Development of Domains of Competence and Core Entrance-to-Practice Competencies for Physical Therapy: A National...

This aimed to use a collaborative, national reactor panel process to develop a domains of competence (DOC) framework for the physical therapist profession, including DOC spanning the learner continuum and entrance-to-practice competencies for the profession.

Competency-based education (CBE) is an educational philosophy and design approach aimed at learner development, patient safety, and standardized performance expectations. In the United States, there have been calls for standardized performance expectations in physical therapist education and practice.

Two hundred individuals were invited to participate in the reactor panel (phases 2, 3, 5, 7); participation varied by phase. One hundred twenty-three individuals participated in the open comment period (phase 8).

A mixed-methods survey design using a three-tiered, iterative data integration approach was used to construct the DOC Framework over 8 phases. Surveys sought feedback on 2 key aspects: 1) clarity and 2) defining the essence of the physical therapist profession. An a priori threshold of 80% or more of responses rated as a 4/5 or 5/5 on the Likert scale was set.

The DOC Framework consists of 8 domains, 69 core entrance-to-practice competencies, and 4 supporting documents. The 8 DOC are Knowledge for practice, Patient and client care and services, Communication, Practice management, Education and learning, Reflective practice and improvement, Professionalism, and Systems-based practice in health care. The average rating for clarity and essence was greater than 90% for domain descriptions and competencies.

The DOC Framework provides a foundation for CBE in physical therapy and fosters shared standards of education and competence in practice. This is one step toward a broader project aimed at enhancing education and practice within physical therapy. Next steps will include the identification of Entrustable professional activities (EPAs) and the mapping of the competencies developed in this project to the EPAs. The DOC Framework is intended to be dynamic and adaptable, evolving as the profession progresses.