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Physiotherapy Access to Continuing Education
Physiotherapy Access to Continuing Education Credits for a New Diploma ALAN WALKERMA Director of Education, Chartered Society of Physiotherapy
IT is now widely recognised that education is a continuing and lifelong process. It is also increasingly clear that the process of education may take many forms, not all of them traditional. No longer can a person's education be associated exclusively with the period of learning which occurs in the first twenty-odd years of life. Nowhere is this more evident than in the professions. The pace of social and technological change is now so rapid and intense that an initial period of professional training can provide only the disciplinary foundations of knowledge and skills, on which further education and experience must be built if they are to remain current and valid. The pace of change also means that professions are in a state of constant mutation, developing new strands and becoming multiform. Education itself may serve as an agent of this change, while new methods of organisation, as currently seen within the National Health Service, provide further impetus of development within professions such as physiotherapy. Here, as elsewhere, the context of change places a great responsibility on the existence and the encouragement of continuing education. While few would dispute this, the reality remains that post-registration study in physiotherapy has largely grown through the dedication of those members of the profession, comparatively small in number, who are prepared t o devote both time and energy to the design and teaching of courses. While the Society has encouraged this growth through its validation process, it is perhaps unsurprising that post-registration developments have been piecemeal and haphazard, though of great intrinsic value. The reasons for this are not hard to find. Education is expensive, and post-registration courses doubly so in that both course fees and study leave must be costed by employers. While the imperative of pre-registration education absorbs training budgets, comparatively little remains for post-registration education opportunities. The upshot is that many physiotherapists are deterred or prevented from pursuing new areas of study, while those who succeed often do so at considerable financial cost to themselves. While economic factors are no doubt important, there are however further reasons why post-registration initiatives do not receive the support they deserve. Because post-registration courses vary in length and depth, they may not carry any permanent recognition. Physiotherapistsmay therefore have little or nothing concrete to show for their further study, apart from the personal and professional development they may have gained. It is surely right that post-registration study, of whatever nature, should count formally towards their legitimate aspirations for greater professional recognition. A small number of courses do have diploma or masters study from parent institutions, while the Society has sought to improve the currency of post-registration courses by
PhVsiotherapn September 1990. w/ 76, no 9
validating them according to national criteria. Overall, however, the lack of recognition may act as another deterrent to undertaking further study. An additional factor of importance is the need to establish and clarify a desirable balance in post-registration study. This is particularly important in a clinical profession where, as already suggested, many specialist strands are emergent. The Society should aim to legitimise the need for specialist study in the eyes of employers and the profession alike. Equally, in a time of change and greater responsibility for physiotherapists, it is vital to promote non-clinical areas of study which transcend professional boundaries, such as 'common core' courses in management, teaching, and communication skills. Above all, post-registration study should stress the continuum of education and the value of experiential learning. The Chartered Society of Physiotherapy has therefore been concerned both with mapping out the territory of continuing education in physiotherapy, and with providing a flexible system by which permanent and widespread recognition can be given to studies undertaken. In these concerns the Society is swimming with the tide. The development of Credit Accumulation and Transfer Schemes (CATS) and National Vocational Qualifications (NVQs) both lay great emphasis on the value of all forms of continuing education, whether academic, practical or experiential, and the need to recognise these endeavours by the most flexible means. In the case of CATS, the Society also has a ready-made vehicle for transforming its plans into reality. The result of the Society's work is a new framework for post-registration study: PACE, standing for Physiotherapy Access to Continuing Education. The PACE system is built explicitly on a credit accumulation structure. This has twin advantages: first, a Chartered physiotherapist will be able to build up credit on a gradual basis for studies undertaken; and second, these studies can reflect a pathway unique to the individual physiotherapist, combining different types of continuing education. New Diploma At the heart of the PACE system will be a new award issued by the Society: the Diploma in Advanced Physiotherapy Studies. To obtain this award, a Chartered physiotherapist will need to accumulate at least 120 credit points from a study pathway that exhibits a coherent balance between practice-oriented courses, the 'common core' courses already referred to, and experiential learning. It is expected that the 120 points will be gained over a maximum period of five years, and will break down into the component parts as follows: Practice-oriented courses
4 0 - 8 0 credit points
'Common core' courses
2 0 - 4 0 credit points
Experiential learning
20-40 credit points
The practice-oriented course will include those specialist skill-based or client-group-based courses already validated
537
