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College-Selected Activity

Being a physiotherapist requires a lifelong commitment to learning and professional growth. As a professional, you are required to stay up to date on professional practice standards, advances, changes and trends in patient treatment and care. Lifelong learning and a “do better” mindset are key to your commitment to practicing competently. The activities undertaken during your career deepen your professional skillset, connection to the profession, and the quality of care you provide.

Each year, physiotherapists on the General Register take part in two Continuing Competence Program activities before renewing their practice permit. One activity is a Self-Selected Activity and the other is a College-Selected Activity. Both support physiotherapists to learn and grow.

The College of Physiotherapists of Alberta is responsible for supporting physiotherapists to deliver safe, competent, ethical care. Part of this includes raising the profession’s collective awareness of issues, professional practice standards, ethical conduct and legislation governing physiotherapist's practice.

A College-Selected Activity is an activity that the College of Physiotherapists of Alberta selects and requires members to complete. Mandatory participation ensures a profession-wide collective and common understanding of a topic. Topics are based on profession and public interest issues, practice standards and other rules governing physiotherapist practice. The topic will vary from year-to-year. The activity may be completed in the form of educational modules, self-assessments, knowledge tests, etc.

You must complete the College-Selected Activity before you renew your practice permit.  

The College of Physiotherapists of Alberta will let you know when the College-Selected Activity is available for completion, typically in late spring, and will provide instructions for completion.

Physiotherapists currently on the General Register must complete the 2023 College-Selected Activity.

Physiotherapists will not be able to renew their practice permit in August/September 2023 without first completing the 2023 College-Selected Activity. When they renew, physiotherapists must declare that they have met the College-Selected Activity learning objectives.

Physiotherapists who are currently registered and planning to take a leave of absence must also complete the 2023 College-Selected Activity during the current registration year (before October 1, 2023). This means you must complete the 2023 College-Selected Activity before you cancel your registration if you plan to practice in Alberta in the future.

The topic of restricted activities was selected as the 2023 College-Selected Activity due to the broad application of these activities in physiotherapy practice and recent changes to the legislation governing the performance of these activities.

Restricted activities are identified as such in legislation due to the risks they pose to the public if performed by individuals lacking the competence (knowledge, skills, and attitudes) necessary to perform the activities safely.

Although not all physiotherapists perform restricted activities in their daily practice, all physiotherapists must be cognizant of the legislation that governs practice and must be thoughtful about how that legislation applies to their daily work.

Guiding Principles
  • Physiotherapists are knowledgeable of and adhere to the legislation and regulatory requirements that govern practice in Alberta.
  • Physiotherapists perform restricted activities that they are competent in, within the context of providing a physiotherapy service, in accordance with the Standards of Practice and when those restricted activities are appropriate for the patient and the patient’s condition.
  • Physiotherapists mitigate the risk of harm arising from all aspects of their practice, including the performance of restricted activities, by proactively developing patient safety incident management plans relevant to their practice settings, patient populations served, and services provided.
DO

Review the following practice resources:

Mandatory

Additional Resources

These additional resources are provided for use by those who wish to dive deeper into this topic.

LEARN

Learning objectives

After completing the 2023 College-Selected Activity, you:

  • Understand the governing legislation and recent legislative changes pertaining to restricted activities relevant to the physiotherapy profession in Alberta.
  • Can describe the restricted activities relevant to the physiotherapy profession and related competence requirements, including:
    • Those restricted activities that require additional individual authorization from the Registrar.
    • Those activities that are authorized to all registrants.
    • Those activities that must not be performed by a registrant on the Provisional Register.
  • Can explain the supervision requirements relevant to restricted activities including:
    • Describing what is meant by direct supervision.
    • The instances where direct supervision of a restricted activity is required.
  • Know the key elements of a critical event plan and have developed or reviewed critical event plans specific to your practice setting.
GROW

After reviewing the resources, take a few minutes to consider, either on your own or with your colleagues, how this information informs your behaviours and your practice.

