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Clinical Examination

The successful completion of a clinical competency examination approved by Council is a registration requirement established in Section 3(c) of the Physical Therapists Profession Regulation (PTPR). As long as this requirement exists in the legislation there will continue to be a clinical examination.

Physiotherapy Alberta is aware of the efforts of several Canadian physiotherapy organizations to review examination best practices and registration requirements. However, until that work is complete, recommendations known, and amendments accordingly made to the Physical Therapists Profession Regulation, individuals seeking admittance to the General Register will be required to complete a clinical competency examination approved by Council. As we have highlighted in prior messages, the process to conduct these reviews, review recommendations and complete any required policy or legislative amendments is expected to take an extended period.

In the interim, the College must fulfill its mandate and responsibilities to the public, ensuring all individuals admitted to the General Register are competent and qualified to provide physiotherapy services to Albertans.

Council has approved two further administrations of the temporary alternate examination, the Post-Graduate Clinical Evaluation, offered by the Faculty of Rehabilitation Medicine Continuing Professional Education Unit of the University of Alberta (the CPE Unit). Examinations will be administered on:

  • October 15 and 16, 2022 and (Please note that incorrect examination dates were originally posted. They have since been corrected. We apologize for the inconvenience.)
  • February 25 and 26, 2023

No other examination administrations are currently scheduled.

The Post-Graduate Clinical Evaluation will be an in-person, hands-on clinical examination, held at the University of Alberta HSERC facility.

Candidates will register for one examination administration (October or February) and will attend for examination on one of the two dates listed for that administration. For example, if a candidate chooses to register for the October examination administration, they must be available on both October 15 and October 16. Candidates will be assigned their examination date by the CPE Unit, after examination registration closes.

Successful completion of the examination will allow candidates to move from the Provisional Register to the General Register of Physiotherapy Alberta.

To be eligible to participate in either the October 2022 or February 2023 alternate examinations, a candidate:

  • Was registered on Physiotherapy Alberta’s Provisional Register on March 31, 2022. This includes:
    • Individuals with no prior unsuccessful attempt at a clinical competency examination approved by Council to fulfill the registration requirement established by Section 3(c) of the PTPR.

AND

  • Individuals with one previous unsuccessful attempt at a clinical competency examination approved by Council to fulfill the registration requirement established by Section 3(c) of the PTPR.

OR 

  • Is a former regulated member of Physiotherapy Alberta whose registration was cancelled after January 1, 2017, in accordance with Section 7(3) or 7(4) of the PTPR AND has not exhausted eligibility in the Clinical Component of the Physiotherapy Competency Examination administered by the Canadian Alliance of Physiotherapy Regulators.

These eligibility criteria result in three categories of examination candidates.

Group 1 – Physiotherapist Interns Admitted to the Provisional Register Before April 30, 2021

Physiotherapist Interns who were admitted to the Provisional Register prior to April 30, 2021, and whose practice permits have already been extended due to examination disruptions,

AND

Physiotherapist Interns whose practice permits will need to be extended to allow them to continue to practice until April 30, 2023, are required to register for and complete either the October or February examination administration.

Practice permits for this group will not be extended past April 30, 2023. 

Group 2 – Physiotherapist Interns Admitted to the Provisional Register After April 30, 2021

Section 7(4) of the Physical Therapists Profession Regulation states:

A registration on the provisional register is valid for a period not to exceed 2 years.

As already stated, the clinical examination requirement will remain in place, in accordance with Physiotherapy Alberta’s governing legislation, for the foreseeable future.

Individuals admitted to the Provisional Register after April 30, 2021, are advised that they are only eligible for a practice permit for two years after the date they were admitted to the Provisional Register. With the availability of two examination administrations, Physiotherapy Alberta will no longer extend practice permits for individuals who have been on the Provisional Register for 2 years, except in accordance with Section 7(5) of the Physical Therapists Profession Regulation. Examination availability alone is not considered a valid extenuating circumstance for this group.

Over the past year, Physiotherapy Alberta has been successful in its efforts to address the legislated clinical examination requirements of Physiotherapist Interns by contracting the CPE Unit to administer the Post-Graduate Clinical Evaluation. We remain committed to addressing the requirements that exist in our governing legislation. However, the fact remains that there are no examinations currently scheduled beyond February 2023.

Candidates in this group are strongly encouraged to register for and complete one of the upcoming scheduled examination administrations. Individuals who choose not to do so must be prepared to accept the uncertainty that arises from their choice.   