by the Society, together with similar courses operated by other bodies. 'Common core' courses will encompass a wide range of relevant non-clinical subjects, as offered by the Open University, the Institute of Health Services Management, the Health Education Authority, and so on. They will also include teacher training courses as approved by the City and Guilds and the CNAA, already a component part of the Society's DipTP award. Experiential learning naturally has a wide potential remit, and the Society intends to issue further guidance on this area, particularly in terms of 'portfolio' development, at the beginning of 1991. Examples of such individualised learning could however include in-service programmes accredited by the Society, or the process of actually planning and developing a practice-oriented course. As a general point, it should be stressed that the Society intends t o introduce a certain amount of retrospective recognition in all three elements of the PACE system. Accreditation System ' In order t o establish credit ratings for the practice-oriented courses, the Society has developed a process of course accreditation which will replace the validation system hitherto operated. The Society will also be seeking to develop its accreditation of 'common core' courses by means of the credit ratings assigned to them by their parent bodies. The Society has already been exploring these possibilities with such bodies as the Open University and the IHSM, and these discussions will continue in the future. While the PACE system very much represents a lateral, practice-based route of study, the Society also wishes actively t o encourage the development of physiotherapyrelated courses at postgraduate diploma and Masters level. As yet these are few in number, though with the rapid development of honours degrees, they may be expected to increase in the future. The Society intends t o adopt a
:o-ordinating role in the development of postgraduate ?ducation by acting as a centre for advice, support and nformation. In particular, it is intended to organise Norkshops on the subject in the near future. In launching the PACE system, the Society wishes above all to develop post-registration study on a flexible basis. PACE is intended t o meet the needs of all Chartered physiotherapists, whether in the public, private, or voluntaly sector; whether newly-qualified, returning to practice, or changing career direction; whether developing specialist clinical skills, working with a client group, or qualifying as a teacher. The individualised study pathway will provide a unique profile of the Chartered physiotherapist's background, experience and qualifications. The Diploma in Advanced Physiotherapy Studies should become an award that is both sought by physiotherapists and preferred by their employers. It would be naive t o suggest that the PACE system will necessarily solve all the problems of post-registration education, particularly its funding. The Society hopes, however, that by providing a clear outline of required study, and a greater reward for those who successfully complete it, employers will be more convinced of the significance and value that post-registration study represents, while physiotherapists themselves will be more inclined t o pursue it. The Society is therefore publicising the PACE system by means of leaflets and letters t o members, employers, postregistration course teams and higher education institutions. There will be a formal launch during Congress at Bournemouth in September, followed by a study day for postregistration course teams and a series of regional launches aimed at employers and the higher education sector. The leaflet enclosed with this copy of the Journal gives further details to members on how to enter the PACE system and whom to contact for further information. We hope that you will do so.
The Use of Injections by Physiotherapists t As physiotherapists already administer certain drugs, such as Movelat, and use invasive techniques (acupuncture), it Seems a small logical step to combine these to enable precise local treatment of tissues. t The ability of a physiotherapist to administer a simple injection All letters expressed a desire to see the use of injections could provide quick cost-effective treatments. by physiotherapists. The main points they raised to support t Side effects of drugs are no more dangerous than those of their views, and argue against the published views of the modalities already at physiotherapists' disposal, eg shortwave diathermy, laser, manipulation, and so on. Professional Practice Committee, were as follows: t Referral to other agencies increases the time the patient is in t That the comment following paragraph 1.2 'This does not mean pain and off work. that the injection of drugs is appropriate to physiotherapy' could t With regard to causing confusion between physiotherapists and equally well have been written 'This suggests that the injection doctors, the use of treatments at the discretionof physiotherapists Of drugs may be appropriate for physiotherapists'. is the norm, with physiotherapists taking responsibility for the treatment they carry out. t There should be post-registration courses for those physiotherapists specialising in the treatment of soft tissue and t It is not unusual for medical practitioners to prescribe drugs musculoskeletal conditions, who wish to extend their existing and for other professions to administer; this applies to opticians (atropine), midwives and podiatrists. skills and expertise by using injection techniques. Although the committee did not change its view following t Given physiotherapists' poor record on research, it was felt unrealistic that the committee requesteddetails of research studies consideration of these points, members of the Society are 'that had tested out whether injectionscould be shown to be more still invited to forward their views t o Penelope R Robinson efficacious than non-invasive treatment modalities'. M A MCSP, director, CSP Professional Affairs Department t The methods and modalities available to physiotherapists were as this debate is not considered closed, the opinions of not always effective in respect of certain conditions, such as bursae members are welcome and will be considered.
