Competency-based physiotherapy education at Queen's University.

The Physical Therapy (PT) Program at Queen’s is now a Competency-Based Education Program

As the incoming class of  2023, you're the first cohort to participate in our redesigned curriculum. The physiotherapy program at Queen's University is now a competency-based education program. Queen's has been at the forefront of implementing competency-based education in our Health Sciences program. This aligns well with the shift to more responsive and accountable training models for healthcare professionals.

Queen’s Physiotherapy Program

Our curriculum is packaged and delivered in a way that provides you as a learner with maximum benefit as you train to build your profile of essential competencies required for licensure. Our program is built on the national physiotherapy Entry-to-Practice Curriculum Guidelines. We're the first PT program in Canada to transition to this model of learning, and you're the first cohort to participate in our redesigned curriculum.

What is Competency-Based Education?

So what is Competency-Based Education? Competency-Based Education organizes training around milestones and competencies, rather than specific content areas or knowledge. Milestones serve as the well-defined learning outcomes for each of our courses, and each of our milestones makes up a competency. Competency-Based Education is built to help you progress through the milestones over the two years of the program. And as a learner, you are at the center of the teaching and learning environment, and you'll be a self-directed learner throughout our program.

Domains, Competencies, & Milestones

So let's look at some domains, competencies, and milestones that are used to build our program. There are seven domains in our competency-based program which relate to the seven essential competencies of a ready-to-practice physiotherapist. One of these domains is communication. Communication comprises several competencies and each competency is made up of milestones. As an example, one of the competencies related to communication is adapt communication approach to the context. Some milestones that build to this competency are identified different communication strategies; their strengths, limitations, and risks, apply strategies and methods of consist of communication with purpose and setting, and recognize barriers to effective communication, and identify strategies to overcome these barriers. So as you can see these milestones relate to the overall competency of adapt communication approach, to context, and these build into our overall domain of communication.

How does CBE work?

So how does Competency-Based Education actually work? Your program is organized into three time periods. The foundations which is at the first semester of your first year, the core of practice which is the remainder of your first year, and transitions to practice which is your second year of your program. Each time period targets a set of milestones to ensure progression from foundations level to core, and finally to the entry practice proficiency by the end of year two. In each of these time periods you'll be enrolled in three courses. The PCLM course, which is professionalism, collaboration, leadership, and management. The EBPR course which is evidence-based practice and clinical reasoning, and the Applied Clinical Competencies course or ACC. Rather than having courses that are solely knowledge based, such as Anatomy, you will develop knowledge within the broader context through guided preparatory work, and case studies. You'll also revisit these foundational concepts throughout the program, and apply them to new case contexts.

Spiral Curriculum

The curriculum is also organized as a spiral, which means you will revisit essential competencies throughout the program. The spiral allows you to be introduced to cases and contexts, and then revisit them with increase in complexity. You'll be exposed to different clinical conditions, and you'll revisit them with increasing complexity throughout the program. You'll revisit cases across the lifespan from pediatrics, adults, and older adults. And you'll also revisit cases in various practice settings, such as acute care hospital, rehabilitation, community care, and primary care. The spiral curriculum will help you progress from foundations of PT practice until you're ready to transition to an entry level of physiotherapy practice.

Foundations of PT Practice: Sept 2023 to Dec 2023

Core of PT Practice: Jan 2024 to Aug 2024

Tradition to PT Practice: Sept 2024 to Aug 2025

What about assessment in CBE?

And what about assessment in Competency-Based Education, how does that work? To assess if you're reaching the necessary milestones and progressing towards competency, we'll use frequent low stakes and meaningful assessments. So instead of having one large exam at the end of the course to see if you've met the competencies, you'll be evaluated weekly through smaller assessments based on milestones. Evaluations will be done by instructors, by your peers, and also through self-evaluation. So this will help you see how you're progressing over time. At Queen's we also have a custom designed online system for you and your instructors to track your progress. This allows us to regularly review your progress towards the competencies, and identify early any difficulties in meeting the milestones. We've also had built-in opportunities for learners to catch up on milestones to help you stay on track, and meet your individual learning needs.

What about clinical placements in CBE?

And how about clinical placements? Throughout the program, you'll also participate in six clinical placements with over 1 000 hours of clinical placement hours. In our new curriculum, Competency-Based Education is operationalized in clinical placements through the concept of Entrustable Professional Activities or EPAs. EPAs are professional activities that are entrusted for a learner to perform. Each EPA covers a specific set of competencies, making assessment more specific than before. So what's unique about using EPAs? We've intentionally included developmental milestones, instead of always expecting you to achieve the highest level of performance. This allows you to grow as a trainee from the initial stage of requiring your preceptor's assistance to perform the clinical task, to being able to execute the task unsupervised. We will also use our custom online system to track your EPAs, and you'll be able to initiate your own EPA assessments during your placement, when you decide that you're ready for observation and feedback. That's why we say that a competency-based education program promotes self-directed learning.

What does CBE mean to you?

So what does Competency-Based Education mean to you as a learner? Competency-Based Education is a learning approach that provides you with the flexibility in learning, frequent opportunities for low stakes assessment, and frequent feedback. By the end of the year two of the program, you can expect to have reached the milestones, the progressions of expertise required for each essential competency outlined by the National Physiotherapy Advisory Group. We look forward to having you join us at Queen's University to engage in our learner-centered, competency-based curriculum.

Ready-to-Practice Physiotherapist