APPLICATION
FOR CREDENTIALING OF RESIDENCY & FELLOWSHIP PROGRAMS
Application for Credentialing of Residency/Fellowship Programs 1 APTA September 2008
APPLICATION FOR RESIDENCY/FELLOWSHIP PROGRAM CREDENTIALING INTRODUCTION
Thank you for your interest in credentialing your developing or existing residency or fellowship program. Congratulations on your commitment to excellence in physical therapy education. There are many benefits to developing and credentialing residency and/or fellowship programs including improving patient/client outcomes, promoting evidence based practice in physical therapy, and establishing your clinic‟s reputation of excellence in patient/client care and physical therapist education. The credentialing application process also has many benefits for your program, including the opportunity to: Take an in-depth look at your program Compare your program to the credentialing requirements Identify program strengths and weaknesses Develop your program further in a systematic way APTA‟s Residency/Fellowship Program Credentialing Application Packet is divided into the following five sections: 1.) APTA‟s Credentialing Policies and Procedures: This section describes the history, purpose, benefits, eligibility and ongoing requirements, administration and responsibilities of the credentialing process. Additionally, information on confidentiality, appeals, use of logos, fees, and complaint procedures are found in this section. 2.) Application Instructions: This important section provides the applicant with the necessary directions to compile and send the application. 3.) Application, including Credentialing Requirements and Evidence: This section includes the requirements for credentialing and describes the evidence to be submitted as demonstration of compliance with the credentialing requirements. 4.) Application Forms: This section contains the forms that are completed and submitted as evidence of compliance with the corresponding requirements. 5.) Additional information: This section includes the Evidence Checklist, a tool to assure that you have responded to all of the credentialing requirements, a glossary, and resources. Additionally, APTA‟s Committee on Clinical Residency and Fellowship Program Credentialing has compiled the Application Resource Manual, also available at www.apta.org to serve as a guide as you prepare your documents for credentialing. These real examples were provided by APTA credentialed programs and are not intended to be prescriptive as every program is unique and that individuality should be reflected in the application. Programs may seek assistance for program development from the Professional Development staff or from a consultant. Professional Development staff may be reached at profdev@apta.org or 703-706-8514. APTA provides a consulting service that includes consultants for residency/fellowship development and credentialing. Please see www.apta.org; or call 800-999-2782, ext. 3145 or 3146, or by e-mail at insfinsvcs@apta.org. Please don‟t hesitate to contact us as you develop your program and prepare your application for credentialing.
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APPLICATION FOR RESIDENCY/FELLOWSHIP PROGRAM CREDENTIALING TABLE OF CONTENTS PART 1: APTA Credentialing Policies and Procedures 1. Historical Background ..................................................................................................... 6 2. Purposes ........................................................................................................................... 6 3. Benefits of Becoming Credentialed ................................................................................. 6 4. Definitions of Clinical Fellowship and Clinical Residency ............................................. 7 5. Eligibility Requirements for Application as a Credentialed Residency or Fellowship Program ......................................................................................................... 7 6. On-going Requirements for Credentialed Clinical Residency or Fellowship Programs ....................................................................................................... 7 7. Administration of the Credentialing Process ................................................................... 8 8. Outline of Responsibilities during the Credentialing Process ......................................... 8 9. Credentialing Process ...................................................................................................... 9 Requests for Applications ................................................................................................ 9 Requirements and Evidence for Postprofessional Clinical Residency or Fellowship Programs for Physical Therapists .................................................................. 9 Review Process for Credentialing .................................................................................. 10 a. Written Application ................................................................................................. 11 b. Site Visit .................................................................................................................. 11 c. Committee Action ................................................................................................... 12 d. Types of Actions to be taken by the Committee ..................................................... 12 10. Withdraw of Application by Applicant/ Request for Inactive Credentialed Status ....................................................................... 14 11. Confidentiality and Disclosure of Information .............................................................. 15 12. Credentialed Program Responsibilities a. Annual Report ......................................................................................................... 15 b. Renewal/Reapplication............................................................................................ 15 13. Appeals Process ............................................................................................................. 16 14. Use of Logo ................................................................................................................... 19 15. Fees ................................................................................................................................ 19 16. Committee Statement on Credentialed Program Status and Clinical Residency or Fellowship Graduates............................................................................... 20 17. Procedure for Handling Complaints Against a Credentialed Program .......................... 20 PART 2: Application Instructions 1. Compilation of Application ........................................................................................... 23 2. Materials to be Included ................................................................................................ 23 3. Submission of the Application ....................................................................................... 24 PART 3: Application Signature Page ...................................................................................................................... 26 Applicant Information .......................................................................................................... 27 Clinical Residency/Fellowship Program Agreement ........................................................... 28 Preface .................................................................................................................................. 29 1.0 Organization................................................................................................................... 30 2.0 Resources ....................................................................................................................... 33 3.0 Curriculum ..................................................................................................................... 38 4.0 Ongoing Evaluation ....................................................................................................... 41
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PART 4 : Application Forms Form: Evidence 1.2.3.3 – Residents/Fellows Currently Enrolled in Program ..................... 46 Form: Evidence 2.1.1 – Description of Patients by Diagnostic Group/ Impairment Category............................................................................................................ 47 Form: Evidence 2.2.2/2.2.3 - Program Faculty .................................................................... 48 Form: Evidence 2.3.1.1.A – Clinical Facilities Utilized in Program.................................... 49 Form: Evidence 3.3.1.A – Curriculum Overview ................................................................ 50 Form: Evidence 3.3.1.A – Sample Weekly Schedule........................................................... 51 Form: Evidence 3.2.1.B – Program Graduates ..................................................................... 52 Form: Evidence 3.2.2 – Instructional Methods and Hours ................................................... 53 PART 5: Additional Information Evidence Checklist ............................................................................................................... 55 Glossary of Terms ................................................................................................................ 58 Resources ............................................................................................................................. 62
Please retain this application information for reference throughout the application process and future credentialing period. Replace with most current edition, as they are made available.
September 2008 Edition
Application for Credentialing of Residency/Fellowship Programs 4
APTA September 2008
PART 1 – APTA CREDENTIALING POLICIES AND PROCEDURES
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APTA September 2008
APTA CREDENTIALING POLICIES AND PROCEDURES
1.
HISTORICAL BACKGROUND In November of 1996, the American Physical Therapy Association implemented a voluntary credentialing process for postprofessional clinical residency programs for physical therapists. The five-member Committee on Clinical Residency Program Credentialing was established in November 1997, and charged with the development and implementation of a credentialing process for postprofessional clinical residency programs. In November of 2000, APTA added credentialing of clinical fellowship programs and the committee name was changed to Committee on Clinical Residency and Fellowship Program Credentialing (Committee). In 2002, APTA merged with the American Academy of Orthopedic Manual Therapists (AAOMPT) for credentialing orthopedic manual therapy fellowships; and in 2004, merged with the Sports Medicine Section for credentialing sports physical therapy residencies. Both organizations continue to have representation on the Committee and Reviewer Subcommittee. Credentialing of post-professional clinical residency or fellowship programs (Programs) for physical therapists is a voluntary, non-punitive process designed to recognize Programs of sufficient length and scope that significantly advance a physical therapist‟s knowledge and skills in patient/client management within a defined area of practice as measured by an established set of requirements.
2. PURPOSES The purposes of clinical residency and fellowship program credentialing are to: Assure a consistent level of quality through a formalized process of evaluation and consultation, and Facilitate an ongoing process of analysis, assessment, and review, leading to enhanced clinical and educational quality and effectiveness. 3. BENEFITS OF BECOMING CREDENTIALED A credentialed residency or fellowship program has demonstrated compliance with standards of quality and consistency in the teaching and practice of physical therapy. Through voluntarily participation and adherence to the requirements of the credentialing process, these programs: Confirm to potential residents or fellows their commitment to providing quality learning experiences; and Affirm commitment to the protection of the consumer of physical therapy to the public at large. The submission of an application to become a credentialed residency or fellowship program also directly benefits the Program. The application process promotes objective documentation of curriculum and administrative policies and procedures, and enables the program administrators to compare their programs to established criteria. APTA-credentialed programs provide a clinical and didactic experience, based on a practice analysis, which advances physical therapist practice. To achieve this outcome, graduates of these programs must successfully complete an outcome-oriented curriculum. Credentialed programs are recognized in APTA publications and are presented with a certificate suitable for framing. These credentialed programs may also use the official APTA "Credentialed Post professional Clinical Residency Program" logo or the “Credentialed Post professional Clinical Fellowship Program” logo.
