Competency-Based Education in Physical Therapy: Exploring Stakeholder Views

• In Event: Competency-Based Education in the Health Professions: Using Applied Research to Improve Learner and Societal Outcomes

Abstract

Objectives/Purpose: As the profession of physical therapy began to consider the opportunities offered by competency-based education (CBE), discussions were initiated with educational leaders in other health professions who have explored as well as published their journey and are currently using some form of CBE within their curriculum. Engagement of stakeholders, across both academic and clinical environments, has been key to this process. The purpose of this paper is to share the findings from critical stakeholder groups, clinicians and academic faculty.

Method: Three stakeholder data collection points have been gathered and analyzed for this case. The first was a series of facilitator-led focus groups done in conjunction with a national conference with leaders from both academic and clinical settings. The focus groups explored participants understanding of CBE, the current state of the profession in meeting the health needs of society, and identification of opportunities and challenges if such a framework were to be implemented. A second stakeholder session, again in conjunction with a national conference, was facilitated by medical education leaders where following an overview of CBE and current progress in medicine, participants then discussed from the perspective of one of three key stakeholder group (students, clinicians, faculty) fears and concerns about CBE and potential opportunities and challenges. A third data point was an Outcome Strategy Meeting held with representatives from academic and clinical communities. Consultants from medical education facilitated the strategy meeting which focused on identification of key drivers for transitioning to a CBE framework, possible role of various framework(s) for defining learner outcomes entering practice, and identified next steps for the profession.1-4

Data/Findings: Key themes from the focus groups included: too much variation within PT curricula and an urgent need for change, current assessment tools were not capturing the true performance of learners, and agreement that standardization of outcomes would assist with validation of the profession to the public. The public accountability theme was also strongly supported in the second stakeholder session, while concerns were expressed about the implementation of CBE, impact on productivity, whether the model would become an accreditation requirement, the financial implications for students and programs, and resources needed for faculty development. Outcomes strategy meeting results included: unanimous identification of two frameworks (domains of competence (DoCs) and EPAs), and that EPA’s would be developed to assess PT graduates entering clinical practice. Four panels were established to modify an existing DoC framework used in Canada for PTs, develop EPAs, develop a CBE research agenda, and to communicate the work of all the groups within the profession. A timeline was developed for the work of the panels over the subsequent 18 months with the utilization of a reactor panel as well as additional points for stakeholder feedback.

Significance: The need for the profession to engage in a process of educational innovation that can address concerns for unwarranted variation across educational programs contributes to the public good. The physical therapy profession’s progress towards CBE continues to be enhanced through collaboration across professional organizations, stakeholders, and other health professions.

Authors

• Jean Fitzpatrick Timmerberg, Columbia University

• Gail M. Jensen, Creighton University