Reflective Practice Review is an annual registration renewal requirement that requires individual reflection on practice and encourages relevant learning to maintain competence and enhance practice. All physiotherapists are expected to reflect within the context of their role and work environment.

Reflective practice is an educational strategy intended to result in changes to one or more of the following: knowledge, attitudes, skills, behaviours, practice or processes by encouraging critical thinking about professional competencies and practice. It requires one to self-assess and then take action to learn and improve practice. 

Reflective Practice Principles:

  • Physiotherapists are self-directed and will use the outcomes of reflection and systematic learning planning to improve competence and enhance practice.
  • The Essential Competencies for Physiotherapists in Canada provides the foundation for ongoing competence assessment.
  • Clinical reflection includes comparing one's patient care practices with related evidence for practice decisions and processes.
  • Other methods of reflection are acceptable to inform self-assessment and learning.

There are 3 forms you need for reflective practice review. (You may have to save the form to your desktop if you are using a newer version of Chrome or Firefox):

Self-assessment (Step 1) PDF Word
Patient Care Reflection Tool (Step 2) PDF Word
Learner Planner + Tracker Form (Step 3 + 4) PDF Word

Download and save the forms to your computer before completing. If you have trouble downloading the forms read the help section below. The forms are available in PDF or Word format and are meant for online completion. However, if you prefer to complete them manually you may. In either case, you must maintain the completed forms for 5 years. At this time you may want to set up an electronic filing system or plan where you will keep the document for the required 5 years.

Completion instructions are provided in the next sections. Sample completed forms are also provided.

Other documents

You also need the Essential Competency Profile for Physiotherapists in Canada and one patient record of a recently or soon to be discharge patient.

Help Downloading Forms

The PDF forms are designed for online completion using Adobe Reader 7.0.5 or higher.

  • Ensure Adobe Reader 7.0.5 is installed on your computer. (Download for Windows or Mac)
  • If a form doesn't automatically open, save it to your computer first, 'save as', and then open.
  • If it still doesn't automatically open, manually select to open the file using Adobe Reader.
  • Try a different web browser.

Help Completing Forms

  • Completion tips appear on PDF forms as your mouse hovers over a field.
  • Text boxes expand to accommodate your full response.

Still need help? Call 780.438.0338 or 1.800.291.2782, email info@physiotherapyalberta.ca

Physiotherapy Alberta is pleased to provide members with an online platform to manage their Reflective Practice Review activities.

While we had previously advised members that using the online platform, to manage their Reflective Practice Review activities, was mandatory before September 2017, this is no longer the case. For the next year, until we know what the new competence program looks like, members may use the online platform or continue with the downloadable forms to record their Reflective Practice Review activities. 

Access the online platform

Go to: https://www.skilsure.net/skilsure_pac_cpd/

Your User Name is: [Registration Number]

Your Password is: [Member Last Name] (you will be prompted to change your password before entering any information)

Important information

  • There are important User Tips and Instructions throughout the platform well worth reading.
  • Give yourself plenty of time until you become familiar with the platform
  • Because it takes two years to complete one full cycle, you must enter information for the previous year the first time you start using the online platform (if you were on the General Register before April 2016). The year(s) displayed in the online platform will depend on when you were admitted to the General Register so use the available year(s) to guide your activities. 

The reflective practice self-assessment exercise assists with evaluating individual competence in relation to the essential competencies defined for physiotherapists in Canada. Completion of a self-assessment helps to identify potential learning goals.

Documents + forms you'll need to complete a self-assessment

How to complete a self-assessment

The Essential Competency Profile for Physiotherapists in Canada (The Profile) is the foundation for the self-assessment process. It:

  • Includes competencies required of physiotherapists throughout their career.
  • Is based on the key roles of a physiotherapist and applies across all areas of practice.
  • Describes the roles for physiotherapists.

As you review the Profile, think about the roles and competencies in relation to your current practice.  On the self-assessment form:

  • Describe the importance of each competency in relation to your role/job.
  • Provide examples of how you have applied the competencies in your current practice.
  • Note any competencies you wish to develop further*.
  • Record the date of completion/review on the form.

*Did you identified more than one competency you wish to develop further in your initial self-assessment? If yes, then in subsequent years you do not need to complete a full self-assessment provided the remaining competencies are still relevant to your role.