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4. DEFINITIONS OF CLINICAL RESIDENCY AND CLINICAL FELLOWSHIP Clinical Residency Program A planned Program of post professional clinical and didactic education for physical therapists that is designed to advance significantly the physical therapist resident's preparation as a provider of patient care services in a defined area of clinical practice. It combines opportunities for ongoing clinical mentoring, with a theoretical basis for advanced practice and scientific inquiry. Clinical Fellowship Program A post professional planned learning experience in a focused area of clinical practice (not infrequently for post-residency prepared or board-certified therapists). A clinical fellowship combines opportunities for ongoing clinical mentoring with a theoretical basis for advanced practice and scientific inquiry in a defined area of subspecialization beyond the generally accepted Description of Specialty Practice (see definition below). Neither 'clinical residency' nor 'clinical fellowship' is synonymous with the terms „clinical internship.' (See Glossary of Terms) A clinical internship is typically initiated and often completed as part of the professional education of a physical therapist prior to licensing. 5. ELIGIBILITY REQUIREMENTS FOR CREDENTIALING AS A RESIDENCY OR FELLOWSHIP PROGRAM Clinical Residencies: To be eligible to apply for credentialing as a clinical residency program for physical therapists, a clinical residency program must possess a curriculum that: 1) covers the entire spectrum of the corresponding Description of Specialty Practice; 2) includes a minimum of 150 hours of one-on-one clinical mentoring; 3) includes a minimum of 75 hours of didactic training; and 4) provides a sufficient and appropriate patient population to address all components of the DSP. The clinical residency program must have at least one (1) resident enrolled in the program at the time of application, whose background must include licensure as a physical therapist. Additionally, the program must have a minimum of one faculty member who has obtained American Board of Physical Therapy Specialists (ABPTS) certification as a specialist in the Program‟s content area. Clinical Fellowships: To be eligible to apply for credentialing as a clinical fellowship program for physical therapists, a clinical fellowship program must possess a curriculum that: 1) is focused, with a minimum of 50 hours of advanced didactic instruction within a subspecialty area of practice; 2) is intensive and includes extensive clinical experience with a minimum of 100 hours of one-on-one mentoring; and, 3) provides a sufficient and appropriate patient population to create an environment for advanced clinical skill-building. Additionally, the clinical fellowship program must have at least one (1) fellow enrolled in the Program at the time of application, whose background must include: 1) licensure as a physical therapist; 2) specialist certification or completion of a residency in a specialty area, 3) substantial clinical experience in a specialty area; or 4) demonstrable clinical skills within a particular specialty area. An orthopedic manual therapy fellowship must have a minimum of one fellow of the American Academy of Orthopaedic Manual Therapy on faculty. 6. ON-GOING REQUIREMENTS FOR CREDENTIALED CLINICAL RESIDENCY OR FELLOWSHIP PROGRAMS APTA-credentialed Programs must meet ongoing requirements, including: Adhere to the Clinical Residency/Fellowship Program Agreement, signed as part of the application;
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Comply with APTA policies and positions, including not placing a resident/fellow in a clinical education experience where the clinic is in a referral for profit situation; Pay an Annual Fee for each year of credentialed status; Provide an Annual Report for each year of credentialed status that includes a description of updates/changes to the Program in the previous year; and Revise the Program curriculum when a new Description of Specialty Practice (DSP) or practice analysis for the specialty area is published. APTA has responsibility to maintain the integrity of the credentialing process and to monitor the quality of the clinical residency or fellowship experience offered by a credentialed Program; therefore, the Committee retains the right to monitor a Program‟s organization, resources, curriculum, and outcomes. 7. ADMINISTRATION OF THE CREDENTIALING PROCESS The Committee on Clinical Residency and Fellowship Program Credentialing (Committee) administers APTA‟s credentialing of Programs. The Committee, a five-member body appointed by the Board of Directors of APTA, is responsible for the oversight and management of the credentialing process. APTA‟s Department of Professional Development is responsible for the day-to-day administration of the credentialing process. Questions concerning the credentialing process should be directed to the Department of Professional Development at 1-800-999-2782, x8514. 8. OUTLINE OF RESPONSIBILITIES DURING THE CREDENTIALING PROCESS Clinical Residency or Fellowship Program Submits five (5) copies of the application with each section and attachment tabbed and the application fee (Electronic submission of the application is not permitted.) Identifies conflict(s) of interest from list of available reviewers Provides additional information as requested by the Committee Negotiates site visit date once application has been accepted as complete Arranges site visit schedule for site visit team Reviews team report and provides additional comments or materials if required Evaluates site visit team Reimburses APTA for site visit team expenses APTA Department of Professional Development Staff Logs application and creates file, including one (1) copy of application Maintains communications with the Program throughout the credentialing process Provides list of available reviewers for identification of conflict(s) of interest with the Program or the Program‟s umbrella organization Selects a minimum of two (2) reviewers from the Committee on Clinical Residency and Fellowship Program Credentialing and/or the Reviewer Subcommittee and forwards the application to the reviewers Collates and manages all written materials related to the credentialing process Assists in the establishment of a site visit (eg, scheduling dates, arranging air transportation) Committee on Clinical Residency and Fellowship Credentialing Identifies conflict(s) of interest with the Program Participates in application review and site visit as requested Reviews and discusses results of application review to determine readiness for the site visit Determines if the Program is ready for a site visit
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Identifies information to be provided by the Program prior to the site visit May identify areas of concern to be emphasized at the site visit and discusses with on site reviewers Reviews Program Evaluation and Program comments to determine readiness for credentialing Makes credentialing decision
Review Team (up to four members, two of which function as the site visit team) Reviews the written application and communicates results to the Committee Participates in determining a plan for the site visit, based on review of the application Team leader communicates with Program Director to finalize agenda and make final travel arrangements Visits site to collect additional data and triangulate the written application Completes and submits Program Evaluation to the Committee Participates in conference calls as requested by the Committee Retains application materials and a copy of the report until action is complete. 9. CREDENTIALING PROCESS Requests for Applications A Program interested in becoming an APTA-credentialed Program should review the following materials: Application Packet Application Resource Manual FAQs Other documents under the “Applicants” section of the web site. All materials, including the application, can be downloaded from the APTA website at http://www.apta.org ; mouse over “Professional Development;” and click on “Residency/Fellowship. Requirements and Evidence for Postprofessional Clinical Residency or Fellowship Programs for Physical Therapists The “Requirements and Evidence for Postprofessional Clinical Residency or Fellowship Programs for Physical Therapists” are divided into four sections, each of which has an introduction, requirements for credentialing, and a description of the evidence necessary to demonstrate compliance with the requirements. The four sections of requirements are: 1) Organization 2) Resources 3) Curriculum 4) Ongoing Evaluation The Committee expects that Programs will comply with the intent of each requirement and supply evidence as indicated to demonstrate compliance. The interpretative guidelines included with select requirements are provided to clarify the intent of the requirement. The Committee seeks to credential those Programs recognized to be in substantial compliance with the requirements; however, the Committee recognizes that residency or fellowship programs can be cited as out of compliance with some requirements and still be credentialed with corrections reported in the first Annual Report. The Program curriculum must be based on the Description of Specialty Practice (DSP); a valid practice analysis; or a detailed description of the knowledge, competency expectations, and patient population of a component of the DSP (fellowship only). The Committee retains the right to determine if a practice analysis or explanation of a component of a DSP (fellowship only) is sufficient for development of a Program
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curriculum. Programs completing a practice analysis should follow the “Guidelines for Conducting a Practice Analysis,” also available at the web site. Review Process for Credentialing The review process for credentialing a program includes a review of the written application materials and a site visit by two members of the two to four-member review team specifically assigned to a given program. The following diagram depicts the credentialing process:
The Credentialing Process
Application Submission Application Review Ready for site visit? Site Visit
Report Respond
No
Yes Credential?
Return for Revision/Clarification
Program Program Committee Committee
Credential
Deny
Site Visit Team Site Visit Team
The review team is selected from the Committee and/or the Reviewer Subcommittee, a pool of trained reviewers. At least one of the review team members is a content expert. A Committee member is assigned to each application and may or may not be present at the site visit. The entire credentialing process from submission of the application to completion of all required documents and scheduling of the site visit should take no longer than one year. Programs that exceed the one year application time frame will be required to pay an additional application fee equal to one half of the original application fee. Upon completion of the paper review and the site visit, the Committee member on the review team reports to the full Committee, who then makes a credentialing decision by vote based on the materials submitted in the application and the results of the on site visit. The two sources for substantiating information about the elements of the Program in relation to the requirements are the written application and the site visit, which includes interviews with administration, faculty, and students; review of documents; observation of a mentoring session; and other documents and/or experiences as requested by the site visit team.
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The following is a description of the review process: a. Written Application The written application is the primary source of information about the Program. Faculty, administrative officials, and physical therapist residents or fellows should be involved in preparing the application. Responsibility for completing portions of the application can be delegated and may be shared by several individuals. Applications are due to the Professional Development staff at APTA by March 1 or September 1. To be effective, all programs must be based on the most current version of their area‟s Description of Specialty Practice (DSP), a valid practice analysis, or a detailed description of the subspecialty. Therefore, the application must reflect the most current document. If a new version of a DSP is published less than a year prior to the receipt of the application, the Program can apply using the prior version of the DSP as the basis for the curriculum. However, the Program may be asked to describe their plan for updating the curriculum at the site visit and must include a plan for updating the curriculum in the next Annual Report. The written application provides information that is vital to evaluation of the Program by the Committee. The application should be clear and concise. It should be written in such a way as to help those who are unfamiliar with the Program to: Develop a clear understanding of the environment in which the Program operates and the nature of the learning experiences provided; and Gain the information needed for the Committee to evaluate the Program fairly, in relation to the Program‟s stated goals and the current requirements.