THE Society received five letters covering 13 signatories following the publication of the discussion document on injections in the April edition of Physiotherapy (pages 218-219).
538
physbthewy, September 1990, wf 76, no 9
DELIVERY OF THERAPY SERVICES IN THE NEW NATIONAL HEALTH SERVICE One-day conference t o be held at
The St John's Swallow Hotel, Solihull Tuesday, November 6, 1990
10 am until 4 pm APPLICATION FORM
Name (Mr/Mrs/Miss/Ms) .......................................................................
BLOCK CAPITALS PLEASE
Address ..............................................................................................
......................................................................................................... .......................................................................................................... Daytime telephone number ................................................................... Occupational title if appropriate.. ........................................................... Do you have any special needs? ............................................................ If yes, please detail ..............................................................................
......................................................................................................... Please note that any delegates with a disability should be self-sufficient for their everyday needs or accompanied by an attendant who will be admitted free. If you will be accompanied, please give attendant's name.. ................................................................................
Do you have any special dietary requirements?
YES/NO
If yes, please detail ................................................................................................
The registration fee for the conference is f 75 per person, inclusive of background papers, morning coffee, lunch, afternoon tea and VAT (VAT no. 232323800). Please make cheques/postal orders payable t o 'The Chartered Society of Physiotherapy'. If it is more convenient for us t o invoice you, please contact the Events Organiser. The closing date for applications is Friday,' October 26.
IF YOU WOULD LIKE ANY FURTHER INFORMATION ON THE CONFERENCE, PLEASE DO NOT HESITATE TO CONTACT THE EVENTS ORGANISER.
Please return this form to Jane Morrison, Events Organiser, Chartered Society of Physiotherapy, 14 Bedford Row, London WClR 4ED (tel 071-242 1941 fax 071-831 4509). PhVsiothsrapy, September 1990, vd 76, no 9
DELIVERY OF COMMUNITY CARE IN THE NEW NATIONAL HEALTH SERVICE One-day conference to be held at The Queen Elizabeth II Conference Centre, London SW1 Monday, November 12, 1990
10 am until 4 pm APPLICATION FORM
Name (Mr/Mrs/Miss/Ms) .......................................................................
BLOCK CAPITALS PLEASE
Address ..............................................................................................
......................................................................................................... .......................................................................................................... Daytime telephone number ................................................................... Occupational title if appropriate.. ........................................................... Do you have any special needs? ............................................................ If yes, please detail ..............................................................................
......................................................................................................... Please note that any delegates with a disability should be self-sufficient for their everyday needs or accompanied by an attendant who will be admitted free. If you will be accompanied, please give attendant's name. .................................................................................
Do you have any special dietary requirements?
YES/NO
If yes, please detail ................................................................................................
The registration fee for the conference is f 75 per person, inclusive of background papers, morning coffee, lunch, afternoon tea and VAT (VAT no. 232323800). Please make cheques/postal orders payable to 'The Chartered Society of Physiotherapy'. If it is more convenient for us to invoice you, please contact the Events Organiser. The closing date for applications is Friday, November 2.
IF YOU WOULD LIKE ANY FURTHER INFORMATION ON THE CONFERENCE, PLEASE DO NOT HESITATE TO CONTACT THE EVENTS ORGANISER.