Group 3 – Individuals Whose Practice Permits Were Cancelled After January 1, 2017

Individuals previously registered on the Provisional Register of Physiotherapy Alberta, and whose registration was cancelled after January 1, 2017, in accordance with Section 7(3) or 7(4) of the Physical Therapists Profession Regulation of Alberta are eligible to register for the Post-Graduate Clinical Examination provided they have NOT exhausted their eligibility at the Clinical Component of the PCE administered by the Canadian Alliance of Physiotherapy Regulators.

Individuals belonging to this group are no longer regulated members, therefore Physiotherapy Alberta does not have accurate, up to date contact information for these individuals.

Individuals belonging to this group who wish to receive the examination registration link must complete the form at this link. Only individuals who meet the criteria should complete the form. Physiotherapy Alberta will be verifying eligibility based on its registration records.

NOTE: As the administrator of the clinical examination, the CPE Unit has the discretion to implement any measures deemed necessary to protect the health and safety of examination candidates, examiners, standardized patients and university staff. Examination candidates are required to comply with health and safety measures established by the CPE Unit as a condition of participating in the examination.

We expect to begin accepting registrations for the Post-Graduate Clinical Evaluation for both the October and February examination administrations in mid-June.

Registrations for both examination administrations will close on July 29, 2022.

All eligible individuals in Groups 1 and 2 will receive direct communication from the College when examination registration is open. 

Eligible individuals in Group 3 will only receive direct communication from the College notifying them when the examination registration is open IF they have provided their contact information using the form in the link above.

Examination registrations will be accepted on a first come first served basis. 

There are enough examination spots available to accommodate all eligible candidates. However, candidates will need to register for the examination early should they wish to ensure that they are able to participate in their preferred examination administration (October 2022 or February 2023).   

Candidates may only register for one of the clinical examinations. Physiotherapy Alberta is not maintaining a “waiting list.”

All eligible candidates currently on the Provisional Register will receive direct communication from the College to advise them of their examination eligibility and exam registration considerations.  Individuals are advised to review the direct communication and FAQs posted on Physiotherapy Alberta’s website in full BEFORE contacting the College with questions regarding their eligibility.

When are the next clinical examination dates?

There are two examination administrations scheduled:

Fall 2022 – October 15th and 16th, 2022*

Winter 2023 – February 25th and 26th, 2023

Candidates will register for one examination administration (October or February) and will attend for examination on one of the two dates listed for that administration.

For example, if a candidate chooses to register for the October examination administration, they must be available on both October 15th and October 16th. Candidates will be assigned their examination date by the CPE Unit, after examination registration closes.

No other examination administrations are currently scheduled.

*Disclaimer: Please note that incorrect examination dates were originally posted. They have since been corrected to October 15-16, 2022. We apologize for the inconvenience. (Updated at 12:30 April 13, 2022)

Who is eligible?

Eligible candidates were contacted directly by Physiotherapy Alberta.

To be eligible to participate in either the October 2022 or February 2023 alternate examinations, a candidate:

  • Was registered on Physiotherapy Alberta’s Provisional Register on March 31, 2022. This includes
    • Individuals with no prior unsuccessful attempt at a clinical competency examination approved by Council to fulfill the registration requirement established by Section 3(c) of the PTPR.

AND

  • Individuals with one previous unsuccessful attempt at a clinical competency examination approved by Council to fulfill the registration requirement established by Section 3(c) of the PTPR.

OR 

  • Is a former regulated member of Physiotherapy Alberta whose registration was cancelled after January 1, 2017, in accordance with Section 7(3) or 7(4) of the PTPR AND has not exhausted eligibility in the Clinical Component of the Physiotherapy Competency Examination administered by the Canadian Alliance of Physiotherapy Regulators.
Other examination details

The Post-Graduate Clinical Evaluation will be an in-person, hands-on clinical examination, held at the University of Alberta HSERC facility.

Candidates will register for one examination administration (October or February) and will attend for examination on one of the two dates listed for that administration. Candidates are advised that they will be assigned an examination date by the CPE Unit after registration closes. If a candidate chooses the October administration, they must be available both October 15th and 16th. If they choose the February examination administration, they must be available both February 25th and 26th.

Candidates are responsible for all travel and accommodation arrangements and costs.

When does registration open?

We expect to begin accepting registrations for the Post-Graduate Clinical Evaluation for both the October and February examination administrations in mid-June.

Why don’t you have a confirmed date for opening examination registrations?

With past examination administrations, Physiotherapy Alberta has managed the number of eligible candidates and made sure that there were enough examination spots for everyone eligible to participate. This is the first time that we have opened two examination administrations at the same time and have a larger group of eligible candidates. While there are enough spots for everyone eligible to take the exam in total, no single administration can accommodate everyone, and we know that people will have their own preferences for which examination administration they wish to participate in.