The format for completion of the application is contained in Part 4 of this application. This information includes the “Requirements and Evidence for Postprofessional Clinical Residency and Fellowship Programs for Physical Therapists” with interpretative guidelines and the required sources of evidence. Program responses should be typed into the form as indicated. b. Site Visit The site visit is an essential component of the review process used by the Committee to determine whether the Program meets the requirements for APTA credentialing. The primary purpose of the site visit is to obtain a comprehensive view of the Program in its particular environment and to validate the information contained in the written application through discussions with administration, faculty, staff, and residents or fellows. In addition, the site visit provides an opportunity for the Program to elaborate upon information provided in the written application. A list of all Committee members and potential site visitors will be shared with the Program prior to assignment of reviewers for the written application. The Program will have ten (10) business days to identify any individuals on the list that may be considered to have a conflict of interest with the umbrella organization or Program applying for credentialing. To ensure an objective and non-biased evaluation of the Program, the identified individuals will not be eligible to participate in the review of the written application, site visit, discussion, or decision of credentialing for that Program. Two members of the review team assigned to the Program conduct the site visit to collect data and triangulate information provided in the application. The site visitors do NOT render judgments regarding the Program‟s compliance with the credentialing requirements; the credentialing decision is entirely the decision of the Committee. The site visit will take place over a one- to two-day period and will consist of a series of conferences with administrative officials, faculty, and residents or
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fellows, as well as visits to selected Program facilities and, if appropriate, affiliated umbrella organizations. The following are examples of items and/or activities, which may be reviewed: Observation of actual training (classroom/lab or clinical) Review of organizational policies Review of facility resources Review of faculty CVs or resumes Review of curriculum Review of performance of residents or fellows Interviews with clinical faculty Interviews with current residents or fellows Interviews with director/coordinator Interviews with administrative officials Overview of site visit findings with Program Director The Program and APTA‟s Professional Development staff will collaborate to schedule the site visit once the Committee has determined that the written application is complete and the Program is ready for a site visit. Site visitors are available for consultation to the Program upon request by the Program at the completion of the site visit. Consultation is confidential and will not be included in the site visit report. Upon completion of the site visit, the site visit team will complete the Program Evaluation, which will be distributed to the Committee. The Program will be provided with a copy of Program Evaluation within two (2) weeks of the date of the visit. The Program will have the opportunity to provide written comments as an attachment to the report. In addition, the Program will be provided with an instrument to evaluate the site visit team. All documents must be submitted to APTA within thirty (30) days of the site visit. Site visit expenses are the responsibility of the Program. Site visitors will be reimbursed through APTA for expenses incurred during the scheduled visit; APTA will charge the Program the actual expenses in accordance with APTA‟s guidelines for reimbursement of member expenses. Site visitor expenses will be for a maximum of two (2) days for one or two visitors. All reasonable efforts will be made to minimize travel expenses. c. Committee Action The Committee as a whole will vote on the credentialing of each Program applicant during scheduled telephone conference calls. The Program Evaluation and the Program‟s response/comments will be distributed to all Committee members prior to the conference call in which the Committee is schedule to discuss the Program‟s credentialing. After a brief oral summary of the application, the Committee will vote on the credentialing status of the Program. The Committee Chair shall vote on each application. A minimum of three Committee members‟ votes will be required for an official vote and a majority vote of the Committee rules. d. Types of Action to be taken by the Committee The Committee will make one of the following decisions:
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Credentialed A credential is granted when the Program is in substantial compliance with APTA‟s requirements for credentialing. The initial credential will begin on the last day of the month in which the Committee approves the Program, and is granted for a period of five (5) years. Recredentialing is dependent upon the Program meeting ongoing requirements, including the submission of an annual report and an annual fee, and submission of a re-credentialing application. The letter to a credentialed Program will include: Credentialed status period Copy of APTA credentialing statement for promotional materials Electronic copy of APTA credentialing logo Information on Annual Report and annual fee requirements Authorized Statement of Credential: Once applicants have been credentialed, and for as long as they remain credentialed, they may use the following statement on all educational and promotional materials relating to the Program:
(Name of Program) is credentialed by the American Physical Therapy Association as a postprofessional clinical [residency/fellowship] program for physical therapists in (Area of Specialty) . A Program may not use a different formulation to describe APTA‟s credential. A Program may not use the APTA credentialing authorized formulation and/or logo for any other purpose than to identify the credentialed program. APTA staff will notify the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) when an orthopaedic manual physical therapy fellowship has been credentialed. The corresponding APTA Section and Chapter will be notified of residency and fellowship programs in that specialty area that are credentialed. Denial A credential is denied when the Committee, after a full review of the application, determines there is not substantial compliance with the requirements. The reasons for denial will be specified in writing to the applicant. When a denial is issued, the applicant may appeal the decision to the Committee as outlined in the appeals process. The applicant may reapply at anytime. Suspended A credential is suspended when the Program fails to submit an Annual Report and/or annual fee. The involved program will receive written notification of pending suspension and actions required to prevent suspension prior to initiation of the suspended status. Suspended programs will be identified as such on all Committee documents and will not be eligible for any of the benefits of credentialing. A majority vote of the Committee is required to lift the suspended
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status and may only come to vote after the Program has met all requirements outlined by the Committee. Withdrawal A credential is withdrawn when the Committee, after full review of the annual report and any other requested materials, determines there is no longer substantial compliance with the requirements, the Program fails to submit an annual report, or the Program fails to comply with the Clinical Residency/Fellowship Program Agreement. The reasons for withdrawal will be specified in writing to the Program. When a withdrawal is issued, the Program may appeal the decision of the Committee as outlined the appeal process. The Program may re-apply at any time. The Committee will determine the effective date of any action. APTA staff will notify the applicant of the Committee‟s action by letter. Letters to applicants that have been denied will include the specific reasons for the Committee‟s decision. The Committee will notify credentialed programs of changes to the requirements. Credentialed programs are required to develop a plan to meet the revised or new requirements immediately and report the plan and progress toward completion in the next Annual Report. 10. WITHDRAWAL OF APPLICATION BY APPLICANT/REQUEST FOR INACTIVE CREDENTIALED STATUS Withdrawal of Application: The Director of the Program applying for credentialing may withdraw the application at any time during Committee review. Such withdrawal must be made in writing and the application fee is not refundable. Request for Inactive Status: Credentialed Programs may request in writing to be placed in an “inactive” status for a period of one (1) year. Reasons for an inactive status can include but is not limited to: major staffing changes or reduction, financial considerations, or significant changes within Program that demand temporarily suspension of the acceptance of applicants. During this one-year period, the Program must pay an annual fee of $100 and must submit an annual report detailing the status of the Program, readiness to return to active status, and rationale. Programs will continue to be identified as “credentialed”; however, a notation of “Inactive” will be placed next to Program name. A Program must request in writing to have the inactive status removed within the one-year period. In that notification, the start date for the Program must be listed and the status of either current or incoming residents or fellows must be clarified. Programs are not required to have residents or fellows in place at the time of the request to lift the status; however, a timetable for reviewing and accepting applicants must be presented. If a Program does not reactivate their credentialed status within one year, the Program must reapply, and have residents enrolled at the time of such reapplication. The usual “application fee” must accompany the reapplication (See Section 15: Application Fees.). A site visit may be required, based on the Committee‟s review of the new application. Residents or fellows of a Program in “inactive” status can still consider themselves graduates of a credentialed program if the Program submits a request for reactivation within the one-year period, or if they are enrolled after the Program applies for and is successfully granted another credential.
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11. CONFIDENTIALITY AND DISCLOSURE OF INFORMATION The Committee will maintain the integrity of the credentialing process by respecting the confidentiality of information provided by the applicant. Therefore, no information about programs in the credentialing process will be revealed. The following information about credentialed Programs may be released by APTA: Names of credentialed Programs, including dates of the credentialing period Names of formerly credentialed Programs whose credential is no longer current Names of formerly credentialed Programs that voluntarily withdrew from credentialing status Names of formerly credentialed Programs that were denied re-credentialing (not initial credentialing) APTA will maintain the list of credentialed Programs on its web page at http://www.apta.org; mouse over Professional Development; click on Residency/Fellowship. 12. CREDENTIALED PROGRAM RESPONSIBILITIES Annual Report Each credentialed Program will submit an annual report on or before January 31st for the previous year (See “Part 4 – Forms”). Newly credentialed Programs will submit an annual report for that portion of the year for which they are credentialed. If a Program is credentialed during the fourth quarter of a calendar year, this report will be deferred until January 31st of the following year unless otherwise directed by the Committee. Annual Reports that are not received by January 31 will receive a written notice of delinquency and will be assessed an additional 10% of the annual fee. If the Annual Report and fee have not been received by March 1 of the following year, the Program‟s credential will be suspended. When a new DSP is published in the Program‟s content area, the Program must report their plan for updating their curriculum to be consistent with the most current DSP in the Annual Report. Those changes must be complete by the time of re-credentialing. The language and terminology in all reports to the Committee should be consistent with the Guide to Physical Therapist Practice. Programs are responsible to report substantive changes in the Annual Report including, but not limited to, change in program mission, goals, and objectives, faculty, number of students, location, resources, and program outcomes. Programs are also responsible to report changes in contact information to the APTA Professional Development Department. After reviewing an annual report, the Committee will make one of the following decisions: Credentialed Program is in continued compliance Credentialed Program appears to be in noncompliance, requiring further inquiry After further inquiry, if indicated, the Committee will make one of the following decisions: Credentialed Program is in continued compliance Credentialed Program is in noncompliance and the credential is withdrawn Renewal/Reapplication The renewal process will evaluate the Program‟s continuing ability to meet all requirements for credentialing. A credentialed Program seeking to maintain the credentialed status without interruption should submit an application and renewal fee four (4) to six (6) months prior to the expiration of the
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credential. If a re-credentialing application is not received by the end of the credential period, the credential will be withdrawn. A site visit will not be required, unless the written application lacks sufficient evidence to demonstrate ongoing compliance with the credentialing requirements. If a site visit is required, the Program will be responsible for the costs incurred. 13. APPEALS PROCESS A Program may appeal the actions of the Committee when a Program‟s application is denied credentialing or when a credentialed Program has its credential withdrawn. A. RECONSIDERATION Request for Reconsideration A Program may ask the Committee on Clinical Residency and Fellowship Program Credentialing (Committee) to reconsider decisions: 1) to deny credentialing on the Program‟s application; or 2) to withdraw credentialing. The request for reconsideration must be received at APTA headquarters within thirty (30) days after the date of receipt of the Committee‟s decision (if sent by registered or certified mail, return receipt requested) or otherwise within thirty-five (35) days after the date of the decision. Requests for reconsideration should be mailed to the Chair of the Committee, c/o Professional Development Department, American Physical Therapy Association, 1111 N. Fairfax St., Alexandria, VA 22314-1488. The Committee shall promptly notify the Program of the date on which it received the Program‟s request. A Program‟s request for reconsideration should set forth concisely the Program‟s reasons for challenging the Committee‟s decision. (See the basis of overturning a Committee decision in Standard of Review below.) Standard of Review The Committee (on reconsideration) will uphold its initial decision unless the Program demonstrates that: The Committee‟s decision was not supported by substantial evidence or was arbitrary, capricious, or an abuse of discretion; or, Information that was not reasonably available prior to the Committee‟s decision would compel or support a decision in the Program‟s favor. Statement in Support of Request The Program will have thirty (30) days from the Committee‟s receipt of the Program‟s request in which to submit a detailed statement in support of the Program‟s request for reconsideration. Hearing If the Program wants to testify or argue before the Committee, the Program must say so in its statement of support, explain why the Program thinks the Committee should grant the Program a hearing, and identify any person the Program plans to call as a witness. The Chair of the Committee will decide whether to call a hearing, and he/she shall notify the Program promptly of the decision and the date, time, and place of the hearing (if one is to be held). The Committee must give the Program notice of a hearing at least thirty (30) days in advance. The hearing may be a telephone conference call. The hearing shall be recorded by audiocassette or other means.