Please return this form to Jane Morrison, Events Organiser, Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED (tel 071-242 1941 fax 071-831 4509). 540
PhVsiotherapy, Septmber 1990, vd 76, IK) 9
IT is now widely recognised that education is a continuing and lifelong process. It is also increasingly clear that the process of education may take many forms, not all of them traditional. No longer can a person's education be associated exclusively with the period of learning which occurs in the first twenty-odd years of life. Nowhere is this more evident than in the professions. The pace of social and technological change is now so rapid and intense that an initial period of professional training can provide only the disciplinary foundations of knowledge and skills, on which further education and experience must be built if they are to remain current and valid. The pace of change also means that professions are in a state of constant mutation, developing new strands and becoming multiform. Education itself may serve as an agent of this change, while new methods of organisation, as currently seen within the National Health Service, provide further impetus of development within professions such as physiotherapy. Here, as elsewhere, the context of change places a great responsibility on the existence and the encouragement of continuing education. While few would dispute this, the reality remains that post-registration study in physiotherapy has largely grown through the dedication of those members of the profession, comparatively small in number, who are prepared t o devote both time and energy to the design and teaching of courses. While the Society has encouraged this growth through its validation process, it is perhaps unsurprising that post-registration developments have been piecemeal and haphazard, though of great intrinsic value. The reasons for this are not hard to find. Education is expensive, and post-registration courses doubly so in that both course fees and study leave must be costed by employers. While the imperative of pre-registration education absorbs training budgets, comparatively little remains for post-registration education opportunities. The upshot is that many physiotherapists are deterred or prevented from pursuing new areas of study, while those who succeed often do so at considerable financial cost to themselves. While economic factors are no doubt important, there are however further reasons why post-registration initiatives do not receive the support they deserve. Because post-registration courses vary in length and depth, they may not carry any permanent recognition. Physiotherapistsmay therefore have little or nothing concrete to show for their further study, apart from the personal and professional development they may have gained. It is surely right that post-registration study, of whatever nature, should count formally towards their legitimate aspirations for greater professional recognition. A small number of courses do have diploma or masters study from parent institutions, while the Society has sought to improve the currency of post-registration courses by
PhVsiotherapn September 1990. w/ 76, no 9
validating them according to national criteria. Overall, however, the lack of recognition may act as another deterrent to undertaking further study. An additional factor of importance is the need to establish and clarify a desirable balance in post-registration study. This is particularly important in a clinical profession where, as already suggested, many specialist strands are emergent. The Society should aim to legitimise the need for specialist study in the eyes of employers and the profession alike. Equally, in a time of change and greater responsibility for physiotherapists, it is vital to promote non-clinical areas of study which transcend professional boundaries, such as 'common core' courses in management, teaching, and communication skills. Above all, post-registration study should stress the continuum of education and the value of experiential learning. The Chartered Society of Physiotherapy has therefore been concerned both with mapping out the territory of continuing education in physiotherapy, and with providing a flexible system by which permanent and widespread recognition can be given to studies undertaken. In these concerns the Society is swimming with the tide. The development of Credit Accumulation and Transfer Schemes (CATS) and National Vocational Qualifications (NVQs) both lay great emphasis on the value of all forms of continuing education, whether academic, practical or experiential, and the need to recognise these endeavours by the most flexible means. In the case of CATS, the Society also has a ready-made vehicle for transforming its plans into reality. The result of the Society's work is a new framework for post-registration study: PACE, standing for Physiotherapy Access to Continuing Education. The PACE system is built explicitly on a credit accumulation structure. This has twin advantages: first, a Chartered physiotherapist will be able to build up credit on a gradual basis for studies undertaken; and second, these studies can reflect a pathway unique to the individual physiotherapist, combining different types of continuing education. New Diploma At the heart of the PACE system will be a new award issued by the Society: the Diploma in Advanced Physiotherapy Studies. To obtain this award, a Chartered physiotherapist will need to accumulate at least 120 credit points from a study pathway that exhibits a coherent balance between practice-oriented courses, the 'common core' courses already referred to, and experiential learning. It is expected that the 120 points will be gained over a maximum period of five years, and will break down into the component parts as follows: Practice-oriented courses
4 0 - 8 0 credit points
'Common core' courses
2 0 - 4 0 credit points
Experiential learning
20-40 credit points
The practice-oriented course will include those specialist skill-based or client-group-based courses already validated
537
