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Update Regarding Pelvic Health (Internal Examinations)

The physiotherapy treatment of pelvic health conditions has considerable high-quality supporting evidence. In recent years, increasing numbers of physiotherapists have expressed interest in this area of practice due to increasing recognition of the role physiotherapists can play in the treatment of pelvic health conditions such as incontinence and pelvic pain.

However, concurrent with 2018’s amendments to the Health Professions Act regarding sexual abuse and sexual misconduct, the then Minister of Health and Alberta Health representatives raised questions regarding this area of physiotherapy practice, including how physiotherapists develop their skills and competencies in this area, and how patients could identify physiotherapists able to provide pelvic health services (internal examinations).

Alberta Health requested that the College of Physiotherapists of Alberta develop a practice guideline to inform the clinical practice of physiotherapists who work in the area of pelvic health, including identification of the minimum education standards for physiotherapists who provide internal examinations. The College of Physiotherapists of Alberta and Alberta Health agreed that the guidance document would include discussion of:  

  • The College of Physiotherapists of Alberta’s expectations regarding education and competence development
  • Consent
  • Communication/sensitive practice

Alberta Health also identified a need for the College of Physiotherapists of Alberta to provide a mechanism by which members of the public can identify physiotherapists who are competent and authorized to provide pelvic health services and to perform the restricted activity of pelvic internal examinations. The College of Physiotherapists of Alberta’s Council has opted to address this request through a change to how authorization to perform this activity is granted to regulated members.

The Standards of Practice for Alberta Physiotherapists establish the expectations for physiotherapists and their practice. The Performance of Restricted Activities Standard of Practice has, therefore, been revised to include competence development expectations for this area of practice, and supervision rules for regulated members on the general and provisional registers.

Importantly, the revised standard also establishes the requirement for individuals to apply for and receive authorization from the Registrar to perform the activity independently.

The College of Physiotherapists of Alberta is currently circulating the revised Performance of Restricted Activities Standard of Practice for physiotherapist and external stakeholder feedback.

All regulated members are encouraged to review the revised Standard and to provide their comments through this online form.

The consultation period for the draft Standard will end on October 19, 2020.  

Consistent with the government’s request and the College of Physiotherapists of Alberta’s routine practices, the Pelvic Health (Internal Examinations) Resource Guide for Alberta Physiotherapists has been created to further aid registrants’ understanding of the continuing competence and other requirements outlined in the draft Standard.

The draft Standard is subject to change based on the feedback received from our stakeholders. The College of Physiotherapists of Alberta aims to have the revised Standard finalized and in effect in early 2021.

There will be a transition period for physiotherapists affected by any changes adopted. Further details regarding the transition will be communicated in the coming months.

Page updated: 20/04/2022