To accommodate all these variables, Physiotherapy Alberta is building an examination registration system that will enable candidates to choose their preferred examination administration and which will close registration when an examination administration reaches its capacity. Our intent is to make registering for the examination seamless.

The College will endeavor to provide advance notice of when examination registrations will open closer to the date, once the registration system has been built and tested, however providing advanced notice may not be possible.

Examination candidates are advised to monitor the College website and their email closely in early June.

Other registration details:

Registrations for both examination administrations will close on July 29, 2022.

All eligible individuals registered on Physiotherapy Alberta’s Provisional Register on March 31, 2022.

will receive direct communication from the College when the examination registration is open. 

Eligible individuals who are former regulated members of Physiotherapy Alberta whose registration was cancelled after January 1, 2017, and who have not exhausted their eligibility in the Clinical Component of the PCE administered by the CAPR will only receive direct communication from the College notifying them when the examination registration is open if they have provided their contact information using the form provided.

Are there enough examination spots for all eligible candidates?

There are enough examination spots available to accommodate all eligible candidates over the course of the two examination administrations. Examination registrations will be accepted on a first come first served basis. 

Candidates will need to register for the examination early should they wish to ensure that they are able to participate in their preferred examination administration (October 2022 or February 2023).   

Note: As with other online portals, there can be challenges if all eligible candidates attempt to register for the examination at the same time. There are enough examination spaces to accommodate all eligible candidates. If you have no preference for examination administration date (October versus February), please consider giving others with pre-existing commitments or strong preferences the opportunity to register first.

Can I register for more than one examination?

Candidates may only register for one of the clinical examinations. Physiotherapy Alberta is not maintaining a “waiting list.”

While there are enough examination spots available to accommodate all eligible candidates there are not enough spaces for candidates to hold an examination spot in reserve in case they fail an exam attempt in October.

What if I take the October examination and fail? Will I be able to sign up for the February examination?

Depending on examination registrations and uptake for each examination administration, there may be some spots available in the February examination for individuals who are unsuccessful at an attempt at the October examination administration.

If this should happen, Physiotherapy Alberta will determine which candidates fill these spaces based on the date of their initial registration and date of practice permit expiration. 

Should a candidate be unsuccessful at their attempt at the October examination administration a spot in the February examination is not guaranteed.

Is the examination reliable and valid?

As we have said previously, universities are in the business of educating and assessing learning. The CPE Unit has offered an OSCE-style examination for many years. The OSCE developed by the CPE Unit was specifically developed to approximate the PCE for internationally educated physiotherapists enrolled in the University of Alberta’s Bridging to Canadian Physical Therapy Practice Graduate Certificate, to aid their preparation for the PCE and for entry into Canadian physiotherapy practice.

The CPE Unit has now administered three Post-Graduate Clinical Evaluation on behalf of Physiotherapy Alberta. With the data available from these examination administrations, Physiotherapy Alberta has contracted with independent psychometricians to evaluate the examination’s performance and to provide recommendations for future examinations. We anticipate that the results of this evaluation will be known prior to the October examination administration and will be used to further refine the Post-Graduate Clinical Evaluation.

With all the challenges that the pandemic has posed, how can candidates be assured that this examination will go forward?

The effects of the COVID-19 pandemic continue to be a consideration for the administration of the Post-Graduate Clinical Evaluation.

Key enablers of the examination include:  

  • The scale and scope of this examination. This is an Alberta-based examination. This removes the logistical challenges related to providing an examination simultaneously in multiple jurisdictions, addressing different provincial restrictions and public health orders, and the need for inter-provincial travel of some candidates.
  • The Faculty of Rehabilitation Medicine has robust policies and procedures in place to enable in-person instruction and examination. These policies and procedures are based upon Physiotherapy Alberta’s Guidance for Resuming Physiotherapy Practice During a Pandemic, CMOH Orders and Alberta Health’s COVID-19 Guidance for Post-Secondary Institutions.

However, as the January 2022 examination postponement has taught us, there are risks to proceeding with the Post-Graduate Clinical Evaluation, and examinations may need to be postponed if the COVID-19 situation worsens or public health restrictions and requirements necessitate such a change.

As the administrator of the clinical examination, the CPE Unit has the discretion to implement any measures deemed necessary to protect the health and safety of examination candidates, examiners, standardized patients and university staff. Examination candidates are required to comply with health and safety measures established by the CPE Unit as a condition of participating in the examination.

What happens if the examination were to be cancelled due to COVID-19?

