December 2, 2015

Supervised Practice for New Physiotherapy Graduates

The new Supervised Practice requirement for new physiotherapy graduates will begin at the end of January 2016.

Individuals potentially affected:

New graduates who passed the written component and are registered on the Examination Candidate Register. This group took the November 2015 OSCE but did not pass. This group will now be required to practice under the supervision of a physiotherapist.
New graduates who have not undertaken any component of the PCE or who have failed any component of the PCE and do not qualify for Active Practice registration as of January 30, 2016.

New graduates who are currently on the Examination Candidate Register and who have passed the November 2015 OSCE will transfer to the Active Practice Register and are not affected by the change to supervision.

The term “supervision” refers generally to the relationship that is established between a more experienced physiotherapist and an entry to practice physiotherapist who has met the first stage of requirements for registration but has not met all the requirements for full independent practice on the Active Practice Register. The terms “supervisor” and supervisee” are used generically to describe the two participants in the supportive relationship.

Duration of Supervision: The minimum and maximum requirements for supervision vary with the needs of the supervisee involved. At a minimum, the period of supervision should be set for as much time as is needed for the applicant to successfully complete the clinical component of the PCE.

Selection of Supervisors:

The supervisee is responsible for identifying the supervisor or employer and securing agreement for the entry to practice supervision. The final approval of the supervisor and site rests with the College of Physiotherapists of Manitoba.

Eligibility Criteria: Based on best practice, eligibility criteria for supervisors should include the following: The supervising physiotherapists must:

Be registered in good standing with CPM
Hold an unrestricted license (e.g. not be subject to any fitness to practice or orders).
Have no significant past history with CPM that would prevent him/her being a competent supervisor.
Have no conflict of interest (e.g. no relationship to the candidate)
Have a minimum number of 3 years of experience in independent practice in Canada.
Be able to assess the quality of the work performed (e.g. be working in the same area of practice) and
Have the same employer as the supervisee.

Supervision Approach and Responsibilities:

Supervision Approach: The supervision approach in entry to practice situations must ensure safe delivery of physiotherapy services and the prevention of any undue risk of harm to the public. Since the supervisee has not yet been deemed competent to practice independently, it is the supervisor’s responsibility to monitor the activities of the supervisee using both direct and indirect methods of observation and to develop an appropriate supervision plan. It is also the responsibility of the supervisor to evaluate the supervisee between the first 10 and 30 days of the period of supervised practice. The specific methods and level of supervision will vary depending on the supervisor’s initial and ongoing assessments of the supervisee’s level of competency. Examples of methods of supervision include: direct observation, chart audits, meetings, case reviews and feedback from peers and other team members. If a supervisee is unsuccessful in an attempt on the clinical component of the PCE, the supervisor should take this into account and adjust the supervision plan accordingly.

Responsibilities of the Supervisor: Since the supervisor is required to either indirectly or directly monitor the activities of the supervisee, the supervisor and supervisee will optimally have the same employer. The supervisor(s) should be on site to indirectly or directly monitor the activities of the supervisee until the initial evaluation is completed. Afterwards, the supervisor is expected to consider the individual needs of the supervisee and provide the necessary level of supervision to ensure safe delivery of physiotherapy services and protection of the public. At this point, working with a delegate of the supervisor may be possible. Availability by telecommunication may also be considered in certain circumstances (e.g. supervisee has demonstrated good insight related to circumstances requiring supervisor input). Other responsibilities of the supervisor include: ensuring informed consent is obtained from the patient for involvement of supervisee; making arrangements for supervision when not available, ensuring employer comprehension and acceptance of professional obligations regarding supervision; notifying CPM of changes in supervisor; mandatory reporting of incompetence or misconduct; and completion and submission of evaluations as required. There may be multiple supervisors (up to three) as long as one supervisor has primary responsibility.

Responsibility of the Supervisee: The supervisee may be in either a part-time or full-time position. The supervisee is accountable for his/her actions and will have the same requirements for liability insurance as a full registrant. The supervisee is also responsible for notifying CPM of changes in supervision.

Evaluation /Monitoring

Evaluation Requirements: The supervisor must evaluate the supervisee between the first ten to 30 days of the period of supervised practice to determine an appropriate level of supervision. Supervisors should consider arrangements for ongoing monitoring (about every three months), and a progress report given to the supervisee during longer periods of supervision so that the level of supervision can be adjusted accordingly. A final evaluation should be completed 2 weeks before the supervisee is scheduled to undertake the clinical component of the PCE and sent to CPM.

Evaluation tool: Whenever possible, an evaluation tool that has been determined to be valid and reliable for measuring entry level competence of physiotherapists should be utilized to evaluate supervisees in entry to practice supervision situation. CPM is developing the initial evaluation tool and recommends the ACP (Assessment of Clinical Performance) tool. Monitoring of Supervisee Evaluations by CPM: CPM is responsible for monitoring the evaluations of supervisees that have been identified as having performance issues during the supervised practice or failure(s) on the examination. The Board of Assessors will review the ACP evaluation forms. Supervisees who fail the clinical component of the PCE will be required to develop a plan of action which identifies and addresses weak areas on the PCE. As well, the Board of Assessors will have a face to face interview with the supervisee to discuss their action plan.

Updated: December 2, 2015