What to do after initial completion

  • Keep your completed Essential Competency Self-Assessment in a retrievable format.
  • Consider reviewing and updating in subsequent years to help identify potential learning goals, maintain an awareness of physiotherapist essential competencies and their applicability to your current job role.

Patient care reflection encourages physiotherapists to reflect about care provided to a patient using the patient’s physiotherapy record as the prompt for reflection. Reflection on care provided is another way to evaluate your practice and identify areas for enhancement. Only physiotherapists involved in direct patient care must complete this step.

Documents + forms you'll need to conduct a patient care reflection

  • One patient record of a recently or soon to be discharged patient.
  • Patient Care Reflection Tool in PDF format or Word format.

How to conduct a patient care reflection

  • Answer the questions in the Patient Care Reflection Tool as they relate to the patient record you selected. 
  • Review care provided against available evidence-informed standards, guidelines, care pathways, research, outcomes, courses.
  • Recorded your reflections on the Patient Care Reflection Tool.
  • Enter the date of completion on the form.
  • Add specific details about the current resources you used to inform your patient care processes. At least one resource should be listed; more is better. 

Privacy considerations

To respect privacy laws, do not enter any information on the form that could enable patient identification. Instead create a unique identifier (word/code) to identify the patient record reviewed. Ensure privacy best practices are followed regarding informing patients/clients around the potential uses for their non-identifying information, see below.

Under Alberta’s privacy acts, Health Information Act (HIA), Personal Information Protection Act (PIPA) and Freedom of Information Protection of Privacy (FOIP), Physiotherapy Alberta - College + Association has the authority to collect non-identifying health and personal information without specific patient consent. However, privacy best practices stress that, where possible, patients/clients are informed of the potential uses for their health and personal information.

Physiotherapists working under the Personal Information Protection Act (PIPA) (e.g., in private organizations) can include the following wording into existing consent to release information forms or post a separate notice in the clinic.  

Under the Health Professions Act, Physiotherapy Alberta - College + Association licenses physiotherapists to practice in Alberta. To comply with licensing requirements, physiotherapists are required to participate in a Continuing Competence Program (CCP) which requires them to use non-identifying patient information.

Physiotherapists will never be required to submit information to Physiotherapy Alberta that identifies you as a patient. However, when participating in the CCP your physiotherapist may be required to describe general information from your 
file, such as assessment or treatment techniques.

If you have questions about the use of patient information for the Continuing Competence Program contact: 

CompetenceCompetence Program Manager
Physiotherapy Alberta - College + Association
Suite 300, 10357 109 Street Edmonton, Alberta
Email: competence@physiotherapyalberta.ca
Tel: 780.438.0338 T/F: 1 800.291.2782

In Step 3 you will identify a learning goal and learning activities that will enable you to achieve your learning goal.

Documents + forms you'll need for Step 3

About your learning goal

  • Must be implemented and achieved within the registration year.
  • Is based on a competency you identified through the self-assessment and/or patient care reflection process that you would like to develop further.
  • Must align with a key competency in the  Essential Competency Profile for Physiotherapists in Canada.
  • Should be relevant to your current practice.
  • Should strive to achieve meaningful improvements in patients/clients, the physiotherapy/health service as well as your knowledge and skills. Goals related to business practice are not acceptable.
  • Is a written description (goal statement) of your learning intentions: what you want to accomplish, how you will achieve this, and by when.
  • May be structured in a way that works best for you. You may choose to write your goal statement following the Learning Goal Statement or SMART Goal Statement format. Review the Learning Goals + SMART Goals document if you need help.

On the Learning Planner and Tracker Form:

  • In the learning goal section record your goal statement. 
  • Record the key competency that your learning goal is based on.
  • Describe the rationale for why you chose this goal.
  • Identify at least 3 learning activities that will enable you to achieve your goal and set a target completion date. List a variety of activities that demonstrate data/information gathering, transformation and application to practice.
  • Enter target and completion dates.

Implement the learning activities, track progress and reflect on the outcomes of learning.

Documents + forms you'll need for Step 4

  • Learning Planner and Tracker Form you started in Step 3.

Implementation

  • Complete the professional development activities identified in Step 3.
  • Track completion of these activities on the Learning Planner and Tracker Form.