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Decision on Reconsideration As soon as practicable after the Program submits its statement of support (or after the hearing), the Committee will review all submitted materials for the purpose of affirming, modifying, or reversing its initial decision. The Committee will give the Program notice of its decision, and state its reasons for such, by registered or certified mail (return receipt requested). If the Committee decides against the Program, it will inform the Program of its right to appeal. B. APPEAL Notice of Appeal The Program will have thirty (30) days after the date of receipt of the Committee‟s decision on reconsideration in which to appeal. The Program may do so by submitting a “notice of appeal” to the President of APTA, addressed to APTA headquarters, with a copy to the Chair of the Committee. The notice of appeal must set forth concisely the Program‟s reasons for challenging the Committee‟s decision on reconsideration. APTA shall promptly notify the Program of the date on which the notice of appeal was received. Selection of the Appeal Panel A three-member Appeal Panel (Panel), selected from among the members of the Appeal Panel Pool, will hear any appeal. The pool shall consist of individuals with a working knowledge of clinical residency or fellowship education, appointed by the Executive Committee of APTA‟s Board of Directors. Individuals shall be appointed to the Appeal Panel Pool for a five (5) year term. Within ten (10) days of receiving the Program‟s notice of appeal, the President of APTA will send a list of current members of the pool to the Program and the Chair of the Committee. The Program and the Committee will have fifteen (15) days from the date of the President's notice to ask the President (with a copy to the other party) to exclude from consideration any member(s) who has an actual or apparent conflict of interest or who lacks the knowledge needed to rule on the Program‟s appeal. The President shall have sole discretion whether to exclude any member of the pool from consideration for assignment to the Panel. The President will appoint three (3) members of the pool to the Panel and will send a copy of each letter of appointment to the Program and the Chair of the Committee. The Panel promptly will elect a Chair and notify the Program, the Chair of the Committee, and APTA‟s President. The notification must specify the address of the Chair of the Panel for purposes of mail and courier delivery. Transmittal of Record Once the Chair of the Committee has been notified of the name of the Chair of the Panel, he/she will transmit a complete record of the matter to the Panel. The record will include (without limitation) the following items, if applicable: The complete application for clinical residency or fellowship Program credentialing, and any supplements the Program submitted, Each action taken by the Committee with respect to the application (i.e., approval, deferral, or denial), Correspondence between the Program and the Committee prior to the Committee‟s action(s) with respect to the application, The decision by the Committee to withdraw approval, The Program‟s request for reconsideration, The Program‟s statement in support of its request for reconsideration and any supplement thereto, and
APTA September 2008
Application for Credentialing of Residency/Fellowship Programs 17
The transcript of the hearing upon reconsideration.
The Chair of the Committee will prepare a list of all items included in the record, which shall be sent to the Chair of the Panel with the record, and a copy of such list to the Program. Standard of Appellate Review The Program has the burden of demonstrating that the Committee‟s decision on reconsideration was not supported by substantial evidence or that the decision was arbitrary, capricious, and/or an abuse of discretion. Status of Appellate Pending Review The Program‟s filing of a timely notice of appeal will have the effect of staying a decision of the Committee to withdraw approval. However, the Chair of the Committee may for good cause petition the Panel (or, prior to the appointment of an Appeal Panel, the APTA Executive Committee) to lift such stay. The Program‟s filing of a timely notice of appeal will not operate to stay any other action of the Committee. Statement on Appeal The time for the Program to submit a detailed statement in support of its appeal ends fifteen (15) days after the date of the notice of the election of a Chair of the Panel, or thirty (30) days after the date of APTA‟s receipt of the notice of appeal, whichever occurs later. The Program must address its statement on appeal to the Chair of the Panel, with a copy to the Chair of the Committee. The Committee has fifteen (15) days after receipt of the Program‟s statement on appeal to submit a statement in opposition to the appeal, which must be addressed to the Chair of the Panel with a copy to the Program. Hearing on Appeal The Panel will decide the appeal on the basis of the record on appeal. Neither the Program nor the Committee may introduce testimony or evidence outside the record without express consent of the Panel, (which consent the Panel will not grant freely). If the Program wants to present oral arguments to the Panel, the Program must submit a request for a hearing with its statement on appeal. The request must state why the Panel should grant a hearing. The Chair of the Panel will have sole discretion to decide whether to call a hearing. The Chair of the Panel will notify the Program and the Chair of the Committee promptly of the decision and the date, time, and place of the hearing, if one is to be held. Such notice of hearing shall be sent at least thirty (30) days before the hearing date. The hearing may be a telephone conference call. Conduct of Hearing At the hearing, the Program or counsel for the Program may present oral arguments in support of the appeal. The Chair of the Committee, or her/his designee, may present oral arguments in support of the Committee action. The hearing shall be recorded by audiocassette or other means. Decision of Appeal Panel The Panel will reach its decision by majority vote. It will issue a written decision to affirm the Committee‟s action or to remand the matter to the Committee for further proceedings. A decision to affirm is not subject to any further appeal. The Panel will transmit its decision to the Program and the Chair of the Committee, by registered or certified mail (return receipt requested), with a copy to APTA‟s President. The Panel will transmit its decision within fifteen (15) days after the hearing, if any, or within thirty (30) days after receipt of the Program‟s statement on appeal, whichever occurs later.
Application for Credentialing of Residency/Fellowship Programs 18 APTA September 2008
Expenses of Appeal The Program will be responsible for its own expenses of preparing and presenting its appeal. APTA will bear the expenses incidental to the selection of the Panel. APTA will bear any expenses of arranging for a place to conduct a hearing. The Program and APTA will share equally the reasonable expenses of the members of the Panel (i.e., travel, meals, lodging) incurred in connection with the hearing, reasonable out-of-pocket expenses of the members of the Panel incurred in connection with the appeal (e.g., courier services, telephone/fax expenses), and the cost of transcribing the hearing. 14. USE OF LOGO Once an APTA Program has been credentialed, the Program may use the APTA-credentialed clinical residency or fellowship Program logo on educational and promotional materials directly related to the Program only. The logo may be used as long as the Program remains credentialed. 15. FEES The following sliding fees apply: Resident(s)/Fellow(s) 0–5 6 – 10 11 or more Inactive status Application Fee $1,500 $2,000 $2,500 Annual Fee $750 $1,000 $1,250 $100 Renewal Fee $750 $1,000 $1,250
Application Fee A non-refundable application fee must accompany each application. The fee schedule for credentialing of residency and fellowship programs is determined by the number of residents/fellows enrolled as indicated above. The written application is not distributed to the reviewers until the application fee has been paid. Site Visit Fees The Program agrees to reimburse APTA for the direct expenses of travel, lodging, and meals for a team of two on-site visitors for a one-day visit for a single site. Programs with multiple clinical and/or educational sites may require two day visits, depending upon the number of sites and the distance between them. The Committee and site visitors will make every effort to minimize the expenses associated with travel. Annual Fee The Program will pay an annual fee for each subsequent year of credentialing; the annual fee is not charged for the application year. The fee (and Annual Report) is due on or before January 31. A 10% late fee will be added to accounts not received by January 31. The amount of the annual fee is based on the number of residents or fellows reported in the Annual Report. Should the number of residents or fellows substantially change from one year to the next, it is the responsibility of the Program to notify the APTA Professional Development Department in the Annual Report or by phone to receive the appropriate invoice amount. Renewal Fee The renewal fee will be due on or before the fifth anniversary of the initial credential. The fee is based on the number of residents or fellows enrolled as of the anniversary date and should be accompanied by an updated, written application that is consistent with the most current version of the Description of Specialty Practice. Renewal fees are the same as the annual fee; therefore, if the annual fee has been paid for the year
Application for Credentialing of Residency/Fellowship Programs 19 APTA September 2008
in which a Program submits a re-credentialing application, no renewal fee is assessed. (i.e., the renewal fee is not an additional fee beyond the annual fee). All fees should be sent under separate cover to: APTA, 1111 N. Fairfax St., Alexandria, VA 22314-1488, Attention: Accounting Department. Please clearly indicate on the check the purpose of the payment (i.e., "Clinical Credentialing Application/Annual/Renewal Fee" as appropriate). Include the Program name on the check. APTA’s tax ID number is 13-1512769. 16. COMMITTEE STATEMENT ON CREDENTIALED PROGRAM STATUS AND CLINICAL RESIDENT OR FELLOW GRADUATES The Committee recognizes the following categories of credentialed status. Residents or fellows may identify themselves as graduates of a “credentialed” clinical residency or fellowship Program in the following circumstances: a. During the Application Process: Residents or fellows are considered graduates from a credentialed Program that had submitted a complete application while the residents or fellows were actively enrolled in the Program, and the credentialing was based on that application. b. During a Lapse in Credentialing: Only those residents or fellows who have graduated from the Program prior to the effective date of termination of the credential will be considered graduates of an “APTA credentialed clinical residency or fellowship program.” c. Withdrawal of Credentialing: If the Committee withdraws a program‟s APTA credential or a program chooses to withdraw due to the closure of its program or other reasons, only those residents or fellows who graduated from the program prior to the effective date for withdrawal will be considered graduates of an “APTA credentialed clinical residency or fellowship program.” 17. PROCEDURE FOR HANDLING COMPLAINTS AGAINST A CREDENTIALED PROGRAM 1. Any person (Complainant) may submit a complaint about a credentialed postprofessional clinical residency or fellowship program (Program) to APTA‟s Committee on Clinical Residency & Fellowship Program Credentialing (Committee), in care of the APTA‟s Department of Professional Development. 2. Upon receipt of a complaint, APTA staff from the Department of Professional Development will forward a copy of the Post-Professional Clinical Residency & Fellowship Program Requirements, Procedures for Handling Complaints About a Credentialed Clinical Residency or Fellowship Program, and a Complaint Form to the Complainant. 3. A Complainant must complete and sign a Complaint Form and submit it to APTA Professional Development Department. By submitting a Complaint Form, the Complainant confirms that he/she is willing to have the Complaint Form known to the Program and agrees that the Complaint Form may be shared with the Program.
