ASSURING QUALITY MECHANISMS IN PHYSIOTHERAPY EDUCATION – THE PHYSIOTHERAPIST EDUCATION FRAMEWORK

Abstract: World Physiotherapy recognizes the central importance for Quality Assurance in relation to all things associated directly and indirectly to the practice of physiotherapy. To support the advancement of physiotherapist education, World Physiotherapy has published the Physiotherapist education framework, a document primarily based on World Physiotherapy's policy statement on education, which sets out expectations of physiotherapist entry level, and post-entry level, education. The document has three sections covering the three components of the Physiotherapist education framework: 1. Domains of physiotherapist practice competence; 2. Physiotherapist entry level education programmes; and 3. Physiotherapist continuing professional development (CPD). The first section describes the competence domains of core physiotherapy practice that student graduates of the entry level education programmes are expected to have upon the completion of the programme. These competence domains are also relevant for maintaining continued competence through continuing professional development. The second, and largest section, describes six elements of a quality physiotherapist entry level education programme including programme foundations; curriculum; teaching, learning and assessment; infrastructure and culture; academic staff; and quality assurance. The third and final section covers key aspects of CPD including formal and informal development, as well as steps in self-directed, lifelong learning in which all active physiotherapists engage to maintain continued competence. The Physiotherapist education framework provides a baseline that can be adapted to reflect country specific needs and the evolving roles of physiotherapists, set within a local educational, socio-political, cultural, economic, and regulatory context.

Introduction: World Physiotherapy is the sole international voice for physiotherapy representing more than 685,000 physiotherapists worldwide through 128 member organisations. One of World Physiotherapy's roles is to advocate for quality assurance (QA) and consequently help set the standards and procedures necessary to attain QA. World Physiotherapy recognises the central importance for QA in relation to all things associated directly and indirectly to the practice of physiotherapy. Ultimately, QA serves to enhance physiotherapy practices; and therefore, quality enhancement envisages taking deliberate steps towards continual improvement in all aspects linked to physiotherapy, including education.

Objective: To support the advancement of physiotherapist education, World Physiotherapy has prepared and published a document - the Physiotherapist education framework with a purpose to position components of physiotherapist education along the lifelong learning continuum as well as to provide guidance for physiotherapist entry level education and continuing professional development (CPD). A summary of the framework is depicted in Fig. 1. The lifelong learning continuum is also illustrated by the development of competence through a physiotherapist's advancement from novice to expert.¹

Figure 1.

Physiotherapist education framework.

It is estimated that one third of the world's population live with a condition that would benefit from rehabilitation. In this light, key questions from physiotherapist educators around the world that emerge are: What competences should physiotherapists have on completion of an entry-level education? What components in a programme of studies will ensure competent graduates? How do physiotherapists maintain their competence to practice?

World Physiotherapy encourages high standards of physiotherapy and global health by facilitating the exchange of information; and produces its own resources that are used to inform professional practice, education, planning, and development. With education, World Physiotherapy understands the need to be responsive to the challenge of meeting a diverse range of license to practice requirements, nationally and internationally, through a curriculum that ensures the necessary intellectual skills to enable graduates to practice as autonomous professionals. The scope of physiotherapy practice reflects the latest evidence and developments of knowledge and technological advances, consistent with the understanding of human movement, which is central to the skills and knowledge of the physiotherapist. These standards represent the profession's commitment to promote optimal health and function by pursuing excellence in practice. As autonomous professionals, physiotherapists should have the freedom to exercise their professional judgment and decision making. This autonomy is derived from the processes involved. As independent practitioners, physiotherapists are subject to ethical principles, and follow codes of ethics and best practice. The actions of individual physiotherapists are their own responsibility, and their professional decisions cannot be controlled or compromised by anyone.

