Supervision and Support Personnel
Support personnel assist the physiotherapist1 in the application of treatment techniques and modalities characteristic of their professional training and clinical judgment. Physiotherapy support personnel job titles shall include the physiotherapy/rehabilitation assistant (group 1) or the physiotherapy/ rehabilitation aide (group 2).
GENERAL PRINCIPLES
- Support personnel must work under the supervision of a physiotherapist
- Physiotherapists maintain responsibility and accountability for the quality of the supervision provided
- Physiotherapists are required to make a judgment about the knowledge, skills and abilities of the support personnel prior to assigning tasks
- Decision to delegate to the support personnel includes factors such as education, training, competence, the environment and the client needs
- Physiotherapists are to obtain informed consent from each client for the involvement of a physiotherapy support personnel in the delivery of their physiotherapy treatment plan
Support personnel vary in their level of preparation, in the amount and type of education and/or training. The Nova Scotia College of Physiotherapists accepts these groupings as defined below:
Physiotherapy/Rehabilitation Assistant (Group 1 Physiotherapy Support Personnel)
The educational background of all physiotherapy/rehabilitation assistants includes all of the following:
- A curriculum that prepares students for physiotherapy practice models in Canada
- A broadly ranging curriculum to match the variety of physiotherapy environments and client populations
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A college diploma/certificate from a recognized post-secondary program that includes a minimum of three terms full time equivalent study of which:
- One term’s equivalent must be in physiotherapy-specific coursework (e.g., use of ambulatory aids, electrotherapy modality instruction, the principles of therapeutic exercise) that includes classroom and laboratory work; and
- One term’s equivalent in physiotherapist-supervised training/fieldwork; and
- One term’s equivalent of generic, program related coursework (e.g., anatomy, physiology)
- Educational program faculty includes registered physiotherapist(s)
Physiotherapy/Rehabilitation Aide (Group 2 Physiotherapist Support Personnel)
The educational background of all physiotherapy/rehabilitation aides includes all of the following:
- Completion of ‘on-the-job’ training that
- Prepares the personnel for the provision of physiotherapy services in that specific work setting
- Is directed by a licensed physiotherapist
- Is physiotherapy-specific
- Can be variable in length and content depending on the background of the support personnel and the needs of the client(s)
- Physiotherapy/rehabilitation aides may have various levels and types of formal education, but their education does not meet all aspects of the criteria for physiotherapy/rehabilitation assistants
- Guidelines for on-the-job training are available through the NSCP at www.nsphysio.com and are available to licensed physiotherapists only
It is assumed that Physiotherapy/Rehabilitation Aides are a heterogeneous group with a large variation in educational background. As a result, fewer assumptions about knowledge, skills and attitudes can be made of everyone within this group.
PHYSIOTHERAPIST RESPONSIBILITIES
The physiotherapist maintains responsibility for the physiotherapy treatment delivered to all clients under his/her care. It is, therefore, always the responsibility of the physiotherapist to:
- Interpret referrals and obtain informed consent,
- Conduct initial and ongoing assessments of the client and interpret the findings,
- Formulate the treatment plan, with goals, in consultation with the client,
- Decide what, if any, components or modifications of the treatment plan can be safely delegated to a physiotherapy support personnel,
- Ensure appropriate documentation,
- Re-evaluate and/or modify treatment plan and goals,
- Provide appropriate education to clients, families and other caregivers,
- Conduct discharge planning.
The physiotherapist is accountable for the appropriate assignment of duties to the physiotherapy support personnel under his/her supervision, and shall not delegate to a less qualified person:
- Any task that the physiotherapist has not observed the support personnel perform competently, or
- Any task that requires the unique skill, knowledge and judgment of a physiotherapist, or
- A task or procedure in a situation where risk requires the continuous clinical judgment of a physiotherapist.
