ESCO ESCO is the multilingual classification of European Skills, Competences, Qualifications and Occupations relevant for the EU labour market and education and training. ESCO is part of the Europe 2020 strategy. To help job matching Enabling mobility Facilitate dialogue between the labour market and education/training Linked to relevant international classifications and frameworks, such as NACE, ISCO and EQF

1st Pillar The list of occupations in this diagram started by using ISCO 08 and was then amended based on the expertise of the group members. However, because of the evolution of healthcare it may be updated and new occupations added in future revisions.

https://ec.europa.eu/esco/hierarchybrowser

ENPHE working group 22nd of March 2014 Suggestions for the definition of physiotherapy Suggestions for the decriptions of physiotherapy related occupations Physiotherapy Assistant Physiotherapist Advanced Physiotherapist

ENPHE WG suggestions 3/2014: Physiotherapy Assistant First of all: most of European countries nowadays do not have assistant in physiotherapy in their health care and education system. We would like to call ‘physiotherapy assistant’ as ‘assistant in physiotherapy’. Our recommendations for describing the level of assistant in physiotherapy are: at least the level of Associate degree at least on EQF level 5 (or 4) depending of the description of the competences Our recommendation for the role of assistant in physiotherapy: Assistant helps to provide physiotherapy services that achieve and optimise client outcomes (Canadian Alliance of Physiotherapy Regulators, 2012).

Physiotherapist Assistant Definition by European Region of the World Confederation for Physiotherapy: A Physiotherapist Assistant assists and works under the sole direction and supervision of the Physiotherapist who delegates specific aspects of interventions. A physiotherapist assistant only works within defined contexts using agreed treatment protocols and procedures. A Physiotherapist assistant is responsible to the Physiotherapist.

ENPHE WG suggestions 3/2014: Physiotherapist Registered physiotherapist (as well as Advanced Physiotherapist) should be first contact autonomous practitioner. Registered Physiotherapists are educated at least on EQF 6 level. Evidence based concept should be explicitly mentioned in the description of registered physiotherapist. Our suggestion for describing the levels is to look at ‘ENPHE Focus Groups’ paper (2012) http://enphe.org/ENPHE/FocusGroups%2820092012%29/EuropeanQualificati onsFramework.aspx Physiotherapy process and Physiotherapy Diagnosis should be explicitly written in the description of registered physiotherapist. It should be mentioned in the description that the registered physiotherapist is also able to supervise students, other professionals, colleagues etc…

Physiotherapist Definition by European Region of the World Confederation for Physiotherapy: A Physiotherapist is an autonomous health care professional who assesses, diagnoses, plans, treats and evaluates clients/patients and is responsible for his/her own actions. A Physiotherapist has their own caseload of clients/patients with complex needs and practices within complex and increasingly unpredictable contexts. A Physiotherapist practices according to professional codes of practice and conduct. A Physiotherapist has completed a minimum of Bachelor of Science Physiotherapy education programme, or equivalent, which is recognised by the state to practice physiotherapy.  

ENPHE WG suggestions 3/2014: Physiotherapy advanced practitioner The description of advanced physiotherapist should be written on EQF 7 level. Our suggestion for describing the level is to look at ‘ENPHE Focus Groups’ paper (2012) http://enphe.org/ENPHE/FocusGroups%2820092012%29/ EuropeanQualificationsFramework.aspx

Advanced Physiotherapist Definition by European Region of the World Confederation for Physiotherapy: An Advanced Physiotherapist is a Physiotherapist who has formally demonstrated an ability to apply advanced competence (knowledge, skills and attitudes) in a defined area, within the scope of practice recognised as physiotherapy. An Advanced Physiotherapist has highly specialised skills to address complex decision-making and manage risk in unpredictable contexts, which demands innovation. An Advanced Physiotherapist has completed an advanced programme or can demonstrate he/she can work at an advanced level, focusing on a specific area of clinical practice, education, research, or professional management among others.

2nd Pillar Skills/Competences/Knowledge & Scope Note To identify the essential skills/competences and knowledge for each occupation listed and provide also a scope note for each skill, competence and knowledge provided.