Evaluation

  • After completing the activities, reflect on your learning outcomes:
  • Did you achieve your intended goal?
  • What did you learn?
  • How were your knowledge or skills impacted?
  • How did learning impact your patients, the people you work with, the organization or service in which you work?
  • On the Learning Planner + Tracker Form provide reflections in two of the three areas:
  • How did implementing this learning plan benefit your individual competence?
  • How did implementing this learning plan benefit your patient/client?
  • How did implementing this learning plan benefit physiotherapy/health care service?
  • Check which two areas your reflections relate to.

Although reflective practice review is required annually it takes 2 registration years to complete all 4 steps. This creates a cycle of completing and reporting as illustrated in the figure below (click to enlarge).

Year 1: 

  • Complete: Conduct a self-assessment (Step 1), engage in patient care reflection (Step 2) and develop a learning plan (Step 3)
  • Report: Key competency your learning goal is based on

Year 2:

  • Complete: Implement learning plan, evaluate and record outcome (Step 4) 
  • Report: Outcome of learning 
  • Complete: Steps 1-3 of your next reflective practice review
  • Report: Key competency your learning goal is based on

Year 3+

  • Repeat of Year 2

You report reflective practice review activities annually when you apply to renew your practice permit. You do not need to submit your completed forms when you renew. If selected for an audit you must provide your completed forms at that time. 

A random audit process will be used to evaluate form completion against defined audit criteria

Rules for Physiotherapy Alberta - College + Association's continuing competence program are required under the Physical Therapists Profession Regulation. Rules address various parameters for a program including details on program requirements and member selection.

  1. All regulated members on the General Register are required to complete a reflective practice review each registration year, which includes but is not limited to: self-assessment, patient care reflection, learning plan development, implementation, and reporting. Learning must be structured to achieve meaningful outcomes in the following areas: individual competence,2 patient care and/or physiotherapy/health3 services.
  2. Records completed for each annual reflective practice review must be maintained for five years following the end of the registration year they were designated to be completed, and in a format that allows for electronic submission to Physiotherapy Alberta.
  3. At the request of the Competence Committee members must submit, within 30 days of the request being made, their reflective practice review records for audit of acceptable completion.
  4. A stratified random sampling method is used to identify members whose reflective practice review records are requested for audit. Up to 10% of members on the General Register will be identified for audit each year.
  5. The audit criteria for the reflective practice review involves establishing whether the records are complete, understandable and provide evidence of critical thinking on the subjects addressed in each record. Records must demonstrate efforts to use current external resources to inform reflection and learning (i.e., evidence, theory, guidelines, pathways, articles, outcomes, courses). Records must demonstrate efforts to achieve meaningful changes in one or more of the following: individual competence, patient care or physiotherapy/health services.
  6. The reflective practice review records audit is conducted under the direction of the Competence Committee.
  7. The Competence Committee makes a final determination as to whether records meet the continuing competence program reflective practice review requirements.
  8. The Competence Committee communicates the results of the reflective practice review records audit to the Registrar (i.e., non-compliance).
  9. Members who request a deferral from the annual reflective practice review or records audit must provide the request in writing including evidence to support the request to the Registrar.
  10. Members directed to submit their reflective practice review record for audit and subsequently cancel their registration during the audit period are considered to have not met the continuing competence program reflective practice review requirements. Prior to receiving another practice permit the member must submit completed reflective practice review records which are deemed to successfully meet audit requirements.
  11. Members on the General Register who cancel their permit anytime during a registration year are required to complete the reflective practice review records for the year they were last registered prior to being issued another practice permit.

Definitions

  1. Competence: knowledge, skills, attitudes, judgements required for professional practice
  2. Physiotherapy/health services includes: research, educational and adminstrative activities directed at improvement in the quality of physiotherapy/health service delivery. Does not include activities to advance business practices or interests.

There are 4 steps to reflective practice review as illustrated in the figure below (click to enlarge).

Self-assessment

Evaluate your individual competence in relation to the profession's esssential competencies

Patient care reflection

Only applicable if you are in clinical practice. Reflect about care provided to a patient using their record to prompt reflection.

Learning plan

Develop a learning goal and identify learning activities to achieve your goal.

Implementation + evaluation

Implement your learning plan, track progress and reflect on outcome of learning.

Why Audit? To ensure members are meeting their obligations under the Health Professions Act. The audit examines members’ Reflective Practice Review records to determine whether members are structuring their learning plans to achieve meaningful changes in individual competence, patient care or health service delivery; are using current information to inform learning and practice; and to evaluate if records are complete, understandable and demonstrate critical thinking.