Application for Credentialing of Residency/Fellowship Programs 20
APTA September 2008
4. APTA staff will review all Complaint Forms to determine if the Complaint Form relates to matters within the scope of the Postprofessional Clinical Residency & Fellowship Program Requirements (Requirements) or Clinical Residency/Fellowship Program Agreement (Agreement). (a) If the Complaint Form does NOT relate to matters within the scope of the Requirements or Agreement, staff will so advise the Complainant, and the Complaint Form will not be sent to the Committee. (b) If the Complaint Form DOES relate to matters within the scope of the Requirements or Agreement, staff will so advise the Complainant, and staff will send the Complaint Form (with all attachments, including supporting documentation) to the Committee for review. 5. The Committee will review the Complaint Form to determine whether the allegations, if true, would justify action by the Committee. (a) If the Committee determines that the allegations, if true, would NOT justify action by the Committee, it will so advise the Complainant, and the matter will be closed. (b) If the Committee determines that the allegations, if true, WOULD justify action by the Committee, it will send the Complaint Form (with all attachments, including supporting documentation) to the Program for response, and it will request any additional information it deems relevant to determining whether the Program is in compliance with the Requirements or Agreement. 6. The Program will be responsible for responding to the Complaint Form and any associated request for information within 45 days, or such other period as the Committee may specify. 7. The Committee (and APTA staff) will share with the Program only the Complaint Form and supporting documentation. APTA staff will not provide the Program any initial letter(s) of complaint (except to the extent such material may be part of the supporting documentation submitted by the Complainant). 8. APTA staff will provide the Program‟s response to the Complaint Form and any associated request for information to the entire Committee for review. 9. Within 45 days of receipt of the Program‟s response, the Committee will: (a) Determine the Program is Out of Compliance and: a. Withdraw the credentialed status of the Program, or b. Request additional evidence to show compliance with designated requirements at the next annual review or as designated by the Committee; or (b) Determine the Program is in Compliance and: a. Take no action, or b. Request additional evidence to show continued compliance at the next annual review. 10. With respect to any Complaint Form sent to the Program for response, the Committee will notify the Program and the Complainant of its decision.
Application for Credentialing of Residency/Fellowship Programs 21
APTA September 2008
PART 2 -- APPLICATION INSTRUCTIONS
Application for Credentialing of Residency/Fellowship Programs 22
APTA September 2008
Clinical Residency and Fellowship Program Credentialing Application Instructions The application for credentialing is based on the “Requirements and Evidence for Postprofessional Clinical Residency or Fellowship Programs for Physical Therapists” (requirements). The requirements are divided into four sections: 1) Organization 2) Resources 3) Curriculum 4) Ongoing Evaluation Each section provides an introduction explaining the purposes of the section. The requirements for credentialing and the description of evidence to be provided follow immediately. In some cases, “Interpretive Guidelines” are provided in italics to further clarify the intent of the requirement and/or the materials that must be included in the application. For each requirement, provide a brief description of how the Program meets the requirement and the documentation or materials as requested in the section labeled “Evidence.” Please note that additional requirements for sports residencies and fellowships and orthopaedic manual therapy fellowships are included in the application. The Application Resource Manual, also available on the web site, provides valuable examples of evidence from credentialed programs. Please note that the Program must have current residents and/or fellows during the application period. Application fees are determined by the number of residents/fellows in the Program at the time of application. The credentialing process must be completed within one year from the date that the application is received at APTA. Programs that fail to complete the credentialing process in one year must reapply and resubmit the application fee. 1. Compilation of Application _____ The materials must be provided in hard copy in a three-ring binder. Please submit five (5) copies of the complete application. Materials should be collated and may be printed on front and back of the paper to limit weight. Applications should be received by March 1 or September 1. _____ Number all pages sequentially in the upper outside corner of each page within each section using the following format: In Section 1.0, number the pages 1-1, 1-2, 1-3, etc. In Section 2.0, pages numbers will begin with 2-1, 2-2, 2-3, and so on (handwritten or typed numbering is acceptable when photocopies are included). Tabs should divide main sections (1.0-4.0) as well as appendices (eg, 1.2.3.3) 2. Materials to be Included An application must include the materials as listed in the order below. Please compile the materials in the following order: _____ A. Signature Page – Each person whose signature is required on the signature page is to review the compiled report prior to signing off on the application. This form is appears in Part 3: Application. _____ B. Applicant Information for Clinical Residency or Fellowship Program Credential – Contact information is generated from this form, making it essential that the form is
Application for Credentialing of Residency/Fellowship Programs 23 APTA September 2008
complete and accurate. It is the Program‟s responsibility to notify APTA staff of any changes on this form. _____ C. Clinical Residency or Fellowship Program Agreement – Signatures of the Program director or coordinator and the umbrella organization‟s administrator are required with submission of the application. _____ D. Preface – A general historical overview of the Program should be described on the form provided in Part 3: Application. This overview should serve as the introduction to the application. If your Program is new, describe the factors that led to the initiation of the Program. Please limit the Preface to two (2) pages. _____ E. Description of compliance – Provide a brief descriptive response for each “Evidence” section within the body of the „Requirements and Evidence‟ document. Please note that areas to be completed are designated in bold and required appendices are indicated with underline. Evidence must be tabbed and attached in the order it appears in the Requirements document. Responses on required forms are to be typed or legibly hand-printed in black ink, which permits legible photocopying. The exceptions to this are certain items, such as recruitment brochures, etc., which can be legible photocopies of the original materials published by the umbrella organization or Program. Where photocopies of materials published by the umbrella organization or Program are supplied as part of the evidence document, they should clearly indicate the name or title of the source and the date of publication. Developing Programs with limited demonstrable evidence for any one criterion are expected to provide a statement regarding how the Program would anticipate fulfilling the requirement. Any exceptions to this expectation have been clearly identified within the requirements and evidence section. _____ F. Application Fee -- Application fees are determined by the number of residents/fellows in the Program at the time of application. Please mail the non-refundable application fee at the time that the application is submitted to prevent processing delays. All fees must be received before the application will be reviewed. The fee schedule is as follows: Resident(s)/Fellow(s) 1–5 6 – 10 11 or more Application Fee $1,500 $2,000 $2,500
3.
Submission of the Application and Fee
_____ A total of five (5) copies of the compiled application in binders and application fee should be submitted by March 1 or September 1 to APTA Professional Development Department.
Please direct questions regarding the application process to the Professional Development staff at 703.706.8514 or via e-mail at profdev@apta.org. More in depth assistance is also available through APTA’s Consulting Service at 800-999-2782, ext. 3145 or 3146, or by email at insfinsvcs@apta.org.
Application for Credentialing of Residency/Fellowship Programs 24 APTA September 2008
PART 3 – APPLICATION REQUIREMENTS & EVIDENCE FOR POSTPROFESSIONAL CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS FOR PHYSICAL THERAPISTS
Application for Credentialing of Residency/Fellowship Programs 25
APTA September 2008
APPLICATION FOR CREDENTIALING OF A CLINICAL RESIDENCY OR FELLOWSHIP PROGRAMS FOR PHYSICAL THERAPISTS
PROGRAM NAME:__________________________________________________________________________________ Check one: RESIDENCY FELLOWSHIP
NAME OF UMBRELLA ORGANIZATION:______________________________________________________________ MAILING ADDRESS:________________________________________________________________________________ __________________________________________________________________________________________________ ___________________________________________________________________________________________________ The Program named above submits the following information in fulfillment of the APTA requirements for credentialing of a physical therapy clinical residency or fellowship program. The information submitted in this application is a true and accurate description of the umbrella organization and the clinical residency or fellowship program with respect to the information requested.