As with the January examination, it is possible that the examinations may be postponed if the COVID-19 pandemic worsens, to protect the health and safety of candidates, examiners and standardized patients and to comply with university rules or provincial health measures.

If the examination was cancelled, candidates would receive a full refund of their exam fees and Physiotherapy Alberta would develop a plan to address the needs of the candidates affected.

Physiotherapy Alberta will continue to comply with all public health restrictions and any rules established by the University of Alberta.   

Why did Physiotherapy Alberta choose the eligibility criteria identified?

Since they began considering options for an alternative clinical competency examination, Council’s priority has been to identify an objective, valid and reliable assessment tool for an alternative examination process to enable individuals to be admitted to the General Register.

With multiple administrations of the Post-Graduate Clinical Evaluation, we now have sufficient data to conduct a psychometric review of the examination and implement any changes warranted by this review. This has provided Council with increased confidence in the alternate examination process and policies in place.

Physiotherapy Alberta is reasonably assured that a balance has been struck between the public interest and the need to allow competent, duly qualified individuals to enter the General Register.

Why is it mandatory that some candidates register for and complete the October 2022 or February 2023 Post-Graduate Clinical Evaluation administrations?

Section 7(4) of the Physical Therapists Profession Regulation states

A registration on the provisional register is valid for a period not to exceed 2 years.

The two-year time limit has been in effect since the Physical Therapists Profession Regulation came into effect, many years ago and remains in effect today. All individuals on the Provisional Register are subject to this rule.

However, in response to the ongoing examination disruptions, Physiotherapy Alberta extended Provisional Register practice permits until September 30, 2022, for those individuals who had exceeded the 2-year time limit due to clinical examination disruptions, as examination unavailability was deemed a valid extenuating circumstance. With the announcement of two upcoming examinations, those individuals who have exceeded the 2-year time limit have options for when they may complete the examination.

Physiotherapy Alberta will extend Provisional Registrations until April 30, 2023, for examination candidates in this group who register for the one of the upcoming examinations.

No further extensions will be offered to this group.

Individuals on the Provisional Register whose practice permits are set to expire between October 1, 2022, and April 30, 2023, are also eligible to remain on the Provisional Register if they register for one of the upcoming examination administrations.

Individuals in these two groups are required to register for and complete either the October 2022 or February 2023 examination administration.

Individuals admitted to the Provisional Register after April 30, 2021, are advised that they are only eligible for a practice permit for two years after the date they were admitted to the Provisional Register. Candidates in this group are strongly encouraged to register for and complete one of the upcoming scheduled examination administrations.

What measures will be in place to keep candidates participating in the alternate examination safe from COVID-19?

At this time (April 2022), it is unclear which, if any public health measures will be in effect at the time of the Post-Graduate Clinical Evaluation.

As the administrator of the clinical examination, the CPE Unit has the discretion to implement any measures deemed necessary to protect the health and safety of examination candidates, examiners, standardized patients and university staff.

Examination candidates are required to comply with health and safety measures established by the CPE Unit and the University of Alberta as a condition of participating in the examination.

Physiotherapy Alberta will endeavor to communicate any requirements to candidates in a timely manner.

Do I need to be vaccinated to participate in the Post-Graduate Clinical Evaluation?

At present (April 2022), the University of Alberta’s vaccination requirement has been discontinued, meaning that if the examination were to be held today, candidates would not be required to be vaccinated against COVID-19 in order to gain access to the examination facility and participate in the Post-Graduate Clinical Examination.

As already stated, as the administrator of the clinical examination, the CPE Unit has the discretion to implement any measures deemed necessary to protect the health and safety of examination candidates, examiners, standardized patients and university staff. Examination candidates are required to comply with health and safety measures established by the CPE Unit and the University of Alberta as a condition of participating in the examination.

Physiotherapy Alberta will communicate any requirements to access the exam facility and participate in the exam should changes occur.

Physiotherapy Alberta continues to strongly encourage all physiotherapists to be vaccinated against COVID-19 and other communicable diseases.

What happens if I fail the Post-Graduate Clinical Evaluation?

If the Post-Graduate Clinical Evaluation was your first failed attempt at a clinical examination, then failing does not impact your current registration on the Provisional Register and practice permit.  You may continue to practice as a Physiotherapist Intern in Alberta as long as you hold a valid practice permit and do not exceed the 2-year time limit. 

However, the failed attempt at the Post-Graduate Clinical Evaluation will be counted as one examination attempt for the purpose of administering Section 7(3) of the Physical Therapists Profession Regulation, which states “If an applicant fails the examination referred to in section 3(c) a second time, the applicant’s registration is cancelled.”

