Supervised Practice - College of Physiotherapists of Manitoba

The College of Physiotherapists of Manitoba adopted the Supervised Practice Program for:

New Canadian graduates
All Internationally Educated Physiotherapists (IEPs)
Re-entry Candidates

Clinical supervision is a formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and the safety of care in complex clinical situations. Please review the Physiotherapists’ Guide to Supervision of Examination Candidates.

Supervised Practice ends when the Exam Candidate successfully passes the Clinical Evaluation.

Objective

To provide the candidate with the opportunity to continue learning prior to the Clinical Evaluation
To facilitate a greater understanding of safety and ethical issues in physiotherapy practice.
To increase the candidate’s confidence in their clinical practice.
To promote effective communication between patients, colleagues and members of the heath care team.
To facilitate networking within the profession.
To provide the candidate with ongoing evaluation.
To assist the candidate to adapt to current Canadian physiotherapy practice.

**Please note there are changes to the forms and submission requirements for Supervised Practice. These changes are in effect immediately. Please read carefully through all the documents before submitting to the College.

Physiotherapists’ Guide to Supervision of Examination Candidates March 2024

Supervised Practice Agreement March 2024

Supervised Practice Plan

Initial Clinical Performance Tool March 2024

Canadian Physiotherapy Assessment of Clinical Performance

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The candidate must secure employment under supervision.
The candidate must submit the Supervised Practice Agreement to the College of Physiotherapists of Manitoba (CPM)
The candidate must maintain current liability insurance coverage and ensure to identify themselves as Physiotherapy Examination Candidate as per Practice Direction 4.23 Use of Title and Credentials.
It is the responsibility of the candidate to notify CPM if there is a change in the Supervisor/employment.
It is the responsibility of the candidate to submit self-reported practice hours at 6 month intervals with the ACP evaluations until the 1200 hours have been met to apply for the Practice Based Competency Assessment or until they have successfully passed an alternate clinical evaluation;

The Supervisor must be a Manitoba registered physiotherapist with a minimum of two years on the Active Practice Register. If there are questions regarding this requirement, the employer/potential supervisor should contact the College.
The Supervisor must submit a Supervision Plan to CPM prior to the Examination Candidate starting Supervised Practice.
The Supervisor assumes responsibility for the delegation of activities that are within the Exam Candidate’s knowledge, skill and abilities and oversees these activities. Chart notes do not need to be co-signed but should be reviewed initially.
Evaluations by the Supervisor are required to be completed and submitted to CPM when requested. This includes the Initial Clinical Performance Tool and an ACP (Canadian Physiotherapy Assessment of Clinical Performance). The Initial Clinical Performance Tool must be completed after a minimum of 10 days of clinical practice and must be kept in the Examination Candidate’s file. This would need to be submitted to CPM if requested. A formal evaluation using the Assessment of Clinical Practice (ACP) tool must be conducted every 3 months during supervised practice with the last evaluation occurring within four weeks of the Examination Candidate applying for the PBCA. A copy of the ACP evaluations must be submitted to CPM for review prior to the individual applying for the PBCA program. There must be one designated facility Supervisor identified to CPM. For specific clinical settings, other physiotherapists may be assigned up to three supervisors maximum to supervise and evaluate the candidate but must report back to the designated Supervisor. A Supervisor may not have more than three supervisees under their Supervision at any given time.
Both parties in the Supervised Practice Agreement may be asked to provide evaluation of the program.

For the supervised practice to be deemed complete, the Examination Candidate must successfully pass an approved clinical evaluation. For Examination Candidates registered in Manitoba, there are three options available:

Ontario exam is a fully virtual scenario-based exam. To be eligible to attempt this exam, the individual must have previously successfully completed the Physiotherapy Competency Exam (written) within the last five years, they meet the technology requirements and have a copy of their physiotherapy degree. An individual will be ineligible if they have unsuccessfully attempted the OCE or another jurisdiction’s approved clinical evaluation on 3 occasions. Council has had confirmation that Manitoba graduates can register for the OCE and Council will accept this as an approved clinical evaluation to move to a full Active license. The Council is aware that the exam is based on Ontario legislation and will assume that Examination Candidates who register for this exam are aware and waive their right to appeal a result based on this reasoning. For more information on the OCE, please visit the College of Physiotherapists of Ontario website: https://www.collegept.org/ontario-clinical-exam.

