AMERICAN BOARD OF PHYSICAL THERAPY SPECIALITIES: ENHANCING PROFESSIONAL DEVELOPMENT THROUGH CERTIFICATION

The Path to Clinical Excellence

Upon completion of this presentation, you'll be able to:  Discuss the role of specialty certification in advancing your clinical practice and importance to our profession  List the current areas of Areas of Specialty Practice  Provide an overview of the ABPTS certification and maintenance of specialty certification program  Describe the minimum eligibility requirements for certification and recertification for specialization  Describe the process for board certification and maintenance of specialty certification  Describe the role of clinical residencies in the certification process  Identify top motivations to pursue ABPTS Specialty certification

Knowledge Clinical Reasoning Movement Virtues Philosophy of PT Practice Multidimensional Patient-centered Collaborative with Patient- Reflective Practice Caring, Commitment, Respect, Ethical Practice Primary focus; Centered on function: hands-on Jensen GM et al (2000) Phys Ther 80(1):28 – 43.

Clinical Excellence: Potential Pathways  Entry level degree  Years of experience  Continuing education  Post–professional residency  Post-professional degrees  Post-professional certifications  Specialization

 Specialization is a process for physical therapist ◦ Established to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice ◦ Professional education and development ◦ Clinical Expertise in specific areas of practice  Clinical specialization responds to a unique area of patient need Recognition  Assists consumers and the health care community in identifying physical therapists who are specialists in a unique area of practice

Key Elements of Board Certification  Voluntary – you decide  Unrestrictive – does not prohibit others  Coordinated - all APTA recognized are managed by a central mechanism (ABPTS)

 Broad based foundation of physical therapy education and clinical practice Combined with…  Depth and breadth of knowledge in specialty area  Clinical experience in specialty area Knowledge

 Advanced clinical expertise, skills, and abilities unique to a specialized practice area  Expertise in clinical reasoning applied to specialty practice area What does Clinical Specialization Require? Knowledge

Purposes of Board Certification  Promote highest possible level of physical therapy care  Promote ongoing development of science and art underlying each specialty practice

Purposes of Board Certification  Recognize specialists through a reliable and valid method for certification of specialty practitioners  Identify for the consumers and the health care community physical therapists who are specialists in a unique area of practice

Areas of Specialty Practice Recognized through Board Certification 1. Cardiovascular & Pulmonary (CCS) 2. Clinical Electrophysiologic (ECS) 3. Geriatrics (GCS) 4. Orthopaedics (OCS) 5. Pediatrics (PCS) 6. Neurology (NCS) 7. Sports (SCS) 8. Women’s Health (WCS)

Minimum Eligibility Requirements for Clinical Specialization Certification  Current license to practice physical therapy in the United States, the District of Columbia, Puerto Rico, or the Virgin Islands  Practice eligibility requirement is 2,000 hours minimum of direct patient care in the specialty area, 25% (500 hrs) of which must have occurred in the last 3 years.

 Direct patient care ◦ must include activities in each of the elements of patient/client management model applicable to the specialty area and included in the Description of Specialty Practice (DSP)

 Practice elements of patient/client management as defined in the Guide to Physical Therapist Practice  Examination  Evaluation  Diagnosis  Prognosis  Intervention

Minimum Eligibility Requirements  Other requirements specific to the specialty such as: ◦ Emergency care certification (SCS) ◦ ACLS certification (CCS) ◦ Patient reports (ECS) ◦ Case reflections (WCS)

Other Options to Meet the Eligibility Requirements for Specialty Certification  APTA Credentialed Clinical Residency ◦ A planned program of post-professional clinical and didactic education that is designed to advance significantly the physical therapist's preparation as a provider of patient care services in a defined area of clinical practice ◦ Residency Curriculum - designed around the DSP ◦ Specialty councils may allow completion of an APTA- credentialed clinical residency to replace all or a portion of the practice eligibility requirements

 Last step in initial certification process  The Specialty Councils develop the examinations  A rigorous examination that tests the application of advanced knowledge and clinical skills & reasoning  National Board of Medical Examiners  Criterion referenced exam Another exam!!!