We have given you these guiding questions to help you to reflect:

Legislation

  • Do I understand what activities are restricted, which are authorized to the physiotherapy profession, which require additional individual physiotherapist authorization and why?

Competence

  • Which restricted activities am I competent to perform?
  • How do I know I am competent in these activities?
  • How have I maintained my skills?
  • How does my practice differ from what I was taught as I was learning to perform the restricted activity? What risks does this practice drift* pose to my patients?

Supervision

  • Do I understand when direct supervision is required for a physiotherapist on the General Register who is performing a restricted activity?
  • Do I understand when direct supervision is required for a physiotherapist on the Provisional Register who is performing a restricted activity?
  • What are the challenges, barriers, and enablers to providing direct supervision of a restricted activity in my practice setting?
  • What strategies can I put in place to enable direct supervision?

Patient Safety Incident Management Plans

  • What are the most likely patient safety incidents to occur within my practice setting? (These may relate to restricted activities or to general physiotherapy services.)
  • What resources and employer-developed plans are in place to manage patient safety incidents?
  • When was the last time I completed “practice drills” of the patient safety incident management plans relevant to the activities I perform?
  • What would I do if a patient safety incident occurred?
  • Are there activities that I perform, for which patient safety incident management plans are lacking or require revision to reflect the current realities of the practice setting?

*” Practice drift” or simply “drift” “is the accumulation of unintentional, typically minor, human errors and/or procedural violations.”1 The term refers to negative practice variation, or deviation away from accepted norms and best practices, in this example, as relate to the performance of a restricted activity.

References
  1. Severinghaus R., Combs C.D. Improving patient safety: A model of drift in health care teams. Presented at: The 10th International conference on Modeling and Applied Simulation. 2011 September 12-14; Rome, Italy.

Physiotherapists on the General Register must complete the 2022 College-Selected Activity before they apply to renew their practice permit in August/September 2022. When they renew, physiotherapists must declare that they have met the learning objectives.

Professionalism

Members of the public have high expectations regarding the professional behaviour of members of regulated health professions, including physiotherapists.

Professionalism and professional behaviour are core to the privilege of being a physiotherapist in Alberta. The purpose of the 2022 College-Selected Activity is raise the professions’ collective awareness of issues related to expectations for professional behaviour and risks and challenges inherent in being a member of a regulated health profession as societal expectations and norms for professionalism evolve.

Guiding Principles for the 2022 College-Selected Activity
  • As members of a regulated profession, registrants of the College of Physiotherapists of Alberta have a responsibility to the public and the patients they serve to hold themselves and their peers to high standards of professional behaviour and to address instances of unprofessional conduct when they occur.
  • Physiotherapists are expected to demonstrate professionalism at all times.
  • Societal norms related to professionalism evolve over time.
  • Challenges and potential risks to professionalism also evolve over time.
  • The challenges to professionalism experienced by different physiotherapists can vary depending on the context and nature of the physiotherapist’s practice.
  • The professional behaviour of individual physiotherapists is integral to upholding the public’s trust in the physiotherapy profession and the broader health system.

How is professionalism defined? What does it mean to be a member of a regulated profession? How do you demonstrate professionalism in your day-to-day activities? And what are the factors inherent in your day-to-day life that put you at risk of failing to meet the responsibilities set out in the Code? These are the questions posed to physiotherapists as they complete the 2022 College-Selected Activity.

Defining Professionalism

Professionalism can be difficult to define in a clear and concrete way. It is often easier to identify when an action or comment is unprofessional.

