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«Physiotherapy Board of Australia & Physiotherapy Board of New Zealand Page 1 of 37 Contents Introduction 3 Physiotherapy practice in Australia and ...»

-- [ Page 1 ] --

Physiotherapy practice thresholds in Australia and Aotearoa

New Zealand

1 May 2015

Physiotherapy Board of Australia & Physiotherapy Board of New Zealand Page 1 of 37

Contents

Introduction 3

Physiotherapy practice in Australia and Aotearoa New Zealand 8

Overview of roles and key competencies 13

Role 1: Physiotherapy practitioner 15 Role 2: Professional and ethical practitioner 19 Role 3: Communicator 21 Role 4: Reflective practitioner and self-directed learner 23 Role 5: Collaborative practitioner 25 Role 6: Educator 27 Role 7: Manager/leader 28 Glossary 29 Bibliography 32 Appendix 1: Development of the Physiotherapy practice thresholds 35 Appendix 2: Regulation of physiotherapists in Australia and Aotearoa New Zealand 37 Physiotherapy Board of Australia & Physiotherapy Board of New Zealand Page 2 of 37 Introduction Background to the Physiotherapy practice thresholds The Physiotherapy Board of Australia (PhysioBA) and the Physiotherapy Board of New Zealand (PBNZ) worked together between 2012 and 2015 to develop and publish the Physiotherapy practice thresholds in Australia and Aotearoa New Zealand (referred to here as “Physiotherapy practice thresholds”).

The PhysioBA and PBNZ will regularly review the published Physiotherapy practice thresholds to maintain their relevance to the expectations of threshold competence required for contemporary physiotherapy practice in Australia and Aotearoa New Zealand.

Purpose of the Physiotherapy practice thresholds The Physiotherapy practice thresholds describe the threshold competence required for initial and continuing registration as a physiotherapist in both Australia and Aotearoa New Zealand.

Format of the Physiotherapy practice thresholds The format of the Physiotherapy practice thresholds draws on a competency framework, the CanMEDS framework, developed by the Royal College of Physicians and Surgeons of Canada (Royal College).

The CanMEDS framework “describes the abilities physicians require to effectively meet the needs of the people they serve” (Frank, Snell, Sherbino et al, 2014, p 1). The CanMEDS framework emerged in the 1990s and was first launched by the Royal College in 1996 and subsequently updated in 2005. The Royal College will publish a third version in late 2015.

The main feature of the CanMEDS framework is the thematic arrangement of competencies based on seven integrated roles of physicians in practice. The thematic arrangement of competencies based on roles of practitioners in practice, drawing on the CanMEDS framework, has gained acceptance in several other countries. The medical profession in Australia, Aotearoa New Zealand, Denmark and the Netherlands has adapted the CanMEDS framework for entry to medical practice. Other professions, including the physiotherapy profession in Canada and the Netherlands, have drawn on the CanMEDS framework to describe the competencies that are “essential” at the beginning of, and throughout, a practitioner’s career.

In applying the CanMEDS approach, the Physiotherapy practice thresholds arrange key competencies within seven integrated and thematic roles: Physiotherapy practitioner, Professional and ethical practitioner, Communicator, Reflective practitioner and self-directed learner, Collaborative practitioner, Educator and Manager/leader. Although the Physiotherapy practice thresholds arrange key competencies within separate roles, the Physiotherapy practitioner role is central to physiotherapy practice in any context, and, as practitioners, physiotherapists integrate the other roles in the Physiotherapy practice thresholds with that central role as they apply to the context of the physiotherapist’s practice.1

The Physiotherapy practice thresholds expand on each of the seven roles at three levels:

1. role definition

2. key competencies, and

3. enabling components.

1The integration of the central role of the Physiotherapy practitioner with the other roles is best illustrated by the CanMEDS diagram. The CanMEDS diagram has not been reproduced or adapted in this document because it is officially trademarked. It can be viewed at www.royalcollege.ca/portal/page/portal/rc/resources/aboutcanmeds.

