Continuing Competence

Continuing Competence in Physical Therapy ….An Ongoing Discussion

Purpose of Meeting • Discuss some of the questions/issues surrounding continuing competence in physical therapy • Collect feedback on the discussion document and provide to APTA via online survey instrument

Who is in the Audience • Licensees: PT & PTAs • Employers • CE providers • Public/consumers • Accrediting agencies : eg, JCAHO • Licensing Boards/regulators

Discussion Questions ?????? • Divide our time to discuss questions of your choice • Chose from the provided list • Additional Questions????

Responsibility • Who is responsible for continuing competence? • What are the roles of the various constituents in continuing competence? • What is the purview of regulation regarding continuing competence?

Scope of Practice • In what portion of the scope of practice should a licensee be responsible for maintaining competence? • What is in a licensing board’s authority to regulate? • In what part of the scope of practice should a licensing board require demonstration of continuing competence?

Scope of Practice • In what part of the scope of practice should a licensing board require demonstration of continuing competence? • Scenario #1 • Scenario #2 • Scenario #3 • Scenario #4

Scenario #1 Minimal competence across entire current entry-level scope of practice? Scenario #2 Minimal competence in entry-level scope of practice defined by licensee? Scenario #3 Minimal competence in entire scope of practice defined by licensee? Scenario #4 A combination of 1 and 3 above?

Entry Level Practice Scope of Practice of Physical Therapy (entire diagram) The portion of current entry level practice that an individual licensee is not incorporating into his/her practice Current Entry-level Physical Therapy Practice The portion of practice of an individual licensee that is defined as current entry level practice The Practice of an individual licensee limited to a practice area The portion of practice of an individual licensee that is defined as advanced practice or beyond entry level Relationship between the scope of practice of a profession, current entry level practice, and the scope of an individual who limits his or her practice to a specific practice area

Is a physical therapist required to maintain competency over the entire scope of current entry level practice physical therapy as shown here, or some portion thereof? Scope of Practice of Physical Therapy The portion of current entry level practice that an individual licensee is not incorporating into his/her practice Current Entry-level Physical Therapy Practice The portion of practice of an individual licensee that is defined as current entry level practice The Practice of an individual licensee limited to a practice area The portion of practice of an individual licensee that is defined as advanced practice or beyond entry level Scenario #1

Is a physical therapist required to maintain current entry level practice in the scope of physical therapy practice in which the physical therapist is practicing as shown here? Scope of Practice of Physical Therapy The portion of current entry level practice that an individual licensee is not incorporating into his/her practice Current Entry-level Physical Therapy Practice The portion of practice of an individual licensee that is defined as current entry level practice The Practice of an individual licensee limited to a practice area The portion of practice of an individual licensee that is defined as advanced practice or beyond entry level Scenario #2

Is a physical therapist required to maintain minimal standards within the entire scope of practice in which the physical therapist is practicing as shown here? The portion of current entry level practice that an individual licensee is not incorporating into his/her practice Current Entry-level Physical Therapy Practice The Practice of an individual licensee limited to a practice area The portion of practice of an individual licensee that is defined as advanced practice or beyond entry level Scenario #3

Is a physical therapist required to maintain minimal standards within the entire scope of practice in which the physical therapist is practicing as well as the components of entry level scope in which the physical therapist is not practicing as shown here? Scope of Practice of Physical Therapy The portion of current entry level practice that an individual licensee is not incorporating into his/her practice Current Entry-level Physical Therapy Practice The portion of practice of an individual licensee that is defined as current entry level practice The Practice of an individual licensee limited to a practice area The portion of practice of an individual licensee that is defined as advanced practice or beyond entry level Scenario #4

Summary of “Scenario” Discussions

Knowledge, Skills, and Abilities Is there a set of knowledge, skills, and abilities that represent contemporary practice that all physical therapists should be able to demonstrate?

Summary “KSA” Discussion • There are core competencies in which all physical therapists should maintain competence • Related to clinical practice and/or area of emphasis • Some elements of the core competencies may evolve with changes in best practice • Each physical therapist should maintain competence within the scope of their personal practice • This includes core competencies that are common to all physical therapists

Safe and Effective Practice • Does continuing competence relate to ensuring safe practice, effective practice, or both? • If it includes effective practice, what is the minimal bar for effectiveness?

What is effective practice? • adequate to accomplish a purpose; producing the intended or expected result: effective teaching methods; effective steps toward peace. • Effective vs Effectiveness

Summary of Safe & Effective Discussion • Continuing competence involves more than safety • The purpose of continuing competence is to help a physical therapist guide their own practice and to protect the public • Define the term “effective” if we use it • Evidence-based (best evidence, patient preferences, clinician experience) decision-making • Not necessarily solely outcomes

How is effective practice demonstrated? How can the licensee demonstrate his or her effective practice in the context of continuing competence? • Demonstrate knowledge and skill in areas of core competencies • Use self-assessment process to determine learning needs • Creates a portfolio that demonstrates clinical-decision making • Case studies, oral, practical exams • Peer observation • Evaluations that assess clinical-decision making • Education on contemporary decision-making and ability to apply the current decision-making techniques

Economic and Legal Implications What are the economic and legal implications of implementing continuing competence requirements?

Fears & Concerns What are stakeholders’ fears and concerns about continuing competence requirements?

Summary of Implications, Fears, and Concerns Discussion

Plan to Promote Discussion and Feedback Distribute Discussion Paper Encourage discussions with: Members at the chapter/district level State Licensure Boards Health professionals community All stakeholder groups Resources and a survey located at this website: www.apta.org/continuingcompetence Feedback survey from individuals and groups Continuing competence resource documents

Thank You! www.apta.org/continuingcompetence

Continuing Competence