Assessment of Specialty Practice & Expertise  Patient Care  Teaching  Administration  Consultation  Communication  Interpretation of Research  As defined by specific DSP Components of the Examination*

 Description of Specialty Practice (DSP) ◦ Describes the advanced knowledge, skills, and abilities for clinical practice in the specialty area ◦ Developed from a valid process for assessing expertise domain and current standards of specialty practice

Description of Specialty Practice (DSP)  Based on data from an extensive practice analysis study ◦ Conducted by Specialty Councils and approved by ABPTS  Document from which the certification exam is developed

 Description of Specialty Practice ◦ Self-Assess strengths and weakness  Develop a plan and strategy, decide on a “path”

 Clinical experience in specialty area  Seek mentor(s) ◦ Board certified specialist  Professional development ◦ Knowledge and skills ◦ Continuing Education ◦ Post professional clinical residency ◦ Post professional education

How to Prepare for the Board Certification Examination?  Continuously review and adapt your “path”  Resources ◦ Resources available from APTA Sections  Recommended textbooks  Reading lists  Advanced Clinical Practice Courses ◦ Study Groups ◦ *ABPTS does not approve or review material or course content*

Specialist Certification Application Process  Application ◦ APTA Department of Post-Professional Certification and Credentialing (  Deadline: ◦ July of the preceding year ◦ To sit for the 2013 exam, applications must be postmarked by: ◦ July 1, 2012 – WCS, CCS, ECS ◦ July 31, 2012 – GCS, NCS, OCS, PCS, SCS  All applications are reviewed

Specialty Certification Fees Certification is valid for ten years with no maintenance fees APTA memberNon-member Applicant Review $500 $845 Examination $800$1,525 Total $1,300$2,370

When is the certification exam administered?  Exams are offered once per year for a two-week exam period  Candidates may sit for the exam between February-March ● 2012 – February 25–March 10, 2012 ● 2013 – March 2-16, 2013

 Computerized examinations, administered at Prometric, Inc. testing centers  FORMAT: Multiple choice questions including case scenarios, videos, pictures

Recognition of Certified Clinical Specialists  Recognized at Opening Ceremony of APTA Combined Sections Meeting (CSM)  Recognized by sections and chapters  Inclusion in online Directory of Certified Specialists  Only individuals who have successfully completed the ABPTS certification process may use the term “Board-Certified Clinical Specialist”

Board-Certified Clinical Specialists Who Are They?

Total Numbers of Certified Specialists by Year Total ,937 individuals

Certified Specialists by Area Cardiovascular & PulmonaryCCS176 Clinical ElectrophysiologicECS156 GeriatricsGCS1422 NeurologyNCS1102 OrthopaedicsOCS7655 PediatricsPCS1178 SportsSCS1094 Women’s HealthWCS154 Total in 2012 = 12,937

Age - Certified Clinical Specialists

Gender - Certified Clinical Specialists

Top 3 Work Settings: Certified Clinical Specialists  Private PT Office  Health system or hospital-based outpatient facility or clinic  Academic Institution

Top 4 Positions held by Certified Clinical Specialists  Supervisor/Director of PT  Staff or Senior PT  Sole Owner/Partner PT Practice  Academic Faculty

 Proof of expertise in specialty area  Personal challenge or achievement  Professional career goal  Earn a credential that reflects advanced practice to patients, physicians, & payers Source: Survey of certified specialists (2007)

What is the impact of the board certification process on the specialists?  Specialists report that board certification has had a positive impact on... ◦ Sense of personal achievement ◦ Self-confidence & professional growth ◦ Patient care, including better outcomes ◦ Increased credibility with patients & referral sources ◦ Recognition in clinical, academic and community settings Sources: Survey of certified specialists (2007)

 Opened doors for professional growth ◦ Consultations ◦ Invited Presentations ◦ New job opportunities ◦ Leadership & service ◦ Teaching opportunities ◦ Research collaboration ◦ Networking

 SACE – exam item writers  CCE – exam item editors  SME – exam standard setting and specialty practice analysis  Specialty Councils – over see exam development process, maintenance of certification, specialty practice analysis  ABPTS – board that oversees all specialties

