The Path to Clinical Excellence

1. AMERICAN BOARD OF PHYSICAL THERAPY SPECIALITIES: ENHANCING PROFESSIONAL DEVELOPMENT THROUGHCERTIFICATION

2. The Path to Clinical Excellence

3. OBJECTIVES Upon completion of this presentation, you'll be able to: • Discuss the role of specialty certification in advancing your clinical practice and importance to our profession • List the current areas of Areas of Specialty Practice • Provide an overview of the ABPTS certification and maintenance of specialty certification program • Describe the minimum eligibility requirements for certification and recertification for specialization • Describe the process for board certification and maintenance of specialty certification • Describe the role of clinical residencies in the certification process • Identify top motivations to pursue ABPTS Specialty certification

4. MultidimensionalPatient-centered Collaborative with Patient- Reflective Practice Clinical Reasoning Knowledge Philosophy of PT Practice Caring, Commitment, Respect, Ethical Practice Primary focus; Centered on function: hands-on Movement Virtues Clinical Excellence: Dimensions Jensen GM et al (2000) Phys Ther 80(1):28 – 43.

5. Clinical Excellence: Potential Pathways Entry level degree Years of experience Continuing education Post–professional residency Post-professional degrees Post-professional certifications Specialization

6. What is Clinical Specialty Certification? • Specialization is a process for physical therapist • Established to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skillsin a special area of practice • Professional education and development • Clinical Expertise in specific areas of practice • Clinical specialization responds to a unique area of patient need Recognition • Assists consumers and the health care community in identifying physical therapists who are specialists in a unique area of practice

7. Key Elements of Board Certification Voluntary – you decide Unrestrictive – does not prohibit others Coordinated - all APTA recognized are managed by a central mechanism (ABPTS)

8. What does Clinical Specialization Require? • Broad based foundation of physical therapy education and clinical practice Combined with… • Depth and breadth of knowledge in specialty area • Clinical experience in specialty area Knowledge

9. Advanced clinical expertise, skills, and abilities unique to a specialized practice area Expertise in clinical reasoning applied to specialty practice area What does Clinical Specialization Require? Knowledge

10. Purposes of Board Certification Promote highest possible level of physical therapy care Promote ongoing development of science and art underlying each specialty practice

11. Purposes of Board Certification Recognize specialists through a reliable and valid method for certification of specialty practitioners Identify for the consumers and the health care community physical therapists who are specialists in a unique area of practice

12. Areas of Specialty Practice Recognized through Board Certification Cardiovascular & Pulmonary (CCS) Clinical Electrophysiologic (ECS) Geriatrics (GCS) Orthopaedics (OCS) Pediatrics (PCS) Neurology (NCS) Sports (SCS) Women’s Health (WCS)

13. Minimum Eligibility Requirements for Clinical Specialization Certification Current license to practice physical therapy in the United States, the District of Columbia, Puerto Rico, or the Virgin Islands Practice eligibility requirement is 2,000 hours minimum of direct patient carein the specialty area, 25% (500 hrs) of which must have occurred in the last 3 years.

14. Minimum Eligibility Requirements • Direct patient care • must include activities in each of the elements of patient/client management model applicable to the specialty area and included in the Description of Specialty Practice (DSP)

15. Minimum Eligibility Requirements • Practice elements of patient/client management as defined in the Guide to Physical Therapist Practice • Examination • Evaluation • Diagnosis • Prognosis • Intervention

16. Minimum Eligibility Requirements Other requirements specific to the specialty such as: Emergency care certification (SCS) ACLS certification (CCS) Patient reports (ECS) Case reflections (WCS)

17. Other Options to Meet the Eligibility Requirements for Specialty Certification APTA Credentialed Clinical Residency A planned program of post-professional clinical and didactic education that is designed to advance significantly the physical therapist's preparation as a provider of patient care services in a defined area of clinical practice Residency Curriculum - designed around the DSP Specialty councils may allow completion of an APTA-credentialed clinical residency to replace all or a portion of the practice eligibility requirements

18. AssessmentBoard Examination Another exam!!! • Last step in initial certification process • The Specialty Councils develop the examinations • A rigorous examination that tests the applicationof advanced knowledge and clinical skills & reasoning • National Board of Medical Examiners • Criterion referenced exam

19. Assessment of Specialty Practice & Expertise Patient Care Teaching Administration Consultation Communication Interpretation of Research As defined by specific DSP Components of the Examination*

20. How are advanced clinical knowledge and skills determined for Board Certification? • Description of Specialty Practice (DSP) • Describes the advanced knowledge, skills, and abilities for clinical practice in the specialty area • Developed from a valid process for assessing expertise domain and current standards of specialty practice

21. Description of Specialty Practice (DSP) Based on data from an extensive practice analysis study Conducted by Specialty Councils and approved by ABPTS Document from which the certification exam is developed

22. Where to Start? • Description of Specialty Practice • Self-Assess strengths and weakness • Develop a plan and strategy, decide on a “path”

23. Professional Development Path Toward Clinical Specialization • Clinical experience in specialty area • Seek mentor(s) • Board certified specialist • Professional development • Knowledge and skills • Continuing Education • Post professional clinical residency • Post professional education

