The Development of the Canadian Physiotherapy Assessment of Clinical Performance (ACP) 2.0 - Alignment with the 2017 Competency Profile.

Purpose: Clinical education and assessment of students' performance during clinical placements are key components of Canadian entry-to-practice physiotherapy curriculum and important in developing entry-level physiotherapy practitioners. The Canadian Physiotherapy Assessment of Clinical Performance (ACP) is the measure currently used to assess physiotherapy student performance on clinical placements in most of the entry-to-practice physiotherapy programmes across Canada. The release of the 2017 Competency Profile by the National Physiotherapy Advisory Group resulted in a revision of the existing ACP.

How Community-Based Health and Social Care Professionals Support Unpaid Caregivers: Experiences From One Health Authority in Ontario, Canada.

In Ontario, Canada, rising rates of caregiver distress have been the 'canary in the coal mine' for a health system out of balance with the needs of an ageing population. Community-based health and social care professionals are well placed to play an important role in the caregiver support process; however, a gap has remained in the understanding of if and how caregiver support strategies are operationalized or experienced by community service providers (CSPs). The goal of this study was to describe how CSPs interpreted policy and how those interpretations may enable their work in supporting unpaid caregivers.

Mitigating Caregiver Distress in South Western Ontario: Perspectives on Role, Community, and Care.

The former South West Local Health Integration Network (SW LHIN) of Ontario, which is in a predominantly rural region, regularly reports the lowest rates of caregiver distress in the province. Caregivers from rural communities regularly face challenges related to the access, applicability, and availability of supports and services, This qualitative case study describes perspectives of caregiving from the region, and explores how role construction and expectations of caregivers might both mitigate distress and influence service support use. Thematic analysis identified five themes: anticipated care, gendered caring, service support assumptions, confidence in community, and the "line in the sand": care decisions for evolving needs.

Improving Cultural Knowledge to Facilitate Cultural Adaptation of Pain Management in a Culturally and Linguistically Diverse Community.

Health care disparities exist for people from culturally and linguistically diverse (CALD) communities. Addressing the cultural competence of health care providers could limit these disparities. The aim of this study was to improve cultural knowledge of and humility regarding pain in a CALD community.

Physiotherapy Students' Performance in Clinical Education: An Analysis of 1 Year of Canadian Cross-Sectional Data.

This research examines 1 year of cross-sectional, Canada-wide ratings from clinical instructors using the Canadian Physiotherapy Assessment of Clinical Performance (ACP) and analyzes the performance profiles of physiotherapy students' performance ratings over the course of their entry-to-practice clinical placements. Canadian physiotherapy programmes that use the ACP were invited to submit anonymized, cross-sectional data for placements completed during 2018. Descriptive analyses and summary statistics were completed.

A Systematic Review and Meta-Analysis of Exercise Interventions and Use of Exercise Principles to Reduce Fear of Falling in Community-Dwelling Older Adults.

Objective: Fear of falling (FOF) contributes to activity restriction and institutionalization among older adults, and exercise interventions are linked to reduction in FOF. Adhering to exercise principles and adapting optimal exercise parameters are fundamental to optimizing the effectiveness of exercise interventions. The purpose of this review was to describe FOF exercise interventions in community-dwelling older adults, evaluate the extent to which these interventions followed the exercise principles and reported exercise parameters, and quantify the effect of these interventions on reducing FOF.

Moral distress experienced by community service providers of home health and social care in Ontario, Canada.

Moral distress occurs when one knows a morally correct action to take but feels powerless to act the way one believes is right. Moral distress has been studied in many contexts but there remains a gap in our understanding of the phenomenon as it manifests outside of hospital-based settings. The aim of this study was to explore the nature of the moral distress experience among community-based health and social care professionals working with older adults and their caregivers.

Clinical Instructors' Perceptions of Internationally Educated Physical Therapists' Readiness to Practise during Supervised Clinical Internships in a Bridging Programme.

The purpose of this study was to describe clinical instructors' (CIs) comments on the Canadian Physiotherapy Assessment of Clinical Performance (ACP) that reflect areas of strength and areas requiring improvement among internationally educated physical therapists (IEPTs) during supervised clinical internships in a bridging programme. We reviewed the assessment records of 100 IEPTs' clinical performance during two internships each for three successive cohorts of learners in a Canadian bridging programme. We extracted the CIs' text from 385 comment sections of the ACP completed during these internships and analyzed them using qualitative content analysis.