What’s involved in the Audit Process?

Three main steps

  1. Members on the General Register are randomly selected and asked to submit their Reflective Practice Review documents online.
  2. Submissions are processed by staff and reviewed by the Competence Committee using approved criteria. The Competence Committee makes the final decision about whether submissions have met the program requirements.
  3. Members and the Registrar are notified of the outcome.

What are the possible outcomes?

  • Category 1 - Inadequate (Does not meet requirements, further action required)
  • Category 2 - Insufficient (Does not meet requirements, further action required)
  • Category 3 - Adequate (Meets requirements, no further action required)
  • Category 4 - Comprehensive (Meets requirements, no further action required)

Click here for Ratings Categories and Process.

What you need to submit

Your completed Reflective Practice Review documents including:

  • Patient Care Reflection Tool(s) (PCRT) (clinicians only)
  • Learning Planner and Tracker(s) (LPT)

How and when to submit?

Documents are to be submitted online within 30 days of request.

Who conducts the audit?

The Competence Committee completes the audit in accordance with approved criteria. Identifiable information is removed from all submissions so the member’s identity is kept confidential when documents are reviewed.

Specific Audit Criteria

Patient Care Reflection Tool

Criteria

  • The PCRT entries are clearly written and easy to understand.
  • Patient care assessment, diagnosis, treatment and/or ancillary patient activities were benchmarked against current information/ resources.
  • It is clear that current evidence and best practices information is integrated into patient care practices.
  • At least one current information resource is listed.
  • There is evidence of substantial critical thinking* throughout the patient care reflection tool
  • The Patient Care Reflection Tool is professionally presented

Detailed Evaluation Criteria

Learning Planner and Tracker

Criteria

  • Learning goal: is written in an understandable and structured format (i.e., SMART) and is achievable within one year. Is intended to achieve meaningful changes in individual competence, patient care or physiotherapy/health services.
  • Rationale: for the goal links to the physiotherapists current practice and is intended to achieve meaningful changes in one or more of the following individual competence, patient care or physiotherapy/health services. (Goals related to business practice are not acceptable)
  • Learning activities: at least three activities are listed (minimum of three learning activities listed will not be enforced until 2017). A variety of activities are listed. At least one current evidence resource (i.e., external information sources, research, guidelines, articles, courses, group, website) is listed. Target and completion dates are provided.

    To achieve the learning goal use a broad range of activities to address your goal. Activities to integrate learning into practice can take many forms (gather information, read, review, discuss, compare, rewrite, apply.
  • Impact of learning: is clearly, thoroughly, and thoughtfully evaluated and described. Critical thinking is evident. At least two areas (individual knowledge/skills, patient care, physiotherapy/health service delivery) are addressed in the narrative.
  • Learning Planner and Tracker form: is professionally presented.

Detailed evaluation criteria

What happens if my submission is not acceptable?

  • Inadequate rating – you will be provided feedback and audit results and directed to meet with the Competence Program Manager to further discuss results and corrections needed. You will be required to correct and resubmit documents for re-audit within 30 days. You will be selected for audit the following year.
  • Insufficient rating – you will be provided feedback and audit results. You will be required to correct and resubmit documents for re-audit within 30 days. The results of re-audit will determine if you are eligible for random selection for audit next year or directed to undergo audit again next year.

What happens if I am not successful?

If your initial submission is unsatisfactory (insufficient or inadequate rating) you will be provided with an opportunity to address deficiencies and resubmit document for re-audit. If your resubmission is unsatisfactory you will be directed to appear before the Competence Committee at a specified location and date for an interview.

The interview will determine whether you have satisfactorily met the Reflective Practice Review requirements. If not, the Competence Committee has the option to require you to.

  • Successfully complete any examinations, testing, assessment, training, education or counseling to enhance competence in specified areas.
  • Practice under the supervision of another regulated member.
  • Limit practice to specified procedures or practice settings
  • Report to the Competence Committee on specified matters on specified dates
  • Refrain from supervising persons engaged in the practice of physical therapy.
  • Demonstrate competence gained in a specified area.

The Registrar has the authority to impose conditions on practice permits at the time of renewal.

Can I opt out of the audit?