PROGRAM DIRECTOR/COORDINATOR
ORGANIZATION ADMINISTRATOR
TITLE
TITLE
SIGNATURE
SIGNATURE
DATE
DATE
INSTRUCTIONS: Complete and attach this sheet, or a photocopy of this sheet, to the front of each of five (5) copies of the application materials being submitted. Submit all materials to:
Department of Professional Development American Physical Therapy Association 1111 North Fairfax Street Alexandria, VA 22314-1488
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APTA September 2008
AMERICAN PHYSICAL THERAPY ASSOCIATION Applicant Information for Clinical Residency or Fellowship Program Credential
Please type or print. Date Completed: _____________
CLINICAL RESIDENCY/CLINICAL FELLOWSHIP PROGRAM (Circle one) NAME OF PROGRAM
SPONSORING UMBRELLA ORGANIZATION
PROGRAM ADDRESS
LINE 1
LINE 2
CITY
STATE
ZIP CODE
TELEPHONE
FAX
WEBSITE (if available)
PROGRAM DIRECTOR/COORDINATOR NAME (last) (first) (middle initial)
CREDENTIALS (i.e. PT, DPT, OCS, etc.)
TELEPHONE
FAX
E-MAIL
PRIMARY CONTACT (if different from Program Director/Coordinator) NAME (last) (first) (middle initial)
CREDENTIALS (i.e. PT, DPT, OCS, etc.)
TELEPHONE
FAX
E-MAIL
PROGRAM INFORMATION TYPE OF PROGRAM □ RESIDENCY □ FELLOWSHIP YEAR PROGRAM STARTED LENGTH OF PROGRAM ____ months _____ hours # RESIDENTS/FELLOWS RESIDENT/FELLOW TUITION/FEE? □ NO □YES AMOUNT$______________
TYPE OF RESIDENCY/FELLOWSHIP CONCENTRATION
COMPENSATION TO RESIDENT/FELLOW?
□ NO □YES AMOUNT$_________________
DOES PROGRAM RECEIVE NON-TUITION INCOME?
□ No □Yes
FELLOW SCHOLARSHIP FUNDED BY OUTSIDE AGENCIES? □ No □ Yes Sponsor: ____________________________________________________
Sponsor:________________________________________ Amount: $______________ Amount: $_____________ PROGRAM DATES □ FIXED □ ROLLING STARTING ______________________ (month/year) ENDING ______________________ (month/year) APPLICATION DEADLINE □ FIXED □ ROLLING DATES: __________________________________ __________________________________
APPLICANT INTERVIEW
MAXIMUM NUMBER OF RESIDENTS/FELLOWS PROGRAM ENROLLS FULL-TIME _______________________ PART-TIME_______________________
□Not required □ Required of each applicant
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APTA September 2008
AMERICAN PHYSICAL THERAPY ASSOCIATION (APTA) Clinical Residency/Fellowship Program Agreement In consideration of APTA‟s review of the application you have submitted for approval as a Credentialed Clinical Residency or Fellowship Program, you hereby agree that: 1. 2. You will furnish accurate and complete information to APTA, and will work cooperatively with it in connection with its review of your application and its monitoring of compliance with your obligations. You will fund direct expenses of travel, lodging, and meals for a team of one to two persons, designated by APTA, to visit facilities housing the Program for the purpose of gathering further information about your Program.
If APTA credentials you, you further agree that: You will report to APTA, in writing within thirty (30) days, any major organizational or programming change that may affect the operation of your Program. All programs are required to assure that their curriculums are reflective of the content area Description of Specialty Practice (DSP) or current version of the foundational validated practice analysis. Revisions to the Program as a result of DSP or practice analysis revisions will be reported. 4. In the course of promoting your Program, you will provide complete and accurate information about your Program, services, and fees. 5. You will comply with the Requirements and Evidence for Postprofessional Clinical Residency or Fellowship Programs for Physical Therapists that appears on pages 30-45 of the September 2008 Application for Credentialing, and with any other conditions that may be attached to your credential, in connection with organization, resources, curriculum, and ongoing performance evaluation of the clinical resident or fellow. You agree that noncompliance constitutes grounds for withdrawal of credentialing. 6. You will comply with APTA‟s policies and positions. You will not place any resident/fellow in a clinical education experience where the clinic is in a referral for profit situation, that is, one in which a referring physician (medical doctor, doctor of osteopathy, podiatrist, dentist, or chiropractor) derives a financial benefit from the physical therapy services provided to the person who is referred. The situations to which this restriction applies include those in which: (a) a physician has an ownership interest in a physical therapy practice to which he or she refers, (b) a physician or the physician‟s practice employs or contracts with physical therapists to provide physical therapy services within the physician practice, or (c) a physician‟s income or bonus is directly or indirectly tied to the revenues of the physical therapy service to which he or she refers patients. You agree that noncompliance with this clause constitutes grounds for withdrawal of credentialing. 7. You will furnish requested information, including an annual report, and pay fees on a timely basis. (See the Postprofessional Clinical Residency/Fellowship Program Credentialing Application for further information.) 8. You will conduct your operations and Program in an ethical manner. 9. You will not publicize, claim, or imply that you are (or were) a Credentialed Clinical Residency or Fellowship Program, except as specifically permitted by APTA in the Postprofessional Clinical Residency or Fellowship Program Credentialing Manual. 10. You will not print or otherwise use the designated logo, except as specifically permitted by APTA in the Postprofessional Clinical Residency or Fellowship Program Credentialing Manual. 11. If APTA, in good faith, institutes any legal action against you on account of any violation of Clause 8 or Clause 9, you will indemnify APTA for all its expenses of preparing for, instituting, prosecuting, and/or settling such an action. 3.
________________________________________hereby agrees with all foregoing terms and conditions. Name of Program
Program Director/Coordinator Name & Title (Print/Type)
Organization Administrator Name & Title (Print/Type) __________ Date
Program Director/Coordinator Signature
Date
Organization Administrator Signature
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APTA September 2008
Name of Clinical Residency/Fellowship Program:
_______________________________________________________________ Address: _______________________________________________________________________ City/State/Zip: ___________________________________________________________________
PREFACE
Please provide a brief historical overview of your Program. This overview should serve as an introduction to the application. If your Program is new, please describe the factors that led to initiation of the Program. Please limit the Preface to two (2) pages.
Application for Credentialing of Residency/Fellowship Programs 29
APTA September 2008
REQUIREMENTS & EVIDENCE FOR POSTPROFESSIONAL CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS FOR PHYSICAL THERAPISTS (BOD 09-01-03-04) INTRODUCTION: The goal of all postprofessional clinical residency and fellowship programs ("Programs") is to produce clinicians who demonstrate superior postprofessional clinical skills, advanced knowledge in an area of clinical practice, and the ability to function as consultants, advocates, and educators of their peers and patients/clients. 1.0 ORGANIZATION INTRODUCTION: The settings in which clinical residencies or fellowships occur are those that support excellence in practice and dedication to physical therapy services provided to consumers. 1.1 Umbrella Organization 1.1.1 Mission and Goals The umbrella organization of the Program has a published statement of its mission and goals, demonstrates ethical conduct, practices responsible fiscal management, and has a system for evaluating itself. 1.1.1.1 The umbrella organization of the Program has a set of realistic goals consistent with its mission statement, which sets forth the umbrella organization‟s intentions, including a consideration of resources, programs, processes, and outcomes. Evidence 1.1.1.1 Provide the statement of mission and goals of that umbrella organization which most directly influences the Program. Example: If the Program is within a private practice, hospital, HMO or part of a health system, use mission and goals of the clinical facility. If the applicant is a university, use the mission and goals of the department or entity most closely associated with the Program. NOTE: The Clinical Residency/Fellowship Program Agreement requires compliance with APTA’s policies and positions. The Program may not place residents/fellows in a clinical education experience where the clinic is in a referral for profit situation, that is, one in which a referring physician derives a financial benefit from the physical therapy services provided to the person who is referred. 1.1.1.2 The umbrella organization has a system for evaluating itself as related to its mission and goals.
