Advanced Musculoskeletal Physiotherapy Clinical Education Framework

Advanced Musculoskeletal Physiotherapy Clinical Education Framework: An Overview

The Advanced Musculoskeletal Physiotherapy Clinical Education Framework (the framework) has been developed to support advanced musculoskeletal physiotherapy (AMP) services operating across outpatient departments and emergency departments of public health services in Victoria.

The framework is divided into a Manual that is generic for all the AMP services and a Workbook for each specific area of AMP practice for example: Post Arthroplasty Review Clinic Workbook. The manual provides details of the development of the competency standard, and the process to achieve competency, mentoring and ongoing competency requirements across all the areas of AMP practice. The workbooks in each of the key areas of AMP practice contain the relevant competency standard, corresponding scope of practice statement, assessment tools and resources required to complete the competency-based learning and assessment. All workbooks can be modified to meet the individual requirements of physiotherapist and organisations however where changes occur it should be documented clearly and agreed upon by the relevant stakeholders.

Key Documents

1. Competency Standard:

This is the first document to become familiar with. It can be found in the manual and at the beginning of each workbook. This standard provides the benchmark for which performance in the clinical setting will be measured against. All the competency assessment tools are mapped back to the performance criteria in this standard. A cross can be placed in the role relevance column to indicate any performance criteria on the competency standard not applicable as decided by the most senior advanced musculoskeletal physiotherapist (or clinical lead).

2. Learning needs analysis (Part A and B):

The learning needs analysis helps the learner identify their starting point. Part A provides an opportunity for the learner to become familiar with the competency standard they will be measured against and also to identify if there is prior learning and assessment already completed that could be recognised. Part B contains the underpinning skills and knowledge required to perform at a competent level. The learner must prioritise from Part A and B what is essential for the context of their role, organisation and patient population.

It is important to note not everything listed in Part B is required to be competent.

3. Learning and Assessment Plan:

This document is split into two parts.

The learning plan maps out the learning activities to be undertaken and should align with the learning needs analysis. An example has been provided in the workbook but additional activities such as in-services, individual and organisational requirements should be documented here.

The assessment plan maps out the assessment procedures to be undertaken. It should also include who will be appointed as assessors and at what time points the assessments will be conducted. The decisions made relating to the assessment procedures should be done in collaboration with the clinical lead, the physiotherapist undertaking the assessment and relevant stakeholders e.g. Medical director. (Organisations wishing to change the assessment procedures should use the Cumulative Assessment Tool found in the workbook. All assessments are mapped to each performance criteria of the competency standard and documented)

4. Self-directed learning modules:

Self-directed learning modules have been developed for each AMP service. It is important to note there is a degree of repetition contained within the learning modules for each area and between the learning modules for each AMP service. This was to allow for each module to be a standalone document. Where there is repetition the learner should just move onto the next relevant section. The learning needs analysis should help the learner to identify and prioritise what modules and what section of each module is most relevant. Group work is encouraged as a time effective way to work through the learning modules.

5. Key Assessment Tools:

Some of the key assessment tool templates include the:

Cumulative Assessment Tool: used to provide a guide for the assessment methods being used for each of the performance criteria. This tool can be used to collate all the evidence collected from the assessment processes.

Direct Workplace Observation checklist: a one page modified checklist is provided for use in the clinical setting.

Case based presentation instruction & summary sheet: Several case presentations are recommended to address the performance criteria required. This summary ensures the performance criteria assessed by this method have been met.

Case based presentation assessment checklist: The assessor is required to complete this following every case presentation provided. The performance criteria addressed at the top of the sheet should be circled.

Final Steps

A final sign off process for the completion the initial learning and assessment competency program should be documented in the operational guidelines for the AMP service. In addition the plan for the ongoing learning and competency assessment should link in with the individual’s annual performance appraisal.

Competency based learning is relatively new to the physiotherapists working in the public sector. Consequently it can initially take some time to become familiar with the terminology, using a competency standard as the key reference point, and organising the assessment to address the performance criteria. When used as intended it provides a valuable resource supporting good clinical governance of AMP services.