Physiotherapists can look to the Health Professions Act (HPA) to understand how government and the College of Physiotherapists of Alberta define unprofessional conduct. In the Act, unprofessional conduct includes “one or more of the following, whether or not it is disgraceful or dishonourable”:

  • displaying a lack of knowledge of or lack of skill or judgment in the provision of physiotherapy services,
  • breaching the HPA or other legislation that applies to the profession, the code of ethical conduct or standards of practice,
  • representing they are a physiotherapist in good standing while their registration or practice permit is suspended or cancelled,
  • representing that their registration or practice permit is not subject to conditions when it is, or misrepresenting those conditions,
  • failing or refusing to comply with the requirements of the continuing competence program,
  • failing or refusing to comply with a conduct process including an investigation, examination, notice to attend a hearing, or notice to produce documents,
  • failing to comply with an agreement that is part of a ratified settlement from a conduct process,
  • contravening conditions imposed on a practice permit or providing physiotherapy services when incapacitated,
  • practicing physiotherapy with another physiotherapist who is contravening the requirements of the HPA related to business arrangements, conduct matters, or incapacity,
  • conduct that harms the integrity of the physiotherapy profession.

While physiotherapists can look to this extensive list to understand the legislative definition of unprofessional conduct, it is not always the case that the absence of unprofessional behaviour means that a person has behaved professionally which is one of the reasons that this topic can be so challenging. With that in mind, it becomes critical that every physiotherapist consider both the challenges they face to their professional behaviour, and the professional expectations that they need to meet.

Challenges to Professionalism

Physiotherapists, like other members of the communities they serve, are challenged each day by a range of stressors and concerns. Some examples may include:

  • Current world events and economic trends
  • Social and cultural trends
  • COVID-19 and related public health orders, misinformation, and disinformation
  • Personal and family responsibilities, and
  • The community and context in which they practice

It is essential to recognize that challenges to professionalism and the expectations for professional behaviour exist in all aspects of a physiotherapist’s day and at any time when the physiotherapist is either using their professional title or can be recognized by members of their community as a regulated health professional.

Pause and consider the challenges, stressors and concerns that you are currently experiencing, both those that are common to all physiotherapists, and those that may be unique to you. How might these challenges affect the way you present yourself in your community and pose risks to your professional behaviour?

Is this self-reflection making you uncomfortable? If so, you are doing it correctly!

Professionalism and professional behaviour are not simple topics. The more you engage with the subject and consider professional behaviour and risks to professionalism the more grey and ill-defined things tend to be. The point of this College Selected Activity is not to provide concrete answers or specific direction to registrants, but to raise awareness and spark genuine reflection about what professionalism means to regulated physiotherapists in Alberta, and the public they serve.

Expectations for Professionalism

Despite these individual and collective challenges, physiotherapists are charged with upholding the public’s trust and instilling the public’s confidence in the physiotherapy profession. Physiotherapists are held to high standards of behaviour by virtue of the status they hold as trusted regulated health professionals.

The Code of Ethical Conduct tasks physiotherapists with the responsibility to

  • Commit to maintaining and enhancing the reputation and standing of the physiotherapy profession, and to inspiring public trust and confidence by treating everyone with dignity and respect in all interactions.
  • Conduct and present themselves with integrity and professionalism.

These are just two of the responsibilities contained in the Code of Ethical Conduct. The Essential Competency Profile for Physiotherapists lists five more competencies related to professionalism and no less than seventeen entry to practice milestones.

The College-Selected Activity for 2022 builds on the foundation of the Code of Ethical Conduct and Essential Competency Profile and the responsibilities regarding professionalism found within these documents, asking registrants to consider

  • What professionalism means to them,
  • The expectations they must meet as regulated professionals, and
  • The unique challenges they face in doing so.

Do. Learn. Grow.

Do

Review the following practice resources:

Mandatory:

Additional Resources

These additional resources are provided for use by those who wish to dive deeper into this topic.

When thinking about professionalism, it can be helpful to consider your personal values and the values of the profession:

In recent years the College of Physiotherapists of Alberta has generated many resources that touch on different aspects of professionalism.

Professionalism Webinar Series

Podcasts

Learn

Learning objectives

After completing the 2022 College-Selected Activity, you know:

  • The definition of unprofessional conduct found in the Health Professions Act.
  • The expectations for professional behaviour as described in the Code of Ethical Conduct and Essential Competency Profile for Physiotherapists in Canada.
  • How these expectations apply to your practice context and interactions with patients and others within the practice environment and beyond.