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APTA September 2008
Evidence 1.1.1.2 Describe the umbrella organization’s ongoing methods used to evaluate the effectiveness of the umbrella organization’s performance. Include evidence of any external agency accreditations (e.g., JCAHO, CARF, Medicare provider or provider network standards, if applicable). 1.2 Clinical Residency or Fellowship Program 1.2.1 Mission, Goals, and Objectives The Program has a published statement of its mission, goals, and objectives* and a system for evaluating the effectiveness of its program. 1.2.1.1 The Program has a mission statement, goals, and objectives that reflect the area of clinical practice and that are compatible with the umbrella organization‟s mission statement. The mission statement addresses the performance outcomes of the Program, and the scope of practice for the area of clinical practice. Interpretive Guideline: Performance outcomes under 4.2.1 should be compatible with the Program’s mission statement, goals, and objectives. (See Glossary for description of mission, goals, and objectives.) Evidence 1.2.1.1.A Provide the Program’s mission statement, goals and objectives. Example of a Program goal: The Program will attract qualified individuals to complete the Program. Note that these are program goals and objectives, not the expected outcomes of the resident/fellow. Example of a Program objective: The Program faculty will develop promotional materials for the residency program. Goals that describe what the resident or graduate will do are not Program goals. For example, the resident will pass the ABPTS clinical specialist examination is a goal for the graduate, not the Program. Evidence 1.2.1.1.B Describe how the Program’s mission statement, goals, and objectives are consistent with one another. Evidence 1.2.1.1.C Describe how the Program’s mission, goals, and objectives are consistent with the mission of the umbrella organization. The site visit will include assessment of the compatibility of the Program’s mission statement with that of the umbrella organization. 1.2.2 Program Policies & Procedures 1.2.2.1 The Program has formal policies and procedures for the resident/fellow including but not limited to: 1) Patient/Client Care Issues: a) a policy on confidentiality safeguards for records and personal information; b) a policy and procedure on the protection of human subjects, consistent with the type of research being conducted by the resident or fellow; c) a procedure for informing the patient/client of any substantial risks of the recommended examination and intervention, where the resident or fellow is involved in specialized procedures; and
Application for Credentialing of Residency/Fellowship Programs 31 APTA September 2008
d) a policy on safety regulations, and evidence of its annual review. 2) Administrative and Human Resource Issues: a) general policies and procedures for the faculty and staff of the Program; b) nondiscriminatory policies and procedures for the recruitment, admission, retention, and dismissal of students or employees; and c) a grievance policy or mechanism of appeal that ensures due process, d) a probationary period policy, e) a termination policy and procedure that includes termination of the resident or fellow that becomes ineligible to practice (e.g. resident or fellow can not obtain licensure in that state.). Interpretive Guideline: The site visit will include review of policies and procedures manuals and discussion with faculty and staff of how well policies and procedures are communicated, how often they are revised and updated, and how well they meet their needs. Additionally, all policies and procedures will be reviewed to ensure against discrimination on the basis of race, creed, color, gender, age, national or ethnic origin, sexual orientation, disability or health status, including those applied in resident or fellow selection, evaluation, and retention. Evidence 1.2.2.1 Provide the table of contents for the resident/fellow handbook and Program and/or umbrella organization’s policy and procedure manual(s) that includes the policies and procedures listed above. Appendix information and tab as Evidence 1.2.2.1. 1.2.3 Resident/Fellow Policies and Procedures 1.2.3.1 The Program has admission and retention criteria, which are reflected in the recruitment materials and/or agreement/contract, and related policies and procedures for the resident/fellow including, but not limited to: 1) Admission criteria 2) Admission process Interpretative Guideline: Residents and fellows must be licensed physical therapists in the state(s) of the Program prior to commencing the Program. Admission criteria should be reflective of the definition of a resident or fellow. Evidence 1.2.3.1.A Provide the recruitment materials. Appendix information and tab as Evidence 1.2.3.1.A. Evidence 1.2.3.1.B Provide the policies and procedures related to admission/retention. Appendix information and tab as Evidence 1.2.3.1.B. 1.2.3.2 The Program shall provide the resident or fellow a written contract/agreement/ letter of appointment. Interpretive Guideline: The contract/agreement/ letter of appointment should include reference to the following items: (a) duties of the resident or fellow, (b) duration of the agreement including grounds for termination, (c) hours of work, (d) fringe benefits (e.g., meals, uniforms, vacation policy, sick leave policy, housing provisions, and payment of dues for membership in selected professional organizations),
Application for Credentialing of Residency/Fellowship Programs 32 APTA September 2008
(e) health, hospital, and disability insurance benefits, (f) professional liability insurance coverage, (g) probationary period, (h) mechanism of appeal, and (i) current information about any financial aid or stipends provided through the umbrella organization or Program. Evidence 1.2.3.2 Provide a copy of a blank contract or agreement or letter of appointment. Appendix information and tab as Evidence 1.2.3.2. 1.2.3.3 The Program maintains a record of current participants in the Program. Evidence 1.2.3.3 Utilize Form 1.2.3.3 to provide the names, physical therapy license number and state, and status (active or inactive) for all currently enrolled residents or fellows. (Form provided in Part 4: Forms) Appendix information and tab as Evidence 1.2.3.3. Interpretive Guideline: Program must have a resident or fellow enrolled in the program at the time of application.
2.0
RESOURCES INTRODUCTION: Resources are available in sufficient quantity and quality to enable the clinical residency or fellowship to accomplish its goals. These resources include adequate patient/client population, faculty, clinical resident or fellow services, staff, finances, access to publications, capital equipment, materials, and facilities. 2.1 Patient/Client Population 2.1.1 The Program has a patient/client population that is sufficient in number and variety to meet the educational purposes and goals of the Program. Interpretive Guideline: Residency and fellowship programs must provide sufficient mentored clinical practice experiences for the most common diagnoses or impairments identified in the Description of Specialty Practice (DSP), the Description of Advanced Clinical Practice (DACP), or practice analysis. Other learning experiences (observation, patient rounds, surgical observation, etc.) may supply sufficient exposure to less commonly encountered practice elements. Clinical Residencies: If the curriculum of the residency program is in an area or portion of an area where American Board of Physical Therapy Specialties (ABPTS) specialist certification exists, the patient/client population must reflect the current ABPTS DACP/DSP. If the curriculum of the residency program is not in an area where ABPTS specialist certification exists, the patient/client population must be consistent with the findings of a reliable and valid practice analysis. Clinical Fellowships: Because the curriculum of a fellowship is designed to advance the physical therapist’s clinical skills beyond that of the residency, the patient/client population must be consistent with the findings of a reliable and valid practice analysis for the subspecialty are or a detailed description of the subspecialty population..
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Evidence 2.1.1 Utilize Form 2.1.1 to summarize the patient/client population available to the residents or fellows over the past year. (Include those patients/clients included in the resident/fellow’s education only. Do not submit total clinic patient demographics.) New programs provide data to date. Categorize these patient/client population in a manner that clearly captures the intent of the DACP/DSP or practice analysis upon which the Program is based (categorize by diagnosis, impairment, body region, and/or practice location, as needed). This chart should also provide a summary of the approximate number of clients seen each year in each category and the percentage of the total patient/client population represented in this category. (Form provided in Part 4: Forms.) Appendix information and tab as Evidence 2.1.1. Site visit will include review of data sources used to generate summary information. Evidence 2.1.1.A In cases where there is limited access to certain patient categories, please indicate how the Program assures that students have adequate learning experiences in these areas, including clinical exposure. 2.2 Faculty 2.2.1 The Program has a director or coordinator whose skills and background meet the qualifications of the position description of program director or coordinator. Evidence 2.2.1.A Provide the program director or coordinator’s job description. Appendix information and tab as Evidence 2.2.1.A. Interpretive Guideline: The program director’s job description should include management of the entire residency program, including, but not limited to accessing and managing resources, assuring consistent curricular application across all didactic and clinical sites, assessing program outcomes and implementing necessary changes, etc. Include the % FTE dedicated to the Program. Evidence 2.2.1.B Provide the program director or coordinator's abbreviated résumé. Appendix information and tab as Evidence 2.2.1.B. Do NOT send lengthy curriculum vitae. 2.2.2 The Program has a sufficient number of faculty with demonstrated expertise in the needed areas of academic and clinical practice, including the appropriate credentials, to achieve the mission and goals of the education program. Interpretive Guideline: The faculty has the collective qualifications necessary to conduct the activities of the Program. Those qualifications include the following: advanced clinical skills, academic and experiential qualifications, diversity of backgrounds appropriate to meet Program goals, expertise in residency or fellowship development and design, and expertise in Program and resident/fellow evaluation. The faculty as a unit, including the Program director or coordinator, has the qualifications and experience necessary to achieve the Program goals through effective processes of Program development, design, and evaluation of outcomes. Faculty members must have expertise in their area of clinical practice and teaching responsibility, effective teaching and evaluative skills, and a record of involvement in scholarly and professional activities. Judgment about faculty competence in a curricular area for which a faculty member is responsible is based on: 1) appropriate past and current involvement in specialist certification and/or advanced-degree
