed to complement and build upon Physiotherapy Alberta’s quality initiatives, its regulatory objectives and other quality practice initiatives physiotherapists undertake in their professional workplaces and spaces.
  • Responsible – administratively feasible while meeting legislative requirements. Engages physiotherapists in program development and evaluation.

Program Design Features: features built into the Continuing Competence Program

  • Focuses on practice risks and supports and their relationships to healthy competent physiotherapist practice.
  • Involves multiple strategies to meet a variety of purposes.
  • Provides a menu of choices to provide for the self-monitoring and assessment of practice.
  • Builds upon strategies members currently use to enhance competence.
  • Integrates workplace learning strategies and practice improvement activities of Physiotherapy Alberta and member physiotherapists.
  • Includes competence and workplace assessments from external parties.
  • Is administratively feasible.
  • Utilizes change management strategies to support physiotherapists’ understanding of and compliance with the program.

Program Purpose/Goal – a statement outlining the intent of the Program which realistically addresses the ideal state

The Continuing Competence Program promotes physiotherapist's practice monitoring and practice enhancement to support the delivery of quality physiotherapy services. 

The redesigned program will have two components: Practice Monitoring + Development and Performance Verification.  Revised September 2017 based on member feedback.

Over the next year, Council and staff will continue to develop the Practice Monitoring + Development component for implementation in October 2018. Work on Performance Verification will take place once Practice Monitoring + Development is established; until then the only information we can share with members is the component concept below.

Continuing Competence Program Re-design 2017 – 2020. 

 

Practice Monitoring + Development 

  • Members will participate in College-led and self-led activities associated with healthy, competent, quality practice.
  • Annual activities with reporting requirements on participation and the impact of participation.
  • Monitoring of participation and review of submitted records.

Performance Verification

  • Screen for performance verification
    • Applicable to a broader number of physiotherapists and/or physiotherapists involved in higher risk practice areas.
  • Performance verification
    • Practice-oriented performance assessment (i.e., practice visit)
    • Periodic activity – limited to a few physiotherapists
    • Remediation will be supportive, educational and improvement-focused.

The Practice Monitoring + Development component ensures physiotherapist's participation, annual reflection and reporting on activities associated with healthy, competent and quality physiotherapist practice.

Principles

In developing the Practice Monitoring + Development component the following principles were considered:

Integrated

  • Strives to incorporate existing strategies physiotherapists use to improve their practice including workplace projects and experiential learning (i.e. collaboration, mentoring).
  • Strives to incorporate Physiotherapy Alberta’s quality improvement projects.

Flexible

  • Includes a range of approved activities and choices for members to meet program requirements.

Evidence-informed

  • Incorporates research evidence examining risks and supports to competent practice.
  • Incorporates results from the 2017 Member Survey showing activities physiotherapists find valuable for improving their competence.

Educational and Practice Relevant

  • Strives to find a balance between encouraging participation in member-led, self-directed practice improvement activities and requiring participation in College-led prescribed monitoring and practice enhancement activities.

Each year, all members on the General Register will participate in two activities to meet the Program requirements:

  • One College-directed activity
  • One Member-led activity

College-directed Activity (Design)

Designed to raise the profession's collective awareness of issues and matters deemed important by Physiotherapy Alberta. Mandatory participation ensures a profession-wide collective and common understanding of a subject.

Types of Activities

Professional issues quiz or educational modules (e.g., safety, ethics, jurisprudence, self-assessment, practice audit).

Reporting + Monitoring

  • Participation reporting and monitoring will be based on the features of the activity.
  • College tracks participation and successful completion.

Member-led Activity (Design)

Designed to ensure physiotherapists implement and report on at least one substantive practice monitoring or practice enhancement activity each year.

Types of Activities

Members will choose one activity from the menu of options which are grouped into three categories:

  • Practice review and monitoring
  • Knowledge building and translation
  • Professional collaboration

Reporting + Monitoring

Mandatory annual reporting on activity participation, implementation, and its impact.

Member-led Activites

Practice Review + Monitoring: what it is and why it counts

Self-directed evaluative activity that monitors practice against defined benchmarks and provides information for practice improvement. 

Evaluation focuses on:

  • Physiotherapist's competence
  • Patient care practices
  • Practice environment

Activities include gathering feedback or information from external sources (i.e. accreditation-organization, colleagues, patients, performance evaluation, results of tests or assignments rated by an accredited organization). 
Participation results in receiving summative and formative information anchored to standards which: 

  • Confirms practice is meeting benchmarks 
  • Serves as a stimulus for further practice improvement (i.e. cues to action) 

Promotes deep learning, critical thinking (case studies/patient reflection).