AND

  • Have reflected on the risks to your professional behaviour, and actions you can take to mitigate these risks and uphold the public trust and confidence in the physiotherapy profession.
Grow

After reviewing the resources, take a few minutes to consider, either on your own or with your colleagues, how this information informs your behaviours and your practice.

We have given you these guiding questions to help you to reflect:

Defining Professionalism

  • How do you define professionalism?
  • How does your definition of professionalism line up with the definition of unprofessional conduct from the HPA?
  • How has your perception of professionalism changed from when you started your physiotherapy entry to practice education program?

Expectations

  • What do the ethical principles listed in the Code of Ethical Conduct mean to you? How do you enact these principles? What challenges have you encountered?
  • The Code of Ethical Conduct includes responsibilities to clients, the public, and to self and the profession. Are there responsibilities that you need to focus on? What actions can you take to address the gaps?
  • In your view, are there expectations or responsibilities that are missing which are important elements of professionalism and necessary for upholding the public’s trust?
  • Why does meeting these expectations matter, in terms of maintaining the public’s trust?
  • How might a loss of public trust in the physiotherapy profession or the health system in general be detrimental?

How Does this Apply to Your Practice?

  • Are there any challenges to maintaining professionalism that are unique to your practice context? What strategies do you use to address these challenges?
  • What are your personal risks to professional practice?

What actions can you take to mitigate those risks?

Completion Requirements

Your declarations to the College that you have completed the College-Selected Activity are the required evidence of completion.

Physiotherapists are cautioned not to declare completion of the CSA until they have met the learning objectives. Making a false declaration is a breach of the Code of Ethical Conduct which requires registrants to act with integrity.

__ I have reviewed the Code of Ethical Conduct and Domain 7 of the Essential Competency Profile and understand the expectations for professional behaviour described in these documents.

__ I have reflected on my professional responsibilities to clients, the public and the profession.

__ I have considered the challenges I face to maintaining professionalism and my risks to professional practice.

Members on the General Register must complete the 2021 College-Selected Activity before they apply to renew their practice permit in August/September 2021. When you renew, you must declare that you’ve met the learning objectives.

Discrimination, Oppression and Inequity 

Discrimination, oppression, and inequity are pervasive in Canadian society and the Canadian health system. While people with many distinct identity factors experience discrimination and oppression, the result of this discrimination consistently includes negative health outcomes, up to and including limited access to health services and reduced life expectancy.

The 2021 College-Selected Activity requires you to demonstrate your actions to DO. LEARN. GROW. your knowledge and competence regarding the effects of discrimination, oppression and inequity on people seeking health services.

LEARN (Objectives)

After completing the CSA activities, you:

  1. Know the meaning of key terms including bias/implicit bias, discrimination, equality and equity, intersectionality, oppression, prejudice, and privilege.
  2. Have a basic understanding of how privilege, oppression, and intersectionality affect:
    1. The lives of your patients,
    2. Your interactions with patients, and
    3. Health service delivery to members of historically marginalized communities at the systems level.
  3. Understand what implicit bias is, have considered your implicit biases, and understand how your implicit biases affect your interactions with patients and others when left unchallenged.
DO
  1. Watch:

This 90-minute presentation is an introductory guide to provide a starting point to learn about equity, diversity, and inclusion. This presentation provides a broad overview of awareness of EDI issues and engagement practices that support a climate of equity and inclusion within health-care settings.

Date and Time - July 28, 2021, 8:00 a.m.

Speaker: Dr. William Yimbo, PhD, MA, BA

Click here to register/watch.

Note: The webinar will be available on demand for individuals not able to attend the live presentation.

  1. Read:

Physiotherapy Alberta’s Understanding Discrimination, Oppression, and Inequity in Physiotherapy.

  1. Read:

Peggy McIntosh’s White Privilege – Unpacking the Invisible Backpack and complete the privilege questionnaire contained in the article available at: https://uucsj.org/wp-content/uploads/2014/01/White-Privilege-Unpacking-the-Invisible-Knapsack.pdf

  1. Complete

A minimum of 2 Harvard Project Implicit Social Attitudes Bias tests, available at: https://implicit.harvard.edu/implicit/takeatest.html (read the info provided, and click "I wish to Proceed").

