INTERNATIONAL CONSENSUS ON ENTRUSTABLE PROFESSIONAL ACTIVITIES FOR DIGITAL PHYSIOTHERAPY PRACTICE: A DELPHI STUDY

M. Merolli¹, P. Vallance^2,3, O. Ahmed⁴, C. O'Sullivan⁵, K. McCreesh⁶, R. Kerry⁷, K. Butler-Henderson⁸, K. Gray²

¹The University of Melbourne, Department of Physiotherapy, Melbourne, Australia, ²The University of Melbourne, Melbourne, Australia, ³Monash University, Melbourne, Australia, ⁴University of Portsmouth, Portsmouth, United Kingdom, ⁵University College Dublin, Dublin, Ireland, ⁶University of Limerick, Limerick, Ireland, ⁷University of Nottingham, Nottingham, United Kingdom, ⁸RMIT University, Melbourne, Australia

Background: As accelerating digital health technologies advance and disrupt routine physiotherapy practices, there is increasing reliance on digital health competency (or capability) frameworks to signpost the characteristics that a physiotherapist should possess. However, such approaches may not be clear enough about clinical activities involving digital health technologies that a physiotherapist must perform. A new international consensus-based approach sets out entrustable professional activities (EPAs) for digital health physiotherapy practice.

Purpose: Enactable, expert guidance on what professional activities using digital health are core to the work of a practicing physiotherapist will support: updating peak body/member organisation accreditation and professional practice proficiency standards; designing training and assessment (partciularly at university); planning continuing professional development.

Methods: This project built on the authors’ meta-synthesis of physiotherapy practice proficiency standards that reference digital health, as well as examination of digital health competency and capabality frameworks relevant to physiotherapy. We undertook an international online Delphi study to develop expert consensus on primary EPAs and their specifications for digital physiotherapy practice. We recruited participants with advanced knowledge of digital physiotherapy from across the world (clinicians, academics, and physiotherapists working in industry) using purposive and snowball sampling. Eligibility to participate was determined by preliminary screening for digital health expertise, based on strict criteria. Over three survey rounds, participants used a Likert scale to rate EPA specifications and provide qualtitative feedback. Items were retained where ≥75% of expert participants rated them as important.

Results: Nine EPAs for digital physiotherapy practice resulted, and eighty-four component activity specifications. EPAs belong to three domains: digital health data governance, digital health data translation to information, and use of digital health technologies (care related). Examples from each domain include: managing patients’ health information digitally, documenting clinical encounters and relevant health information digitally, conducting research using digital health tools, clinically assessing patients using digital health tools, and delivering a physiotherapy intervention that uses a digital health tool.

Conclusions: Digital physiotherapy EPAs make clear what actions a physiotherapist must do in their work. This approach has wide-reaching implications (set out below) for member organisations, universities, and the workforce. It provides evidence-based guidance for digital health practice to support the advancement of the profession, and to give consumers of physiotherapy services confidence that their needs and expectations are being met, in an increasingly digitally-enabled healthcare system.

Implications: Digital Physio EPAs provide:

• A description of what enacting digital health competence entails
• A roadmap for tertiary institutions (including clinical placements) to develop assessable digital health curriculum
• A basis for knowledge and skills gap analysis pertaining to workforce and job roles
• A way to incorporate digital health competency into proficiency standard updates

Funding acknowledgements: This work has been kindly supported by the Universitas 21 Network through receipt of a health sciences group research grant

Keywords:
Entrustable professional activities
Delphi
Digital physiotherapy practice

Topics:
Professional issues
Innovative technology: information management, big data and artificial intelligence
Education

Did this work require ethics approval? Yes

Institution: The University of Melbourne

Committee: LNR 2B Committee

Ethics number: 2022-21174-32191-3