No. Participation and successful completion is required to maintain your practice permit. Under the Health Professions Act, failure or refusal to the comply with the requirements of the Continuing Competence Program’s Reflective Practice Review or cooperate with the Competence Committee is unprofessional conduct which is grounds for referral to the Complaints Director.

Definitions

  1. Understandable means: “Structured to be logical and intelligible such that others can easily comprehend the meaning” (Merriam Webster.com)
  2. Critical Thinking means “Disciplined thinking that is clear, rational, open-minded, and informed by evidence. It involves a mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion” (dictionary.reference.com)

What documents must be completed each year?

All physiotherapists must complete the following Reflective Practice Review documents each year:

Physiotherapists working in clinical practice must also complete:

Am I required to complete my Reflective Practice Review activities while on leave from work?

Yes. Whether or not you are registered while on leave you are expected to participate in the Reflective Practice Review. If you do not have access to a patient chart then you are not required to complete Step 2 (Patient Care Reflection Tool), the rest of the program requirements apply. Download the Going on Leave document for more information.

When do I submit my Reflective Practice Review documents to Physiotherapy Alberta?

You only need to submit your documents when selected as part of the audit process. Physiotherapy Alberta will provide instructions at that time for how and when to submit your documents. In the meantime, keep your documents for the required 5 years.

I changed my role at work and now want to change my learning goal. Is that OK?

Yes. You may change your learning goal and implement a different learning plan than what was initially reported. However, you must complete the learning activities and reflect on your learning outcomes for your new goal before applying to renew your practice permit. 

What it the purpose of the Essential Competency Self-Assessment and Patient Care Reflection Tool?

These are reflection activities focusing on areas of practice Physiotherapy Alberta thinks are important for a self-directed review of practice.

  • Self-assessment promotes compliance with the Entry-to-Practice and Essential Competence practice standard which expects physiotherapists to be knowledgeable of and practice in accordance with competencies set out in the Essential Competency Profile for Physiotherapists in Canada. The self-assessment promotes comprehension and application of the essential competencies to one’s individual practice.
  • Patient Care Reflection requires physiotherapists working in clinical practice to reflect in a structured manner on the care delivered to a patient. The questions in the Patient Care Reflection Tool are designed to cover many factors physiotherapists consider as part of clinical reasoning. Completing the Patient Care Reflection Tool is your opportunity to demonstrate your critical thinking skills. The process not only confirms how much you know but also helps to identify areas for further learning and/or aspects of patient care that can be improved.

How do I complete the Patient Care Reflection Tool when some of the questions don’t apply to my work with patients/clients?

Complete the questions that apply to your practice content and mark those that don't as not applicable.

Why does Physiotherapy Alberta have a Reflective Practice Review?

Professional competence is multifaceted. As such Physiotherapy Alberta's Continuing Competence Program has different strategies to address the multifaceted nature of professional competence. The Competence Program components are:

  • Competence Development,
  • Competence Assessment (i.e. jurisprudence module) and
  • Practice Visits (to be developed)

Reflective Practice Review falls under the Competence Development component. A reflective practice strategy was chosen because it is a flexible and highly individualized approach which can be used by any of our 2,400 members on the General Register to showcase their talents. Reflective Practice Review provides physiotherapists with an opportunity to demonstrate their unique thinking skills about essential competencies and patient care and the steps taken to learn and improve their practice.

How do I fit the Reflective Practice Review into a larger improvement plan that spans 3 years?

If you have a big goal that will take more than one year to complete such as completing a certificate program or developing a new patient care program for your facility, then:

  • Break your big goal into smaller steps and use one of the smaller steps as the learning goal in your Learning Planner and Tracker.
  • Record the big plan/vision in the Rationale section of the Learning Planner and Tracker - this communicates what you hope to accomplish over time.
  • Record the smaller step of your big plan in the Learning Goal section of the Learning Planner and Tracker. You have one registration year (Oct. 1 - Sept. 30) to complete what you have identified.
  • When you report on the outcomes of learning you may end up discussing outcomes of accomplishing the goal as they relate to the broader plan.

What should I do if I cannot retrieve my Reflective Practice Review documents because they were lost or damaged?

Members are accountable for meeting Reflective Practice Review requirements. In the event that a member is unable to retrieve their documents for any reason, they remain accountable for meeting the requirements. If a member is selected for the audit, they will remain accountable for meeting the audit requirements. Click here to view the entire policy.