Do employers support the certification process?  Employer Support of ABPTS Certification ◦ 53% of employers pay at least some of the costs associated with obtaining clinical specialization. ◦ 43% of employers indicate that they give priority in hiring to job applicants who are board certified.  Value expertise of specialist ◦ High patient care standards ◦ Serve as mentors for others ◦ Provide team leadership

Value of ABPTS Certification to Certified Specialists  79% report that certification is a indicator of clinical competence  90% report that certification is an indicator of depth and breadth of knowledge in an area of specialty practice  High rate (68%) of specialists choose to recertify Source: Survey of certified specialists (2007)

 Yes!!  What is the process? ◦ Currency of clinical practice and expertise in the specialty ◦ Currency of advanced knowledge and skills in the specialty ◦ Demonstration of professional development

Current Renewal of Specialty Certification Process  Initial Certification is valid for 10 years.  To maintain the credential, a specialist must meet the requirements of before his or her certificate expires  ABPTS has developed process for assessing currency and recertification standards  Ensures to the public the validity of advanced skills and expertise of the specialist

Purpose of Maintenance of Specialty Certification  To verify current competence as an advanced practitioner in the specialty area  Evaluation of professional development and clinical experience  To encourage ongoing education and professional growth

Maintenance of Specialty Certification Requirements  Current requirements ◦ Direct patient care hours in specialty (2000 hr) AND ◦ Professional Development Portfolio (PDP) OR ◦ Current written examination OR ◦ Graduation from a credentialed APTA clinical residency  Future Model - MOSC

 Documentation of professional development activities and advanced clinical practice related to specialty practice since initial certification  Examples: √ Continuing Education courses √ Clinical Supervision √ College/University courses √ Teaching continuing education or college courses √ Research presentations (platform or poster) √ Presentations to professional groups, classes, or in-services √ Presentations to community or client-based groups √ Author or editor of book chapters, journal articles, grant proposals √ Committee membership in professional organization √ Consultation

Maintenance of Specialist Certification Model (MOSC) Recertification Model MOSC Model

MOSC Licensure Professional Standing Practice Performance Clinical Care & Reasoning Cognitive Expertise Lifelong Learning & Professional Development MOSC #1 #2 #3 # Certification Cycle (10 yrs) years

 Professionals with clinical expertise  Advancing our profession  Making a difference in lives of our patients  Consider setting your career path toward clinical excellence and Specialization CCS, ECS, GCS, NCS, OCS, PCS, SCS, WCS

For more information contact APTA Department of Post-Professional Certification and Credentialing 1111 North Fairfax Street Alexandria, VA / , ext

Literature about Specialization or Specialists  Stepp DD: Focus your career: Specialist Certification. Perspectives for New Professionals of the American Physical Therapy Association. PT InMotion. May, 2010  Bryan J, Blake A. How do other health care professionals view specialist certification? PT Magazine. 2004;12(9):  Bryan J, Gill-Body K, Blake A. How employers view specialist certification. PT Magazine. 2003;11(1):  Thompson M. The role of higher education in the career paths of board-certified clinical specialists in geriatric physical therapy: implications for professional and post professional education. J Phys Ther Educ. 2001;15(2):10-16.

Literature about Specialization or Specialists  Hart DL, Dobrzykowski EZ. Influence of orthopaedic clinical specialist certification on clinical outcomes J Orthop Sports Phys Ther. 2000;30(4):  Milidonis MK, Godges JJ, Jensen GM. Nature of clinical practice for specialists in orthopaedic physical therapy. J Orthop Sports Phys Ther. 1999;29(4):  Ellison J, Becker M, Nelson AJ. Attitudes of physical therapists who possess sports specialist certification. J Orthop Sports Phys Ther. 1997;25(6):

Literature about Specialization or Specialists  Smith LC. The decision to specialize. 2001;9(6):52-59  Edmonds MM. What if? PT Magazine. 1999;7(4):44-49  Wynn KE. Why recertify? PT Magazine. 1996;4(11):68-70  Williams DO. Answering the bell: PTs & school sports. PT Magazine. 1996;4(12):36-39  Woods EN. What’s so special about specialist certification? PT Magazine. 1994;2(2):46-51  Ferrier MPB. One stage in professional evolution. Clinical Management. 1991;11(2):66-70