How Do I Choose a Job? Factors Influencing the Career and Employment Decisions of Physiotherapy Graduates in Canada.

Physiotherapy is a diverse profession: there are many areas in which physiotherapists can practise. New graduates must decide in which area of physiotherapy they would like to work and with which organizations to seek employment. The purpose of this study was to describe the factors that influenced the career (area of practice, practice setting) and employment (organization) decisions of recent physiotherapy graduates.

Evaluation of the Predictive Accuracy of the interRAI Falls Clinical Assessment Protocol, Scott Fall Risk Screen, and a Supplementary Falls Risk Assessment Tool Used in Residential Long-Term Care: A Retrospective Cohort Study.

Falls in residential long-term care (LTC) facilities continue to be a leading cause of injury for residents and cost for the health care system. Interdisciplinary clinical teams are responsible for assessing risk levels for their residents and developing appropriate care plans and interventions in response. This study compares the predictive accuracy of three separate fall risk assessment tools: the interRAI Falls Clinical Assessment Protocol (CAP), derived from the LTC Facility (LTCF) or Minimum Data Set (MDS) 2.

Clinical Performance Scores of Internationally Educated Physical Therapists during Clinical Education in a Bridging Programme.

We describe the numerical ratings assigned by clinical instructors to the performance of internationally educated physical therapists (IEPTs) during their clinical internships while enrolled in a bridging programme. We conducted a secondary analysis of the quantitative data for IEPT learners attending the Ontario Internationally Educated Physical Therapist Bridging Program using the Canadian Physiotherapy Assessment of Clinical Performance (ACP) tool. We extracted the scores from each IEPT's ACP form at the midterm and final evaluations for two internships and conducted a descriptive analysis.

"I've found it's very meaningful work": Perspectives of physiotherapists providing palliative care in Ontario.

Objectives: This study aimed to describe insights from interviews about the experience of physiotherapists providing palliative care in Ontario and their perceptions of the role and value of physiotherapists' involvement in palliative care.

Methods: We conducted interviews with physiotherapists in Ontario, Canada (n = 14), and received emailed submissions from two others (one physiotherapist and one physiotherapy student) with current or recent practice experience in palliative care. We conducted inductive thematic analysis of the interview data and emailed submissions.

Heterogeneity and Its Impact on Rehabilitation Outcomes and Interventions for Community Reintegration in People With Spinal Cord Injuries: An Integrative Review.

Various injury characteristics such as cause, level, severity, and time since injury divide individuals with spinal cord injury (SCI) into many subgroups. The heterogeneity among individuals' injuries and personal characteristics has significant implications for SCI rehabilitation practice, specifically directed toward community reintegration, which is a key goal of rehabilitation interventions for people with disabilities. This study aims to summarize the evidence on attributes that make the SCI population heterogeneous, the impact of these attributes on community reintegration, and the implications of heterogeneity for rehabilitation interventions directed toward optimizing community reintegration.

Imaging use for low back pain by Ontario primary care clinicians: protocol for a mixed methods study - the Back ON study.

Background: At any one time, one in every five Canadians has low back pain (LBP), and LBP is one of the most common health problems in primary care. Guidelines recommend that imaging not be routinely performed in patients presenting with LBP without signs or symptoms indicating a potential pathological cause. Yet imaging rates remain high for many patients who present without such indications.

Knowledge about risk factors for falls and practice about fall prevention in older adults among physiotherapists in Nigeria.

Background And Objective: Falling is a major health concern that has contributed significantly to older people's injury and loss of life worldwide, warranting the development of fall-prevention strategies, the success of which has been attributed to the levels of knowledge and practice about fall prevention among physiotherapists and other health professionals. The objective of this study was to determine the self-reported levels of knowledge on risk factors of fall and practices about fall prevention in older adults among physiotherapists in Nigeria.

Methods: Physiotherapists (N = 237) recruited from the six geopolitical zones of Nigeria completed a three-part structured questionnaire that asked questions about risk factors for fall and common practices for fall prevention using a 5-point-rated Likert scale.

Let's Talk about the Talk: Exploring the Experience of Discussing Student Performance at the Mid- and Final Points of the Clinical Internship.