Physiotherapy Board of Australia & Physiotherapy Board of New Zealand Page 3 of 37 “Role definition” describes the essential characteristics of physiotherapy practice encompassed by the corresponding key competencies. When combined, the seven role definitions describe the essential characteristics of a competent registered physiotherapist in both Australia and Aotearoa New Zealand.

“Key competencies” are described for each role. The key competencies are the practices necessary for a physiotherapist to safely and effectively perform the central role of physiotherapy practitioner in a range of contexts and situations of varying levels of complexity, ambiguity and uncertainty. 2 An individual should demonstrate threshold competence for all key competencies relevant to their field of practice.

“Enabling components” describe the essential and measureable characteristics of threshold competence for the corresponding key competency. Threshold competence requires an individual’s practice to comprise all the enabling components for the corresponding key competency.

The language used in the Physiotherapy practice thresholds describes behaviours that characterise threshold competence in practice. Each key competency and enabling component is prefaced by the words “Registered physiotherapists in Australia and Aotearoa New Zealand are able to”.





The key competencies and enabling components embed the complex conceptual, analytical and behavioural elements that integrate foundational abilities, such as the knowledge, skills, attitudes, values and judgements, that may be learnt in entry-level programmes. The Physiotherapy practice thresholds do not explicitly identify the corresponding foundational abilities (knowledge, skills, attitudes, values and judgements) that may be learnt in entry-level programmes at the level of task-oriented elements that, in isolation, do not assure threshold competence in practice.3

Uses of the Physiotherapy practice thresholds

The PhysioBA and PBNZ each have statutory functions as regulators of the physiotherapy profession in Australia and Aotearoa New Zealand respectively. One statutory function of the PhysioBA is “to register suitably qualified and competent persons in the health profession”.4 One of the statutory functions of the PBNZ is “to set standards of clinical competence, cultural competence and ethical conduct to be observed by the profession”.5 The PhysioBA and PBNZ use the Physiotherapy practice thresholds as a reference point of threshold

competence when exercising their statutory functions, including for:

 registration of individuals who completed an approved physiotherapy programme in Australia or a prescribed physiotherapy qualification in Aotearoa New Zealand (see section headed “Physiotherapy practice thresholds and accreditation of physiotherapy education in Australia and Aotearoa New Zealand” for more details)  registration of individuals who complete their initial physiotherapy qualifications in other countries  re-registration of individuals who were previously registered as a physiotherapist in Australia or Aotearoa New Zealand, and The context of a physiotherapist’s practice may not be limited to (and may not include) direct clinical care. Many of the abilities described in the key competencies are required in direct non-clinical relationships with patients or clients. The abilities are also required when registered physiotherapists work in management, administration, education, research, policy development, advisory contexts, regulatory contexts or other contexts impacting on public health and safety.

3 Unlike the Australian Standards for Physiotherapy (2006) and the Physiotherapy Competencies for Physiotherapy Practice in New Zealand (2009), the Physiotherapy practice thresholds do not “deconstruct” the key competencies or enabling components into task-oriented performance criteria or examples of evidence.

4 Section 35(1)(a) of the Health Practitioner Regulation National Law Act as in force in each state and territory in Australia.

5 Section 118 of the Health Practitioners Competence Assurance Act 2003 (NZ).

Physiotherapy Board of Australia & Physiotherapy Board of New Zealand Page 4 of 37  evaluation of a registrant whose level of competence to practise may pose a risk of harm to the public, for example, if the PBNZ or PhysioBA receives a complaint or notification about that registrant.

The PhysioBA and PBNZ recognise that other organisations and individuals may use the Physiotherapy practice thresholds as a reference point of threshold competence for other purposes. This could include registrants’ self-assessment of their competence, employers’ performance evaluation and management of physiotherapists in the workplace, and the development of health policy and health workforce strategy by agencies responsible for such work.

