Lee D1, Moss P1, Barnett-Harris A1, Sievers N1, Gupta K1, Pritchard S1, Te M2, Blackstock F1,2
1Australian Physiotherapy Council, Richmond, Australia, 2Western Sydney University, Campbelltown, Australia
Background: The Australian Physiotherapy Council (the Council) assessment of overseas-qualified physiotherapists seeking registration to practice in Australia includes clinical practice components ordinarily completed at hospitals and clinics around Australia. Each of the three clinical assessment sessions are high-stakes 2-hour events. Including the time spent by hospital and Council staff to organise sessions, the current clinical assessment requires a significant use of health resources already stretched by the need to support increasing demand to train student physiotherapists.
These challenges were compounded by a 345% increase in the demand for assessments from 2011 to 2017 (96 to 331 candidates), far outpacing the ability to source assessments for existing and future candidates. By 2016, the clinical assessment waiting list grew to 24 months from application to assessment.
Simulation, which had good evidence for use in education of entry-level physiotherapists, appeared to be a viable solution to reducing the wait-time whilst maintaining a robust assessment process.
Purpose: This project examined whether simulation could maintain the rigorous standard of the hospital-based clinical assessment, while reducing the wait-time through a sustainable and efficient model of assessment that also has the ability to scale assessments to meet future changes in demand.
Methods: Multi-practice, clinical environment, simulation laboratories were purpose-built to replicate clinical environments in Melbourne and Sydney, enabling demonstration of physiotherapy practice in the Australian context through acute, rehabilitative and outpatient environments. The set-up facilitated an authentic immersive experience for candidates, while maintaining the control afforded by simulation.
Simulation scenarios mapped to the Australian and New Zealand Threshold Statements of Practice were developed, and validated by physiotherapists. Professional actors portrayed the patient roles, trained by health simulation experts.
Six candidates were scheduled each day to complete three scenarios across cardiorespiratory, neurological and musculoskeletal practice in acute, rehabilitation and outpatient settings. Sessions were timetabled to maximise the efficient use of resources including space and practice scenarios.
Results: The waiting list for scheduling assessments reduced from 1,111 assessment sessions to 715 sessions (36% reduction) in six months. Candidates who were involved in the new model were allocated to simulation sessions within 2 months from their application date, compared to 20 months for a clinical assessment prior to the project. The model demonstrated good scalability: over 6 months (n=14 assessment days) between 9 and 18 assessment sessions were conducted each simulation day (mean=15, sd=2.882, median=15). Up to 36 sessions were conducted in a month, with additional sessions possible should they be required. In comparison, between 1 and 35 sessions a month were previously conducted in hospitals over the same period (mean=5.48, sd=6.257, median=3).
Conclusion(s): Simulation provides a viable model for administering efficient and timely clinical assessments for overseas-qualified practitioners, reducing wait-time from application to completion of assessment, and providing scalability to meet changes in future demand.
Implications: Simulation-based assessments are a feasible method, that can be scaled, for assessment of competency to practice of overseas-qualified physiotherapists applying for registration in Australia. Further research evaluating financial efficiencies of using simulation as an assessment of competency is now needed.
Keywords: Simulation, assessment, competency
Funding acknowledgements: This project was funded by the Australian Physiotherapy Council with in-kind contribution from Western Sydney University.
These challenges were compounded by a 345% increase in the demand for assessments from 2011 to 2017 (96 to 331 candidates), far outpacing the ability to source assessments for existing and future candidates. By 2016, the clinical assessment waiting list grew to 24 months from application to assessment.
Simulation, which had good evidence for use in education of entry-level physiotherapists, appeared to be a viable solution to reducing the wait-time whilst maintaining a robust assessment process.
Purpose: This project examined whether simulation could maintain the rigorous standard of the hospital-based clinical assessment, while reducing the wait-time through a sustainable and efficient model of assessment that also has the ability to scale assessments to meet future changes in demand.
Methods: Multi-practice, clinical environment, simulation laboratories were purpose-built to replicate clinical environments in Melbourne and Sydney, enabling demonstration of physiotherapy practice in the Australian context through acute, rehabilitative and outpatient environments. The set-up facilitated an authentic immersive experience for candidates, while maintaining the control afforded by simulation.
Simulation scenarios mapped to the Australian and New Zealand Threshold Statements of Practice were developed, and validated by physiotherapists. Professional actors portrayed the patient roles, trained by health simulation experts.
Six candidates were scheduled each day to complete three scenarios across cardiorespiratory, neurological and musculoskeletal practice in acute, rehabilitation and outpatient settings. Sessions were timetabled to maximise the efficient use of resources including space and practice scenarios.
Results: The waiting list for scheduling assessments reduced from 1,111 assessment sessions to 715 sessions (36% reduction) in six months. Candidates who were involved in the new model were allocated to simulation sessions within 2 months from their application date, compared to 20 months for a clinical assessment prior to the project. The model demonstrated good scalability: over 6 months (n=14 assessment days) between 9 and 18 assessment sessions were conducted each simulation day (mean=15, sd=2.882, median=15). Up to 36 sessions were conducted in a month, with additional sessions possible should they be required. In comparison, between 1 and 35 sessions a month were previously conducted in hospitals over the same period (mean=5.48, sd=6.257, median=3).
Conclusion(s): Simulation provides a viable model for administering efficient and timely clinical assessments for overseas-qualified practitioners, reducing wait-time from application to completion of assessment, and providing scalability to meet changes in future demand.
Implications: Simulation-based assessments are a feasible method, that can be scaled, for assessment of competency to practice of overseas-qualified physiotherapists applying for registration in Australia. Further research evaluating financial efficiencies of using simulation as an assessment of competency is now needed.
Keywords: Simulation, assessment, competency
Funding acknowledgements: This project was funded by the Australian Physiotherapy Council with in-kind contribution from Western Sydney University.
Topic: Education: clinical; Globalisation: health systems, policies & strategies; Service delivery/emerging roles
Ethics approval required: No
Institution: N/A
Ethics committee: N/A
Reason not required: This project describes an innovative way in which a simulation model was used to address unmet demand for assessments of overseas qualified physiotherapists in Australia.
All authors, affiliations and abstracts have been published as submitted.