The purpose of this study was to explore the experiences of physiotherapy students and clinical instructors (CIs) when discussing student clinical performance at the mid- and final points of clinical internships. The objectives were to identify why performance assessment discussions are valuable, explore the role of each participant throughout the discussion, identify the challenges associated with these discussions, and explore the effect of the standardized assessment tool on the discussion. This study used a qualitative descriptive design, consisting of student and CI focus groups in the Greater Toronto Area from January to June 2016.

Determining the impact of a new physiotherapist-led primary care model for back pain: protocol for a pilot cluster randomized controlled trial.

Background: Back pain is a leading contributor to disability, healthcare costs, and lost work. Family physicians are the most common first point of contact in the healthcare system for people with back pain, but physiotherapists (PTs) may be able to support the primary care team through evidence-based primary care. A cluster randomized trial is needed to determine the clinical, health system, and societal impact of a primary care model that integrates physiotherapists at the first visit for people with back pain.

Photovoice and Persons With Physical Disabilities: A Scoping Review of the Literature.

Photovoice is a group analysis method often affiliated with participatory action research (PAR). It has become increasingly popular in qualitative research with people with physical disabilities. This article details the results of a study that sought to understand the scope of the literature related to how photovoice is conducted with people with physical disabilities.

Demographic Characteristics of Applicants to, and Students of, Ontario Physiotherapy Education Programs, 2004-2014: Trends in Gender, Geographical Location, Aboriginal Identity, and Immigrant Status.

The authors analyzed the demographics of potential future physiotherapists to determine whether they were representative of the Canadian population. The specific objectives were to examine selected demographic variables from all applicants to and students in Ontario English-language Master of Physical Therapy programmes in admission cycles 2004-2014, inclusive, and to analyze the results as compared with Canadian population data. Anonymized applicant records (=14,135) were obtained for admission cycles 2004-2014, inclusive.

Exploring Record Keeping, Clinical Reasoning, and Practice Context: Peer Assessment Findings from the Perspective of Situational Competence.

The College of Physiotherapists of Ontario developed its peer practice assessment (PA) process on the basis of the statutory requirements for quality assurance. We previously reported outcomes from physiotherapists who had two PAs. The aims of the current research were to identify areas of sub-optimal performance on the assessments and explore any associations with the physiotherapists' practice context.

Knowledge and Use of, and Attitudes toward, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in Practice: A Survey of Ontario Physiotherapists.

To investigate Ontario physiotherapists' knowledge and use of, and attitudes toward, non-steroidal anti-inflammatory drugs (NSAIDs) to identify whether there is a need for physiotherapists to receive education specific to NSAIDs. An existing survey instrument was modified and tested by five Ontario physiotherapists. The final version was distributed electronically to approximately 4,400 Ontario Physiotherapy Association members as a self-administered online questionnaire.

Evidence of Reliability, Validity, and Practicality for the Canadian Physiotherapy Assessment of Clinical Performance.

To investigate the internal consistency, construct validity, and practicality of the Canadian Physiotherapy Assessment of Clinical Performance (ACP), a descriptive measure used by physiotherapy students and their clinical instructors (CIs) at the mid- and endpoints of an internship to describe the students' behaviours as observed in the clinical education setting relative to what might be expected of an entry-level physiotherapist. This multi-centre study piloted the ACP in 10 university physiotherapy (PT) programmes. Both CIs and students undertaking clinical internships completed the ACP and the current tool, the Physical Therapist Clinical Performance Instrument (PT-CPI; Version 1997).

A robot-based behavioural task to quantify impairments in rapid motor decisions and actions after stroke.

Background: Stroke can affect our ability to perform daily activities, although it can be difficult to identify the underlying functional impairment(s). Recent theories highlight the importance of sensory feedback in selecting future motor actions. This selection process can involve multiple processes to achieve a behavioural goal, including selective attention, feature/object recognition, and movement inhibition.

Canadian Physiotherapy Assessment of Clinical Performance: Face and Content Validity.

Purpose: To investigate face and content validity of a draft measure to be used across Canada to assess physiotherapy students' performance in clinical education, through broad consultation with physiotherapy clinical instructors (CIs) across Canada.

Methods: An online survey was used to collect input on the draft measure. In addition to demographics, the questionnaire included questions on the preferred rating scale, the items within the measure that should have their own rating scale, and general impressions.