NOTE: Some concerns have been raised about this resource, to learn more about your options, click here.

GROW

After reviewing the resources, take a few minutes to consider, either on your own or with your colleagues, how this information informs your behaviours and your practice. We acknowledge that these conversations are often uncomfortable and depending on the context of your practice and your past experiences, having these discussions with peers may be difficult, threatening or potentially harmful. Where possible, we encourage you to discuss these topics with a trusted peer. As an alternate you can choose to discuss the topic with an individual from outside the practice environment. 

We’ve given you some guiding questions to help you get started:

  1. How do privilege and oppression affect the lives of your patients? Can you think of a patient of yours for whom their status as either privileged or oppressed has affected their access to care and their health outcomes? In what ways did this occur?
  2. Were you surprised by the items included in the privilege questionnaire from Peggy McIntosh’s article? What other indicators of privilege would you add to the list provided in the article based on your own experiences?
  3. What was one thing you learned about yourself from completing the Harvard implicit bias tests? How will you use this information to adjust your interactions with patients?
Additional resources to support your learning

Members on the General Register must complete the 2020 College-Selected Activity before they apply to renew their practice permit in August/September 2020. When you renew, you must declare that you’ve met the learning objectives.

Infection prevention and control in the context of COVID-19

The COVID-19 pandemic has challenged Alberta’s physiotherapists in unprecedented ways. The College of Physiotherapists of Alberta respects that regulated members have done much to learn about and manage the COVID-19 pandemic. The 2020 College-Selected Activity requires you to demonstrate your actions to DO. LEARN. GROW. your COVID-19 and infection prevention control knowledge and competence.

LEARN

Learning objectives

After reviewing the practice resources, you know:

  • The personal, administrative, engineered and elimination measures to control the spread of infectious diseases like COVID-19.
  • How to apply these measures within your practice context to limit the spread of COVID-19.
  • How to respond if experiencing signs or symptoms of respiratory illness.
  • How to react if you encounter a patient exhibiting signs or symptoms of respiratory illness or reporting risks related to COVID-19.
DO

Review the following practice resources:

GROW

After reviewing the resources, take a few minutes to consider, either on your own or with your colleagues, how this information informs your behaviours and your practice. We’ve given you some guiding questions to help you get started:

Infection Control Standard of Practice

  • How are my colleagues and I trained in infection prevention and control practices?
  • What infection prevention and control best practices are applicable to our practice setting?

Infection Prevention and Control Guide

  • What infection transmission risks exist in our practice setting, and how can we break the chain of transmission?
  • How consistent are our hand hygiene practices with the World Health Organizations’ “5 Moments of Hand Hygiene” and how could we improve our adherence?
  • What administrative and engineered controls do we have in place to manage the COVID-19 pandemic and how well are they working?

Guidance for Resuming Physiotherapy Practice during a Pandemic

  • How has patient pre-appointment screening been working and what changes might be needed to make sure that patients, physiotherapists, and other staff work together to limit the spread of COVID-19?
  • What are the challenges of staff daily self-monitoring for COVID-19 symptoms, and what supports are needed to maintain efforts to identify symptoms and staying home when ill?
  • Are there risks unique to our practice that we need to manage (e.g., patient population, staff health, other)?
  • Are there measures that we need to consider adding or eliminating to manage the risks of COVID-19 in our practice?

Optional resources to support your learning

Sexual Abuse and Sexual Misconduct: what members need to know

Members on the General Register must complete the 2019 College-Selected Activity before they apply to renew their practice permit in August/September 2019. When you renew, you must declare that you’ve met the learning objectives.