24. How to Prepare for the Board Certification Examination? Continuously review and adapt your “path” Resources Resources available from APTA Sections Recommended textbooks Reading lists Advanced Clinical Practice Courses Study Groups *ABPTS does not approve or review material or course content*

25. Specialist Certification Application Process Application APTA Department of Post-Professional Certification and Credentialing (www.abpts.org) Deadline: July of the preceding year To sit for the 2013 exam, applications must be postmarked by: July 1, 2012 – WCS, CCS, ECS July 31, 2012 – GCS, NCS, OCS, PCS, SCS All applications are reviewed

26. Specialty Certification Fees APTA memberNon-member Applicant Review $500 $845 Examination $800 $1,525 Total $1,300 $2,370 Certification is valid for ten years with no maintenance fees

27. When is the certification exam administered? Exams are offered once per year for a two-week exam period Candidates may sit for the exam between February-March 2012 – February 25–March 10, 2012 2013 – March 2-16, 2013

28. Examination Format • Computerized examinations, administered at Prometric, Inc. testing centers • FORMAT: Multiple choice questions including case scenarios, videos, pictures

29. Recognition of Certified Clinical Specialists Recognized at Opening Ceremony of APTA Combined Sections Meeting (CSM) Recognized by sections and chapters Inclusion in online Directory of Certified Specialists Only individuals who have successfully completed the ABPTS certification process may use the term “Board-Certified Clinical Specialist”

30. Board-Certified Clinical Specialists Who Are They?

31. Total Numbers of Certified Specialists by Year Total 2012- 12,937 individuals

32. Certified Specialists by Area Total in 2012 = 12,937

33. Age - Certified Clinical Specialists

34. Gender - Certified Clinical Specialists

35. Top 3 Work Settings:Certified Clinical Specialists Private PT Office Health system or hospital-based outpatient facility or clinic Academic Institution

36. Top 4 Positions held by Certified Clinical Specialists Supervisor/Director of PT Staff or Senior PT Sole Owner/Partner PT Practice Academic Faculty

37. Why do physical therapists become Board Certified Clinical Specialists?

38. Top Motivations to Pursue ABPTS Certification • Proof of expertise in specialty area • Personal challenge or achievement • Professional career goal • Earn a credential that reflects advanced practice to patients, physicians, & payers Source: Survey of certified specialists (2007)

39. What is the impact of the board certification process on the specialists? Specialists report that board certification has had a positive impact on . . . Sense of personal achievement Self-confidence & professional growth Patient care, including better outcomes Increased credibility with patients & referral sources Recognition in clinical, academic and community settings Sources: Survey of certified specialists (2007)

40. How has board specialty certification influenced Specialists’ careers? • Opened doors for professional growth • Consultations • Invited Presentations • New job opportunities • Leadership & service • Teaching opportunities • Research collaboration • Networking

41. Service Opportunities Specifically Related to Specialization • SACE – exam item writers • CCE – exam item editors • SME – exam standard setting and specialty practice analysis • Specialty Councils – over see exam development process, maintenance of certification, specialty practice analysis • ABPTS – board that oversees all specialties

42. Do employers support the certification process? Employer Support of ABPTS Certification 53% of employers pay at least some of the costs associated with obtaining clinical specialization. 43% of employers indicate that they give priority in hiring to job applicants who are board certified. Value expertise of specialist High patient care standards Serve as mentors for others Provide team leadership

43. Value of ABPTS Certificationto Certified Specialists 79% report that certification is a indicator of clinical competence 90% report that certification is an indicator of depth and breadth of knowledge in an area of specialty practice High rate (68%) of specialists choose to recertify Source: Survey of certified specialists (2007)

44. Is there a Renewal Process for the Specialty Certification ? • Yes!! • What is the process? • Currency of clinical practice and expertise in the specialty • Currency of advanced knowledge and skills in the specialty • Demonstration of professional development

45. Current Renewal of Specialty Certification Process Initial Certification is valid for 10 years. To maintain the credential, a specialist must meet the requirements of before his or her certificate expires ABPTS has developed process for assessing currency and recertification standards Ensures to the public the validity of advanced skills and expertise of the specialist

46. Purpose of Maintenance of Specialty Certification To verify current competence as an advanced practitioner in the specialty area Evaluation of professional development and clinical experience To encourage ongoing education and professional growth

47. Maintenance of Specialty Certification Requirements Current requirements Direct patient care hours in specialty (2000 hr) AND Professional Development Portfolio (PDP) OR Current written examination OR Graduation from a credentialed APTA clinical residency Future Model - MOSC

48. Professional Development Portfolio • Documentation of professional development activities and advanced clinical practice related to specialty practice since initial certification • Examples: • Continuing Education courses • Clinical Supervision • College/University courses • Teaching continuing education or college courses • Research presentations (platform or poster) • Presentations to professional groups, classes, or in-services • Presentations to community or client-based groups • Author or editor of book chapters, journal articles, grant proposals • Committee membership in professional organization • Consultation

49. American Board of Physical Therapy Specialties Maintenance of Specialist Certification Model (MOSC) Recertification Model MOSC Model

50. Maintenance of Specialist Certification #1 #3 #2 MOSC #4 Certification Cycle (10 yrs) years 3 6 9