CORE COMPETENCY AND CAPABILITY FRAMEWORK FOR ADVANCED PRACTICE PHYSIOTHERAPY

A. Tawiah¹, E. Stokes², M. Wieler³, F. Desmeules⁴, L. Finucane⁵, J. Lewis⁶, J. Warren⁷, K. Lundon⁸, T. Noblet⁹, C. Cunningham¹⁰, L. Woodhouse¹¹

¹Queen's University, School of Rehabilitation Therapy, Kingston, Canada, ²Trinity College Dublin, Dublin, Ireland, ³University of Alberta, Physical Therapy, Edmonton, Canada, ⁴University of Montreal, School of Rehabilitation, Montreal, Canada, ⁵National Health Service, Sussex MSK Partnership, Sussex, United Kingdom, ⁶Central London Community Healthcare National Health Service Trust, Therapy Department, London, United Kingdom, ⁷Office of the Health and Disability Commissioner, Strategic Team, Wellington, New Zealand, ⁸University of Toronto, Temerty Faculty of Medicine, Toronto, Canada, ⁹St George's University Hospitals NHS Foundation Trust, Physiotherapy Dept, London, United Kingdom, ¹⁰University College Dublin, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland, ¹¹Tufts University, School of Medicine, Dept of Public Health and Community Medicine, Phoenix, United States

Background: Advanced practice physiotherapy (APP) is an internationally-recognized, innovative model of care that meets health systems' needs by managing a high volume of patients, reducing wait times and costs. While expanding, there is no standardized core competency and capability framework to support the training of APP practitioners. Lack of a standardized framework risks inconsistencies in training practitioners, implementation and sustainability of the model.

Purpose: The overall aim of this project was to develop a core competency and capability framework for APP that could be used internationally.
The objectives were:

1. To identify the available literature (published or grey) on APP competencies and capabilities.
2. To seek the opinion of stakeholders (APPs, leaders and researchers) on the competencies and capabilities.
3. To assess the face validity of the competencies and capabilities framework.

Methods: The overall project was comprised of the following three (3) studies:
Study 1 A scoping review with narrative synthesis led to the development of the 1st draft of the competency and capability framework. The scoping review followed the Arksey and O’Malley framework and searched four online databases (CINAHL plus, MEDLINE Ovid, PubMed, and Scopus).
Study 2 An interpretive descriptive qualitative study used 4 focus groups to obtain feedback on the 1st competency and capability framework and develop the 2nd draft of the framework. Data from the focus groups were analyzed thematically.
Study 3 A cross-sectional online survey assessed the face validity of the 2nd draft of the framework. Participants rated the importance of each competency and capability on a five-point Likert scale (“strongly disagree”, “disagree”, “neither disagree nor agree”, “agree”, “strongly agree”). The framework was also reviewed by APP subject matter experts.

Results: Study 1 included 19 documents; 13 reports, and 6 research papers from the UK, Canada, Ireland, Australia, and New Zealand. The documents retrieved were mapped out to develop the first draft of 27 competencies and capabilities grouped into 7 domains.
In study 2, 16 participants from the same 5 countries participated in 4 focus groups. Participants were APPs, researchers, and administrators. Five themes developed: clinical expertise, experienced communicator, strong leadership skills, collaboration, and knowledge creation & dissemination. These themes informed the second draft of the framework with 24 competencies and capabilities grouped into 6 domains.
In study 3, 99 participants from the same 5 countries completed the survey to validate the proposed framework. Of interest, the competencies and capabilities associated with patient care were ranked relatively higher than those not associated with patient care.

Conclusions: This project resulted in developing a core framework for APP with 24 competencies and capabilities grouped into 6 domains: Clinical expertise; Communicator; Collaborator, Leader and Health Advocate; Scholar and Professional. Competencies and capabilities directly related to clinical practice and patient care were central to the advanced practice model.

Implications: The competency and capability framework developed from this project could serve as an international framework for standardizing APP training and evaluating APP models. The framework can be adopted and adapted to meet the local and regional needs of countries intending to implement APP.

Funding acknowledgements: University of Alberta

Keywords:
Advanced practice physiotherapy
Competencies
Capabilities

Topics:
Service delivery/emerging roles
Education
Musculoskeletal

Did this work require ethics approval? Yes

Institution: University of Alberta

Committee: Research Ethics Board 2

Ethics number: Pro00099692