1. Promoting Regulatory Excellence Self Assessment & Physiotherapy: the Ontario Model Jan Robinson, Registrar & CEO, College of Physiotherapists of Ontario

2. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 2 Presentation Outline  regulatory context  program history  current program  learnings  where to next

3. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 3 Regulatory Context  Self regulatory model  Quality assurance is mandated  ≈7,000 registered physiotherapists  40/60 split public/private care models

4. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 4 Quality Management Assure quality practice Promote continuing competence

5. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 5 ➔ not a science ➔ start somewhere

6. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 6 Time when continuing professional development (CPD) hours were primary example

7. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 7 Initial program  Learning log  College Review Program (5 components)  Practice Review  Rheumatoid Arthritis  Lower Extremity Function  Disabilities of Arm, Shoulder & Hand

8. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 8 2001 Program Challenges  not used  fairness?  subjectivity  onerous  research findings vs. influence on competence

9. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 9 2002 – 2004 extensive evaluation and program development

10. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 10 Current Quality Management Program  evidence based  confidential  evolves under continu0us evaluation  shared accountability

11. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 11

12. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 12

13. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 13 Practice Reflection Goal : To promote registrant self-assessment, professional accountability and practice reflection to continuously improve the quality of professional performance.

14. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 14 Two mandatory elements  portfolio  PISA (Professional Issues Self-Assessment)

15. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 15 Portfolio  provides evidence of ongoing learning  over fourteen (14) web based tools to customize

16. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 16 PISA (Professional Issues Self-Assessment)  20 questions  change annually  interactive, online

17. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 17

18. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 18

19. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 19 Practice Assessment Goal: To allow registrants to demonstrate competency while providing a positive learning experience.

20. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 20 Practice Assessment Tool Domains assessed:  Practice Issues  Billing  Professional Portfolio Review  Record Keeping  Chart Stimulated Review

21. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 21 Key success factors  tools reliable & valid  assessor calibration  procedural fairness

22. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 22 Committee Review  blinded  physiotherapist input  all other relevant College data provided

23. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 23 Outcomes 1.Satisfactory no further action 2.Self directed Practice Enhancement 3.Committee Directed Practice Enhancement (two options)

24. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 24 Resources for support  focus groups  video webcasts  teleconferences  online tutorials  interactive tools  electronic links to resources

25. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 25 Practice Enhancement Goal: To assist registrants to meet competence standards  PTs in clinical practice identified as having gaps in knowledge, judgment, skills and/or abilities.

26. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 26 Post Visit Questionnaire Data  78% response rate 2008/2009  66% response rate 2007/2008  71% response rate 2006/2007

27. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 27 How confident are you that on the whole the Practice Assessment reflects your practice?

28. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 28 How relevant were the components of the assessment to your practice? Ratings provided as a percentage of those who responded either 4 (relevant) or 5 (very relevant).

29. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 29 Did your participation in this process assist you in identifying any learning needs?

30. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 30 Self identified areas for ongoing learning

31. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 31 How well did the Assessment meet the intended goal?

32. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 32 “I don't need this process to demonstrate my competency or ongoing learning. But I imagine some PTs do, and the process has to be standardized for all. However, I doubt other registered health practitioners … jump through all these hoops!!!!”

33. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 33 “Definitely a positive learning experience. For those of us who actually care that we are doing a good job, it provides a time to reflect and critically evaluate all that we do.”

34. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 34

35. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 35 Continuous Improvement of the Program currently under review against evidence in area of reflection, more specifically related to ➔ practice drift ➔ self assessment ➔ Feedback

36. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 36 Under Consideration  language shift – continuous improvement; shared learning  guided reflection structured in all 3 program components  multisource data input – voluntary & mandatory  registrant skill building on effective use of feedback  building communities of practice

37. CLEAR 2009 Annual Conference September 10-12 Denver, Colorado 37 Questions….