Physiotherapy practice thresholds and accreditation of physiotherapy education in Australia and Aotearoa New Zealand The PhysioBA and PBNZ do not generally directly examine or assess the competence of applicants for registration who completed their physiotherapy studies in Australia or Aotearoa New Zealand, if the programme of study is approved (Australia) or their qualification is prescribed (Aotearoa New Zealand).

Instead, the PhysioBA and PBNZ have approved accreditation and/or audit arrangements that enable them to consider these applicants suitably competent for registration as a physiotherapist in the respective country.

As part of the accreditation/audit arrangements, the PhysioBA and PBNZ appoint an accreditation and/or audit body to assess if the physiotherapy programme, and the university that delivers it, provides students with the knowledge, skills and professional attributes to practise physiotherapy. In Australia, the PhysioBA has approved the accreditation standards developed and used by its accreditation body – the Australian Physiotherapy Council.

The Physiotherapy practice thresholds are not accreditation standards but are, as noted, a reference point for the threshold competence required for initial and continuing registration as a physiotherapist in both Australia and Aotearoa New Zealand. The language used in the Physiotherapy practice thresholds describes abilities in practice. The Physiotherapy practice thresholds do not explicitly identify the corresponding foundational abilities (knowledge, skills, attitudes, values and judgements) that may be learnt in entry-level programmes.

Concept of threshold competence

“Threshold competence” is used here to describe the competence level required to practise as a registered physiotherapist in Australia and Aotearoa New Zealand. This is based on the premise that competence levels can be described on a continuum. The threshold represents the point on the continuum that delineates a minimum acceptable level of competence to practise as a physiotherapist.

This level is described as “threshold competence”.

Figure 1 illustrates the concept of a line on the competence continuum delineating “threshold competence”. The green arrow represents the competence on the continuum above the threshold. The red area represents gradations of competence on the continuum below the threshold. The line labelled “Physiotherapy practice thresholds” is the lower margin of the green arrow – that is, the minimum level of competence required to practise as a registered physiotherapist in Australia and Aotearoa New Zealand.

Physiotherapy Board of Australia & Physiotherapy Board of New Zealand Page 5 of 37 Figure 1: Continuum of threshold competence Threshold competence is often referred to as “entry-level” competence and is described from the perspective of an individual wishing to enter practice from below the line representing threshold competence. This approach often describes competence in the context of the current requirements for graduates of education programmes in Australia and Aotearoa New Zealand to enter practice. Entrylevel competence described from this perspective frequently comprises task-oriented statements that identify the foundational abilities (knowledge, skills, attitudes, values and judgements) acquired in entrylevel programmes during development of the key competencies necessary to practise as a registered physiotherapist at the time the competencies are written.

Rather than describing competence from the perspective of an individual wishing to enter practice from below the line representing threshold competence, the Physiotherapy practice thresholds describe physiotherapy practice at the line representing threshold competence. This perspective defines competence in the context of practice as a physiotherapist and is applicable to a range of contexts including individuals entering from education programmes in Australia and Aotearoa New Zealand.

These contexts include physiotherapy practice across various settings and different chosen fields of practice.

The Physiotherapy practice thresholds use key competencies and enabling components to describe threshold competence. The key competencies and enabling components take into account the complex conceptual, analytical and behavioural elements that integrate competent performance of observable abilities into physiotherapy practice relevant to the key competency. The foundational abilities, such as the knowledge, skills, attitudes, values and judgements, that may be learnt in entry-level programmes are integrated in the abilities described by the key competencies and enabling components of the Physiotherapy practice thresholds.

Maintenance of competence

The Physiotherapy practice thresholds are relevant throughout a registered physiotherapist’s career.

They describe the minimum level of competence that all registered physiotherapists in Australia and Aotearoa New Zealand must maintain for continuing registration.



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