by the Society, together with similar courses operated by other bodies. 'Common core' courses will encompass a wide range of relevant non-clinical subjects, as offered by the Open University, the Institute of Health Services Management, the Health Education Authority, and so on. They will also include teacher training courses as approved by the City and Guilds and the CNAA, already a component part of the Society's DipTP award. Experiential learning naturally has a wide potential remit, and the Society intends to issue further guidance on this area, particularly in terms of 'portfolio' development, at the beginning of 1991. Examples of such individualised learning could however include in-service programmes accredited by the Society, or the process of actually planning and developing a practice-oriented course. As a general point, it should be stressed that the Society intends t o introduce a certain amount of retrospective recognition in all three elements of the PACE system. Accreditation System ' In order t o establish credit ratings for the practice-oriented courses, the Society has developed a process of course accreditation which will replace the validation system hitherto operated. The Society will also be seeking to develop its accreditation of 'common core' courses by means of the credit ratings assigned to them by their parent bodies. The Society has already been exploring these possibilities with such bodies as the Open University and the IHSM, and these discussions will continue in the future. While the PACE system very much represents a lateral, practice-based route of study, the Society also wishes actively t o encourage the development of physiotherapyrelated courses at postgraduate diploma and Masters level. As yet these are few in number, though with the rapid development of honours degrees, they may be expected to increase in the future. The Society intends t o adopt a
:o-ordinating role in the development of postgraduate ?ducation by acting as a centre for advice, support and nformation. In particular, it is intended to organise Norkshops on the subject in the near future. In launching the PACE system, the Society wishes above all to develop post-registration study on a flexible basis. PACE is intended t o meet the needs of all Chartered physiotherapists, whether in the public, private, or voluntaly sector; whether newly-qualified, returning to practice, or changing career direction; whether developing specialist clinical skills, working with a client group, or qualifying as a teacher. The individualised study pathway will provide a unique profile of the Chartered physiotherapist's background, experience and qualifications. The Diploma in Advanced Physiotherapy Studies should become an award that is both sought by physiotherapists and preferred by their employers. It would be naive t o suggest that the PACE system will necessarily solve all the problems of post-registration education, particularly its funding. The Society hopes, however, that by providing a clear outline of required study, and a greater reward for those who successfully complete it, employers will be more convinced of the significance and value that post-registration study represents, while physiotherapists themselves will be more inclined t o pursue it. The Society is therefore publicising the PACE system by means of leaflets and letters t o members, employers, postregistration course teams and higher education institutions. There will be a formal launch during Congress at Bournemouth in September, followed by a study day for postregistration course teams and a series of regional launches aimed at employers and the higher education sector. The leaflet enclosed with this copy of the Journal gives further details to members on how to enter the PACE system and whom to contact for further information. We hope that you will do so.
The Use of Injections by Physiotherapists t As physiotherapists already administer certain drugs, such as Movelat, and use invasive techniques (acupuncture), it Seems a small logical step to combine these to enable precise local treatment of tissues. t The ability of a physiotherapist to administer a simple injection All letters expressed a desire to see the use of injections could provide quick cost-effective treatments. by physiotherapists. The main points they raised to support t Side effects of drugs are no more dangerous than those of their views, and argue against the published views of the modalities already at physiotherapists' disposal, eg shortwave diathermy, laser, manipulation, and so on. Professional Practice Committee, were as follows: t Referral to other agencies increases the time the patient is in t That the comment following paragraph 1.2 'This does not mean pain and off work. that the injection of drugs is appropriate to physiotherapy' could t With regard to causing confusion between physiotherapists and equally well have been written 'This suggests that the injection doctors, the use of treatments at the discretionof physiotherapists Of drugs may be appropriate for physiotherapists'. is the norm, with physiotherapists taking responsibility for the treatment they carry out. t There should be post-registration courses for those physiotherapists specialising in the treatment of soft tissue and t It is not unusual for medical practitioners to prescribe drugs musculoskeletal conditions, who wish to extend their existing and for other professions to administer; this applies to opticians (atropine), midwives and podiatrists. skills and expertise by using injection techniques. Although the committee did not change its view following t Given physiotherapists' poor record on research, it was felt unrealistic that the committee requesteddetails of research studies consideration of these points, members of the Society are 'that had tested out whether injectionscould be shown to be more still invited to forward their views t o Penelope R Robinson efficacious than non-invasive treatment modalities'. M A MCSP, director, CSP Professional Affairs Department t The methods and modalities available to physiotherapists were as this debate is not considered closed, the opinions of not always effective in respect of certain conditions, such as bursae members are welcome and will be considered.