ENPHE WG suggestions 9/2014 On basis of:

Roles Physiotherapy expert Communicator Collaborator Manager Health care promotor Reflective practitioner Professional

Key competencies / Physiotherapy Expert Physiotherapists are experts in function, movement and mobility using ICF-descriptions (physiotherapy process) Consults with the client to obtain information about his/her health,associated history, previous health interventions, and associated outcomes. Collects assessment data relevant to the client’s needs and physiotherapy practice. Analyzes assessment findings. Establishes and a physiotherapy diagnosis and prognosis. Develops and recommends an physiotherapy intervention strategy. Implements physiotherapy intervention. Evaluates the effectiveness of physiotherapy interventions. Completes physiotherapy services. Documents the whole physiotherapy process

Key competencies / Communicator Physiotherapist use effective communication to develop professional relationships with clients, families, care providers and other stakeholders in a patient centered way. Develops, builds,and maintains rapport, trust, and ethical professional relationships through effective communication. Elicits, analyzes,records, applies, conveys and shares information. Employs effective and appropriate verbal, nonverbal, written, and electronic communications.

Key competencies / Collaborator Physiotherapist work collaboratively and effectively to promote interprofessional practice and achieve optimal client care Establishes and maintains interprofessional relationships, which foster effective client-centered collaboration. Collaborates with others to prevent, manage and solve problems and conflict. Is able to collaborate at intercultural and intersectional level

Key competencies / Manager Physiotherapist manage time, resources and priorities at all levels for individual practice and ensure sustainable physiotherapy practice overall Manages individual physiotherapy practice effectively. Manages and supervises personnel involved in the delivery of physiotherapy services. Participates in activities that contribute to safe and effective physiotherapy practice.

Key competencies / Health care promotor Physiotherapist responsibly use their knowledge and expertise to teatch, guide as well as promote and prevent health and well-beeing of individual clients, communities, populations and profession Works collaboratively to identify, respond to and promote the health needs and concerns of individual clients, populations, and communities. Works for prevention of diseases and movement impairments to optimise health

Key competencies / Reflective practitioner Physiotherapist are commited to ongoing learning for the purpose of improving client outcomes to seeking, creating, applying, disseminating and translating knowledge to physiotherapy practice Uses a reflective approach to physiotherapy practice. Incorporates lifelong learning and experiences into best, evidence based physiotherapy practice. Is willing and capable of critical reflection Is voluntary and selfmotivated in continuous professional development

Key competencies / Professional Physiotherapist are commited to the best interests of clients society to ethical practice, support of professionled regulation, and high personal standards of behaviour Conducts self within legal and ethical health care requirements. Respects the individuality and autonomy of the client. Contributes to the development of the physiotherapy profession. Owes scientific attitude

ENPHE WG suggestions 3/2014 Definition of physiotherapy -1/2 Movement is the main concept in physiotherapy. It should be written clearly in the definition. Movement as a concept should be integral in the concepts function, activity and participation (See ICF, International Classification of Functioning, Disability and Health). We would like the definition to be person centred work and take into account the person’s environment. http://www.who.int/classifications/icf/en/ Person centeredness and goal orientation should be clear in the definition. It should stress on evidence based physiotherapy (see http://www.physio- europe.org/index.php?action=130). We would talk about reasoning skills instead of thinking skills in the coming definition.

Definition of physiotherapy- 2/2 Physiotherapy process and physiotherapy diagnosis should be explicitly written in the definition. Physiotherapy definition should include prevention, health promotion and education as well as physiotherapy in individual, group and society level. Interprofessional and multidisciplinary collaboration should be added into the definition. Physiotherapy as part of rehabilitation would be important to mention in the definition. We would talk about optimizing individuals resources instead of maximizing them. Education, guidance, management and research belong to physiotherapy and should also be mentioned in the definition.

ENPHE - FOCUS GROUP ESCO - Estonia 2014 Mara Kulsa, Latvia Bjorg Gujonsdottir, Iceland Marietta Handgraaf, Germany Erna Rosenlund Meyer, Denmark Maija Kangasperko, Marja-Leena Lähteenmäki, Finland Andre an Haack, Rob Tijssen and Jasmin Pekaric, The Netherlands;