Physiotherapist practice is continuously evolving, and these changes should be reflected in competences, programme benchmarks, and standards. It is recognised that physiotherapist education is organised in diverse and complex contexts, characterised by uncertainty and constant change. Therefore, and with this in mind, World Physiotherapy has created the Physiotherapist education framework with the collaboration and contribution of experts and stakeholders to be used as a guidance tool that is critically examined alongside the evidence on the needs, policies, and system characteristics that apply in a specific context.

The Physiotherapist education framework is primarily based on World Physiotherapy's policy statement on education which sets out expectations of physiotherapist entry level, and post-entry level education.² The framework is a tool to support the implementation of the Education policy and integrates previously published World Physiotherapy education related guidelines.^3–7 The Physiotherapist education framework is informed by several relevant World Physiotherapy policies. The document sets international expectations; different countries and education providers may be working at different speeds and levels towards these expectations. The document has three sections covering the three components of the Physiotherapist education framework: 1. Domains of physiotherapist practice competence; 2. Physiotherapist entry level education programmes; and 3. Physiotherapist continuing professional development (CPD).

The first section describes the competence domains of core physiotherapy practice that student graduates of the entry level education programmes are expected to have upon the completion of the programme. These competence domains are also relevant for maintaining continued competence through continuing professional development. The framework describes eight unique competence domains of core physiotherapy practice that graduates of entry-level education programmes are expected to have upon completion of the programme. The domains are physiotherapy assessment and intervention, ethical and professional practice, communication, evidence-based practice, interprofessional teamwork, reflective practice and lifelong learning, quality improvement, and leadership and management.

The second, and largest section, describes six elements of a quality physiotherapist entry level education programme, grounded in the nature and scope of physiotherapy, and covers: programme foundations; curriculum; teaching, learning and assessment; infrastructure and culture; academic staff; and quality assurance. The programme must be delivered at a minimum as a bachelor's degree with physiotherapy in the title.

The third and final section of the framework is dedicated to physiotherapist continuing professional development, lifelong learning and a commitment to professional development as an attribute of a competent physiotherapist. Physiotherapists who provide professional services need to have, and maintain, a broad range of knowledge, skills and abilities that are appropriate to their roles and responsibility they have in practice, education, management, research, and policy. The framework covers key aspects of CPD including formal and informal development, as well as steps in self-directed, lifelong learning in which all active physiotherapists engage to maintain continued competence. It provides information about ensuring CPD quality from both the provider and client perspectives.

The Physiotherapist education framework provides a baseline that can be adapted to reflect the country specific needs and the evolving roles of physiotherapists, set within a local educational, socio-political, cultural, economic, and regulatory context. However, this guidance document is neither intended to provide a full guide to physiotherapist entry level education nor a prescribed set of mandatory competences.

Conclusion: For QA to exist, recognised standards in education, practice and research must exist, with a procedure for reaching these standards. The World Physiotherapy Physiotherapist education framework sets the standards for QA to exist leading to quality enhancement that is ultimately necessary to improving the health of citizens.

References

1. Benner P. From novice to expert. Am J Nurs 1982;82(3):402–7.

2. World Confederation for Physical Therapy. Policy statement: Education London, UK: WCPT; 2019. Available from: https://world.physio/policy/ps-education

3. World Confederation for Physical Therapy. Guideline: Physical therapist professional entry level education. UK; 2011.

4. World Confederation for Physical Therapy. Guideline: Clinical education component of physical therapist professional entry level education. UK; 2011.

5. World Confederation for Physical Therapy. Guideline: Qualifications of faculty for physical therapist professional entry level education programmes. UK; 2011.

6. World Confederation for Physical Therapy. Guideline: Standard evaluation process for accreditation/recognition of physical therapist professional entry level education programmes. UK; 2011.

7. World Confederation for Physical Therapy. Guideline: Delivering quality continuing professional development for physical therapists. UK; 2011.

8. World Physiotherapy. Physiotherapist education framework. London, UK: World Physiotherapy; 2021.

Palabras clave: Fisioterapia; Education; Benchmarking; Garantía de calidad; Atención sanitaria

Keywords:Physical Therapy Specialty; Education benchmarking; Quality assurance; Health care