Activity List

Individual Skill Set 

Performance Evaluation
Self-Assessment of Essential Competencies for Physiotherapist 
Practice Enhancement/Personal Learning Plan 
Peer review and feedback on Practice Enhancement Plans/Learning Plans
Canadian Physiotherapy Association specialization assessment 
Knowledge assessment (i.e. affiliated with a program of study tests administered by accredited organizations Universities, Certification Programs)
APTA recertification exam
Knowledge/competence assessments FOR learning (i.e. assessments that take place for the purposes of benchmarking and identifying areas for practice improvement

Patient Care Practices

Patient Care Reflection – self-administered or peer administered
Patient Case Study
Critical Incident/Significant events Assessment
Review of patient complaints/compliments
Clinical outcomes analysis (i.e. FOTO reports)
Chart Audit (minimum of 10 charts)

Quality Improvement Tools

Privacy Practices Audit
Standards Review and Audit¥
PDSA, FADE, Six Sigma
Accreditation Activity (CARF)
AHS – CRP Site Assessment
Quality Improvement project (evaluating + improvement)

Safety and Risk Assessment

Safety Audits
Occupational Hazards Assessment
Critical Events Analysis

Knowledge Building + Translation: what it is and why it counts

  • Activities focused on acquiring new or expanding upon explicit, technical and systems knowledge needed for quality physiotherapist practice. 

  • Information is gathered through participation in formal organized educational events and self-organized activities. Information gathered is substantive, practice relevant and from credible sources and then applied in a meaningful way to the physiotherapist’s practice context.

  • Participation ensures physiotherapist’s practice knowledge is regularly updated so it is consistent with best practices and emerging evidence.

Activity List

Organized Formal Instructional Events

Continuing Education Event
Certificate courses from accredited organizations
Organized Online learning (MOOC’s)

Self-organized knowledge and skill development using informal instructional resources

Web-resources to inform personal learning or patient care/practice improvement (i.e. job aids, blogs, newsfeeds)
Reading current research from publications
Practice Guidelines 

Knowledge Construction/Translation

Writing articles for publication, including Physiotherapy Alberta publications 
Conducting Research
Teaching

Professional Collaboration: what it is and why it counts

  • Activities focused on professional contributions and collaborative endeavors which often are part of the daily work with others in teams and groups or other professional activities. 

  • Outcomes of professional collaboration may be difficult to quantify, codify or standardize because they are products of social interaction, social referencing, informal, and experiential learning. 

  • Key to collaboration is active engagement for the purposes of practice improvement. Practice is enhanced through the development and acquisition of non-technical, leadership, intuitive, emotional intelligence, professional socialization or social referencing skills. Tacit knowledge may be exchanged which improves confidence, reasoning and/or decision making. 

  • Participation in quality improvement projects/stretch projects can also be included here as well as attendance at group events where the main benefit was due to professional interaction rather than information from presenters.

  • Participation results in improved individual competence, patient care or health services but the reported benefits will be highly individualized based on the context and perceptions of the experience.

Activity List

Supervising students
Mentoring peers (e.g., new grads, CPA divisions)
Ignitephysio actual posts and blog contributions
Community of Practice/Professional Interest Group
Group focused on learning new clinical practice information
Group focused on improving patient care or work processes 
Quality improvement project participation
Volunteering with Physiotherapy Alberta
Volunteering with Canadian Physiotherapy Association divisions
Volunteering with the Canadian Alliance of Physiotherapy Regulators
Peer review and feedback session with colleagues practice enhancement plan, patient care reflections or other audit activity
Other group activities involving leading or contributing to professional learning or practice improvement projects

Feedback

Click here to provide feedback on the Practice Monitoring + Development design and activities list. Deadline date for feedback is November 6, 2017.

Principles

  • Meets the threshold established by Council, eg., # activities annually
  • Provides specific details on completed activity 
  • Supports evidence of participation, work examples can be included and referenced in the reporting
  • Includes reflection
  • Provides evidence of participation and its impacts
  • Includes option to discuss activities that support healthy practice

Reporting Requirements

  • Annually, before renewing, members complete an online Activity Implementation Record
  • Members upload supplemental documentation as evidence of participation
  • Activity to be reported on is completed between October 1 to September 30

Feedback

Click here to provide feedback on the reporting criteria and Activity Implementation Record. Deadline date for feedback is November 6, 2017.

Program rules set out the policies for the program. Each component will have its own set of rules. The Health Professions Act and Physical Therapist Professions Regulations require that Council approve program rules for the Continuing Competence Program.

Council will discuss at their November 2017 meeting and member input sought from December to February 9, 2018.

Physiotherapy Alberta will conduct a records review to ensure compliance with the Monitoring and Development requirement. Council will discuss at their November 2017 meeting and member input sought from December to February 9, 2018.

The concept for the Assessment Component is as follows:

  • Assessment screen for the Performance Verification component
  • Periodic activity
  • Selection criteria to be determined

The assessment component will be developed in 2019 and member input sought at that time.

The concept for the Performance Verification Component is as follows:

  • Assesses performance in relation to practice context.
  • Periodic activity – less frequent than Assessment and limited to fewer physiotherapists.
  • Remediation will be supportive, educational and improvement focused.

The Performance Verification component will be developed in 2019 and member input sought at that time.