Candidates with two unsuccessful attempts at completing a clinical examination (whether PCE or the Post-Graduate Clinical Evaluation) are ineligible to remain on the Provisional Register while completing their next attempt(s) at a clinical competence examination approved by Council.

The Health Professions Act does allow for an extension on the Provisional Register after two failed exam attempts but only if the Registrar is of the opinion that extenuating circumstances exist. An example of an extenuating circumstance would be medically documented illness. Examples of circumstances not considered extenuating include financial stress, generalized exam anxiety, decreased ability to prepare/study for the exam.

How will Physiotherapy Alberta set the fee for the examination?

Physiotherapy Alberta is committed to offering the Post-Graduate Clinical Evaluation on a cost-recovery basis. We are not seeking to generate a profit from the administration of the alternate examination. The fee reflects the costs of administering the examination.

The fee for the examination will be posted on Physiotherapy Alberta’s website with the information regarding how to register for the examination.

Is the Post-Graduate Clinical Evaluation a long-term solution?

Council has committed to reviewing Physiotherapy Alberta’s registration requirements as part of the current Strategic Plan, and this work is in its earliest stages. The ultimate results of the review are unknown.

The outcome of the review may indicate the need for changes to the Physical Therapists Profession Regulation pertaining to registration requirements. Physiotherapy Alberta will not request a change to the legislation until the review of registration requirements is complete, and then, only following Council’s careful discussion of any recommendations arising from the review that would require such changes.

Registrants are reminded that changing the Physical Therapists Profession Regulation is a long-term process. As such Physiotherapy Alberta will continue to work within the existing legislation to register physiotherapists in Alberta.    

Why doesn’t Physiotherapy Alberta put a stop to OSCE examinations entirely?   

Physiotherapy Alberta is aware of the efforts of several Canadian physiotherapy organizations and members of the profession to review examination best practices and registration requirements. However, until that work is complete, recommendations known, and amendments accordingly made to the Physical Therapists Profession Regulation, individuals seeking admittance to the General Register will be required to complete a clinical competency examination approved by Council.

As we have already stated, the process to conduct these reviews, review recommendations and complete any required policy or legislative amendments is expected to take an extended period.

In the interim, the College must fulfill its mandate and responsibilities to the public, ensuring all individuals admitted to the General Register are competent and qualified to provide physiotherapy services to Albertans. 

While many parties continue to advocate on behalf of physiotherapy students and Physiotherapist Interns, this has limited influence on legislated registration requirements.  These requirements are in place with the public interest as the ultimate consideration, not the professional’s interest.

Why isn’t Physiotherapy Alberta advocating on behalf of physiotherapists?

We are glad that you noticed the difference between the messaging of Physiotherapy Alberta and that of the Canadian Physiotherapy Association (CPA)!

Physiotherapy Alberta’s government issued mandate is to serve the public interest. Physiotherapy regulators from across the country are charged with the same responsibility. The CPA is charged with representing the interests of the profession, including those of PCE candidates.  

For more information on Physiotherapy Alberta's history, role, and our primary mandate, listen to College Conversation's Podcast Episode 23.

What would happen if I just didn’t bother to finish the examination process?

As already mentioned, under normal circumstances physiotherapist interns have a two-year time window in which to successfully complete the examination. After this time expires, they are no longer eligible to remain on the Provisional Register.

Practicing without a license is an offence under the Health Professions Act which carries significant fines and the risk of imprisonment.

Physiotherapy Alberta has always fielded questions regarding physiotherapist interns and the Provisional Register, with questions relating to everything from the requirements for becoming a Physiotherapist Intern to the ins and outs of supervision and the performance of restricted activities. In the latter half of 2020 the number of questions received increased, presumably due to the delays to the completion of the clinical component of the Physiotherapy Competency Examination due to the ongoing impact of COVID-19.

This episode provides answers to the most common questions Physiotherapy Alberta receives about this group of Registrants. We discuss the Swiss Cheese Model of safety, and Physiotherapy Alberta’s perspective that the Physiotherapy Competency Examination is one layer within a system designed to make sure that only competent and qualified physiotherapists are providing physiotherapy services.

As time spent in supervised practice passes, most physiotherapist interns will progress in terms of the nature and intensity of supervision that they require to practice safely, but what exactly does that mean? We discuss the differences between direct and indirect supervision and the instances where direct supervision is mandatory at the 6-minute mark of the episode.

We close with a discussion of restricted activities and the rules related to their practice by physiotherapist interns.

Click here to listen.

Page updated: 25/04/2022