Practice Based Competency Assessment (PBCA) Program

Alternate Evaluation BC (ACEBC) – British Columbia’s exam is an in-person OSCE exam that takes place in Vancouver. This exam is run jointly through the College of Physical Therapists of BC and the University of British Columbia (UBC), Department of Physical Therapy. This exam does prioritize spaces for the BC graduates but is open at a later registration date for registrants across Canada. As with Ontario’s exam, an individual is eligible to register if they have passed the PCE (written component) and have not attempted a clinical exam, attempted the PCE (clinical) in or after 2019, or have attempted the BC exam no more than 2 previous times. As with Ontario, individuals will be ineligible if they have unsuccessfully attempted the ACEBC or another jurisdiction’s approved clinical evaluation on 3 occasions. Council has had confirmation that Manitoba graduates can register for the ACEBC and Council will accept this as an approved clinical evaluation to move to full Active license. Council and the College will count any unsuccessful attempts at the ACEBC toward the 3 attempts allowed for Manitoba licensure. For more information on the ACEBC, please visit the College of Physical Therapists of British Columbia’s website: https://cptbc.org/physical-therapists/registration/entry-to-practice-assessment-requirements-for-full-registration/ and the UBC site for registration: https://physicaltherapy.med.ubc.ca/acebc/ .

It is the individual’s responsibility to educate themselves regarding these options, including further details on eligibility, dates available, cost and how to apply. If an Examination Candidate does not successfully pass the clinical evaluation, they must remain under supervised practice until they successfully pass a clinical evaluation. Details regarding requirements to continue in Supervised Practice following a failure of the Practice Based Competency Assessment are outlined in 3.13 Failure of an Entry to Practice Clinical Evaluation and 3.25 Practice Based Competency Assessment. It is important to remember, Registration on the Examination Candidate register may not exceed two years or three failed Clinical Evaluation attempts, whichever comes first.

FAQ

No, co-signing of all chart notes is not required. However, it is expected that chart notes are reviewed as necessary to ensure competency.

This will vary depending on the clinical performance of the Examination Candidate. The Supervisor will have assessed their performance after a minimum of 10 days clinical practice using the ICPT to determine the type of supervision (Direct or Indirect) they require to provide safe physiotherapy services to patients. If you have determine that you don’t need to provide the Examination Candidate with direct supervision, remember that you as a supervisor must provide indirect supervision and be available at all times by phone or virtual means – weekends and evenings – whenever the Examination Candidate is providing physiotherapy services and you are not providing direct supervision. If you are not available to provide supervision you must arrange alternate supervision as per the supervision agreement. Please remember this is supervised, not independent practice and supervision must still be in place.

Yes, Exam Candidates can bill independently.

See answer to #2 above.

The supervisor must assess the Examination Candidate after a minimum of ten days of supervised clinical practice. The purpose of this evaluation is to determine the appropriate level of supervision. The Initial Clinical Performance Tool, developed by CPM, can be used for this purpose. The completed evaluation should be saved in the Examination Candidate’s file. This form may need to be sent to CPM if requested.

A formal evaluation using the Assessment of Clinical Practice (ACP) tool must be conducted and submitted every 3 months during supervised practice with the last evaluation occurring within four weeks of the Examination Candidate applying for the PBCA. A copy of the ACP evaluations must be submitted to CPM for review prior to the individual applying for the PBCA program. If the Examination Candidate is proceeding with an alternate clinical evaluation, the ACP evaluations must continue to be submitted until the College receives verification of the outcome of the alternate clinical evaluation. Should the Examination Candidate fail the PBCA or an alternate clinical evaluation, the period of supervision will be extended. In this event, performance evaluations using the ACP tool must be conducted every three months until the Exam Candidate has successfully passed a clinical evaluation, including the PBCA, or until registration on the Exam Candidate register is cancelled.

Until the Exam Candidate passes a clinical evaluation, including the PBCA, and transfers to the Active register, or until a change of Supervisor is mutually agreed upon by both Supervisor and Exam Candidate. This change must be reported to the CPM.

The Supervisor must make arrangements for supervision by another physiotherapist when the Supervisor is not available. This temporary change does not need to be reported to CPM; only PERMANENT changes in Supervisor need to be reported to CPM.

This is determined by each individual employer, not the CPM.

If the Exam Candidate fails the Clinical Evaluation, they continues on supervised practice.