LEARN

Learning objectives:

After reading and considering the resources the College of Physiotherapists of Alberta developed, you know:

  1. “Who is a patient” as defined by the Sexual Abuse and Sexual Misconduct Standard of Practice.
  2. Why and how the Standard of Practice and guides for protecting patients from sexual abuse or misconduct are relevant to your practice.
DO

Read: Resources the College developed to protect you and your patients:

Who is a patient?

Protecting patients from sexual abuse or misconduct

GROW

After you’ve read the resources, take a few minutes to consider, either on your own or with co-workers, how this information informs your behaviors within your practice environment. We’ve given you some guiding questions.

Standard of Practice: Sexual Abuse and Sexual Misconduct

  • Do you understand when an individual you have treated would be considered to still be your patient, even though you have not seen them for treatment recently?
  • Are there situations where you encounter patients, as defined by the Standard, in social situations? What steps might you take to mitigate any risks that such encounters may pose to you?

Protecting Patients from Sexual Abuse or Misconduct Guide

  • Were you surprised by the reported prevalence of sexual abuse in Canada? How will this knowledge affect how you interact with patients or others in the clinical environment?
  • Looking back on past patient interactions, can you think of a time when a patient did not react as expected to something you said or did in the context of physiotherapy care? Could a patient history of sexual abuse explain the patient’s reactions? What would you do differently if faced with the situation again?
  • Are there activities you engage in in your clinical practice which could re-traumatize a patient who is a survivor of sexual abuse? With this realization, how will you modify your approach to avoid re-traumatizing your future patients?

Protecting Patients from Sexual Abuse or Misconduct: what can patients expect from their physiotherapist (A Guide)

  • What factors in your practice contribute to the power imbalance between you and your patients? What do you do to try to minimize the imbalance?  
  • What strategies could you implement to make your patients feel less vulnerable, and thereby minimize the power imbalance between patient and physiotherapist?
  • Are there clinical practices that you engage in that could be misinterpreted by a patient? What steps have you taken to ensure that the physiotherapy purpose of these activities is clear to the patient and that you have the patient’s consent to engage in the activity?

When is the College-Selected Activity available for completion?

The College of Physiotherapists of Alberta aims to launch the DO. LEARN. GROW. College-Selected Activity in late spring early summer. The launch date will vary every year.

When the College-Selected Activity is posted an email notification is also sent to General Register members. The notification introduces the topic, outlines what must be done, and specifies the completion success criteria. The College’s monthly newsletter will also feature articles related to the College-Selected Activity. Throughout the renewal period, the newsletter provides information to support physiotherapists understanding of and participation in College-Selected activity

I am registered on the General Register but not working. Do I need to complete the College-Selected Activity?

Yes. Regulated members on the General Register must participate in the Continuing Competence Program requirements whether they are practicing or not. This includes clinicians, administrators, educators, and researchers.

I plan to cancel my registration on October 1, do I have to complete the College-Selected Activity?

Yes. Participation in the College-Selected Activity is required for the year you are registered; therefore, it is to be completed while you are registered. Before you cancel your registration, consider checking with the College’s competence staff (competence@cpta.ab.ca) to ensure that you understand the success and completion/reporting requirements. When you reinstate your registration, the College’s Registration Department will ensure that you have met the requirements for the Activity of the year that you were last registered.

Will my College-Selected Activity submissions be reviewed?

Yes. Each year at least 10% of submissions are reviewed by the College staff to ensure General Register members have successfully completed the College-Selected Activity. The success criteria will vary based on the topic and format of the activity.

For years when completion is demonstrated by a declaration of meeting the learning objectives, the review is to confirm the regulated member answered the declaration appropriately.

Must I complete both the Self-Selected Activity and the College–Selected Activity each year?

Yes. The DO. LEARN. GROW Continuing Competence Program is comprised of both a Self-Selected Activity and a College-Selected Activity. Both must be successfully completed annually. Completion is a requirement for ongoing registration with the College. If for any reason you are having difficulty meeting the completion requirements for either the College-Selected or Self-Selected Activity contact Competence Staff. Staff will help you to develop a plan for activity completion so that you are able to meet the practice permit renewal requirements.

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Page updated: 25/09/2023