THE Society received five letters covering 13 signatories following the publication of the discussion document on injections in the April edition of Physiotherapy (pages 218-219).
538
physbthewy, September 1990, wf 76, no 9
DELIVERY OF THERAPY SERVICES IN THE NEW NATIONAL HEALTH SERVICE One-day conference t o be held at
The St John's Swallow Hotel, Solihull Tuesday, November 6, 1990
10 am until 4 pm APPLICATION FORM
Name (Mr/Mrs/Miss/Ms) .......................................................................
BLOCK CAPITALS PLEASE
Address ..............................................................................................
......................................................................................................... .......................................................................................................... Daytime telephone number ................................................................... Occupational title if appropriate.. ........................................................... Do you have any special needs? ............................................................ If yes, please detail ..............................................................................
......................................................................................................... Please note that any delegates with a disability should be self-sufficient for their everyday needs or accompanied by an attendant who will be admitted free. If you will be accompanied, please give attendant's name.. ................................................................................
Do you have any special dietary requirements?
YES/NO
If yes, please detail ................................................................................................
The registration fee for the conference is f 75 per person, inclusive of background papers, morning coffee, lunch, afternoon tea and VAT (VAT no. 232323800). Please make cheques/postal orders payable t o 'The Chartered Society of Physiotherapy'. If it is more convenient for us t o invoice you, please contact the Events Organiser. The closing date for applications is Friday,' October 26.
IF YOU WOULD LIKE ANY FURTHER INFORMATION ON THE CONFERENCE, PLEASE DO NOT HESITATE TO CONTACT THE EVENTS ORGANISER.
Please return this form to Jane Morrison, Events Organiser, Chartered Society of Physiotherapy, 14 Bedford Row, London WClR 4ED (tel 071-242 1941 fax 071-831 4509). PhVsiothsrapy, September 1990, vd 76, no 9
DELIVERY OF COMMUNITY CARE IN THE NEW NATIONAL HEALTH SERVICE One-day conference to be held at The Queen Elizabeth II Conference Centre, London SW1 Monday, November 12, 1990
10 am until 4 pm APPLICATION FORM
Name (Mr/Mrs/Miss/Ms) .......................................................................
BLOCK CAPITALS PLEASE
Address ..............................................................................................
......................................................................................................... .......................................................................................................... Daytime telephone number ................................................................... Occupational title if appropriate.. ........................................................... Do you have any special needs? ............................................................ If yes, please detail ..............................................................................
......................................................................................................... Please note that any delegates with a disability should be self-sufficient for their everyday needs or accompanied by an attendant who will be admitted free. If you will be accompanied, please give attendant's name. .................................................................................
Do you have any special dietary requirements?
YES/NO
If yes, please detail ................................................................................................
The registration fee for the conference is f 75 per person, inclusive of background papers, morning coffee, lunch, afternoon tea and VAT (VAT no. 232323800). Please make cheques/postal orders payable to 'The Chartered Society of Physiotherapy'. If it is more convenient for us to invoice you, please contact the Events Organiser. The closing date for applications is Friday, November 2.
IF YOU WOULD LIKE ANY FURTHER INFORMATION ON THE CONFERENCE, PLEASE DO NOT HESITATE TO CONTACT THE EVENTS ORGANISER.
Please return this form to Jane Morrison, Events Organiser, Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED (tel 071-242 1941 fax 071-831 4509). 540
PhVsiotherapy, Septmber 1990, vd 76, IK) 9