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courses; 2) experience as a clinician; 3) research experience; and 4) previous teaching experience (e.g., classroom, clinical, in-service and/or continuing education, and presentations to, and attendance at, in-service or continuing education courses). When determining teaching effectiveness, multiple sources of data are collected, including evaluations by residents or fellows. The Program has an adequate number of didactic and clinical faculty to allow for: 1) teaching, clinical mentoring, administration, continuing individual counseling, mentoring of residents or fellows by faculty, and supervision and conduct of clinical research throughout the period of study; 2) faculty involvement in residency or fellowship committee responsibilities; and 3) faculty activities that contribute to individual professional growth and development. The Program has a sufficient number of clinical faculty to ensure that the residents' or fellows’ service delivery tasks and duties are primarily learning-oriented. Educational considerations should take precedence over service delivery and revenue generation. Evidence 2.2.2 Utilize Form 2.2.2 for each faculty member that meets the description (full-time or part-time) in the “Interpretative Guideline” above. Provide names, credentials, title, primary place of employment, areas of responsibility, recent professional development activities and percentage of FTE dedicated to the Program, based on 40 hours. (Form provided in Part 4: Forms.) If single faculty member, briefly describe the Program’s contingency plan should the faculty member not be able to function in this role. Appendix information and tab as Evidence 2.2.2. Site visit will include an assessment of the appropriateness of the number and expertise of existing faculty including review of CVs or resumes relative to the number of residents or fellows and the curriculum. 2.2.3 Where the focus of the Program is within an ABPTS specialty or subspecialty area, the Program will have at least one ABPTS-certified faculty member in that area. For orthopedic manual physical therapy programs, the Program will have at least one FAAOMPT on faculty. Interpretive Guideline: Clinical Residencies: At least one ABPTS-certified (current) clinician will serve on the faculty of the postprofessional clinical residency program and be involved in all major areas of the clinical residency program including development of the curriculum, the supervision of clinical experiences, and advising of students. At least one full-time faculty member will be ABPTS-certified (current) in the clinical residency program where full-time faculty exist. A sufficient number of ABPTS-certified clinicians (current) must serve on the faculty of clinical residency programs that are composed of part-time faculty. Clinical Fellowships: The same standards apply for the faculty of a clinical fellowship; however, if the area is in a subspecialty area whereby ABPTS certification is not necessarily appropriate, the faculty must include at least one individual with substantial experience in the subspecialty area, which can be clearly documented. For orthopedic manual physical therapy fellowships, the faculty must include one fellow of AAOMPT. Evidence 2.2.3 Identify all ABPTS-certified/FAAOMPT faculty. Include the area(s) of specialty and the year of certification and/or re-certification. (The
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same form used for Evidence 2.2.2 can be completed, or submission of a two-page resume for each faculty member that is inclusive of those areas clearly delineated in the “Interpretative Guideline” for 2.2.2 above.) Appendix information and tab as Evidence 2.2.3. 2.2.4 The Program has ongoing faculty development programs. Interpretive Guideline: Ongoing faculty development programs are designed to maintain and improve the effectiveness of each individual associated with the Program and to improve the Program as a whole. Resources for development need not be limited to money and may include such areas as mentoring, sharing of clinical expertise, release time for development activities, and participation in journal clubs. Evidence 2.2.4 Provide a summary of professional development opportunities and resources that allow faculty to maintain and improve their effectiveness as clinicians and educators. 2.3 Services to Physical Therapist Residents or Fellows 2.3.1 The umbrella organization and the Program provide adequate services to the physical therapist resident or fellow to support successful completion of the Program. 2.3.1.1 When multiple clinical facilities are used, each clinical site shall be formally linked to the umbrella organization or Program by a document delineating the nature and terms of the relationship. Interpretive Guideline: When the resident's or fellow’s clinical experiences are provided at secondary facilities, the participating clinical facilities indicate their respective commitments either through a memorandum of understanding or a letter from the individual(s) responsible for providing the clinical experiences at the secondary clinical facility. The document acknowledges the affiliation and delineates any financial support (including resident/fellow liability) and educational contributions of the secondary clinical facility. Evidence 2.3.1.1.A Utilize Form 2.3.1.1.A to list clinics utilized for resident/fellow education. (Form provided in Part 4: Forms.) Appendix information and tab as Evidence 2.3.1.1.A. Evidence 2.3.1.1.B Provide affiliation agreements with clinical facilities. Appendix information and tab as Evidence 2.3.1.1.B. 2.3.1.2 The Program ensures that residents or fellows will have malpractice coverage while on clinical assignment and will encourage residents or fellows to have health insurance, which may be provided through the umbrella organization at resident or fellow rates. Evidence 2.3.1.2 Describe the process for obtaining malpractice and health insurance coverage. 2.3.1.3 The Program and/or umbrella organization ensures that residents or fellows have access to educational advising. Interpretive Guideline: Advising regarding current enrollment, matriculation, remediation, withdrawal, and dismissal policies and procedures are provided.
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Evidence 2.3.1.3 Describe the availability of, and accessibility to educational advising and counseling. Residents or fellows will be interviewed on site. 2.4 Financial Resources 2.4.1 The Program has the financial support needed to achieve its stated goals. Interpretive Guideline: For the protection of the residents/fellows in the Program, the umbrella organization demonstrates its support of the Program, in part, by providing sufficient funding resources to sustain the Program over the long term. Evidence 2.4.1.A Describe the Program’s current sources of funding.
Evidence 2.4.1.B Describe the Program’s plan to assure funding throughout the period of credentialing. During the site visit, the site team will discuss this information with the Program director or coordinator and may ask to review additional supporting documentation such as revenue and expense reports. 2.5 Support Staff and Services 2.5.1 The Program has adequate support staff and services to meet the needs of the Program faculty and residents or fellows. Evidence 2.5.1 2.6 Educational Resources 2.6.1 The physical therapist resident or fellow and Program faculty have access to current publications and other materials in appropriate media to support the curriculum. Evidence 2.6.1 Describe the educational resources, including methods of access, available to faculty and residents or fellows. The site visit will include the site team’s assessment of how well these resources meet the needs of the residents or fellows and faculty. 2.6.2 The Program is suitably located, well maintained, and has sufficient space and amenities to accommodate faculty, staff, physical therapist residents or fellows, and patients/clients. Interpretive Guideline: The classrooms, clinics, offices/work space, and laboratories must be sufficient in number and size to accommodate the total number of residents or fellows. Facilities should provide residents or fellows, patients/clients, faculty, and staff with a safe, comfortable, accessible, and hazard-free environment. Evidence 2.6.2 Describe the facilities that house the Program. On-site evaluation will include a tour of the facility or facilities. Site team may request access to one or more affiliated sites. Describe the available support staff and services.
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2.7
Equipment and Materials 2.7.1 The Program has, or has use of, equipment and materials necessary to meet the goals of the Program. Interpretive Guideline: Adequate laboratory, instructional, and office equipment must exist in sufficient quantity for the purposes of instruction and research. There must be adequate supplies and equipment available to provide for appropriate learning experiences. Evidence 2.7.1 List the equipment and materials available to meet the goals of the Program. On-site evaluation will include the assessment of whether the available equipment and materials meet the needs of the Program.
3.0
CURRICULUM INTRODUCTION: Both the clinical residency and clinical fellowship experiences combine opportunities for ongoing mentoring and formal and informal feedback to the physical therapist resident or fellow, including required written and live patient practical examinations, with a foundation in scientific inquiry, evidence-based practice, and course work designed to provide a theoretical basis for advanced practice. Each Program is based on a well-defined, systematic process for establishing content validity of the curriculum that describes practice in a defined area. Residencies may be created in a specialty or subspecialty area; fellowships should have a curriculum based in one or more subspecialty areas. In specialty areas where validated competencies have been identified, the curriculum should be based on those competencies. In addition, the curriculum should be consistent with the Guide to Physical Therapist Practice. Specialized and sub specialized Programs must include postprofessional education and training in the scientific principles underlying practice applications. The curriculum sets forth the knowledge, skills, attitudes, and values needed to achieve the educational goals of the Program. The Program has the responsibility to include activities that promote the physical therapist resident's or fellow‟s continued integration of practice, research, and scholarly inquiry, consistent with the Program's mission and philosophy. An evaluation component helps to ensure that the stated goals are being met by the physical therapist resident or fellow through the curriculum plan. 3.1 Curriculum Development 3.1.1 The Program has a comprehensive curriculum that has been developed from, and is reflective of, a validated practice analysis and that incorporates concepts of professional behavior and ethics. Interpretive Guideline: Clinical Residencies: If the curriculum of the residency program is in an area or a portion of an area where American Board of Physical Therapy Specialties (ABPTS) specialist certification exists, the curriculum must reflect the current ABPTS Description of Specialty Practice (DSP). If the curriculum of the residency or fellowship program is not in an area where ABPTS specialist certification exists, the curriculum must reflect the use of a reliable and valid practice analysis. The practice analysis should be validated by the Committee prior to establishing the
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Program curriculum. See “Practice Analysis Guidelines” for requirements related to conducting a practice analysis for the purpose of residency and/or fellowship program credentialing. Clinical Fellowships: If the curriculum of the fellowship program is in a portion of an area where ABPTS specialist certification exists, the curriculum must not only reflect the current ABPTS DSP but must also extend beyond the DSP in its scope. That is, the program may establish the fellowship curriculum, including didactic content, competency expectations, and description of patients seen through one of the following two methods: 1) A valid and reliable practice analysis in the subspecialty area; or 2) Expansion of applicable portions of a DSP providing a detailed description of the knowledge, competency expectations, and types of patients seen, including references where appropriate. Evidence 3.1.1 Identify the year and version of the DSP/DACP or practice analysis used to develop the curriculum. If the curriculum is not in an ABPTS specialty area, provide a copy of the practice analysis or a detailed description of the expanded component of a DSP that was used to plan the Program and appendix as Evidence 3.1.1. Please be certain that the current version of the DSP is used to develop the Program curriculum. During the on-site visit, the way in which concepts of professional behavior and ethics are incorporated into the curriculum will be discussed with faculty and residents or fellows. 3.1.2. The Program provides a systematic set of learning experiences that addresses the content (knowledge, skills, and behaviors) needed to attain the performance outcomes for the clinical residents or fellows. All residents must have a minimum of 150 hours of 1:1 mentoring and 75 hours of classroom and lab instruction over the course of the Program. All fellows must have a minimum of 100 hours of 1:1 mentoring and 50 hours of classroom instruction over the course of the Program. Orthopedic Manual Physical Therapy programs must meet the following additional requirements: A minimum of 440 hours of clinical practice with an orthopedic manual physical therapist instructor available A minimum of 130 clinical practice hours must be under the direct clinical mentoring of the instructor in which the fellow must serve as the primary clinician responsible for the patient/client‟s care for a minimum of 110 of the 130 hours. A minimum of 40 hours of interaction with clinical instructors focusing on clinical problem solving. Sport Physical Therapy programs must meet the following additional requirements: A minimum of 1500 hours of clinical practice in a variety of settings that allow for at least 40% sports physical therapy caseload A minimum of 200 hours of sports physical therapy coverage at athletic venues A minimum of 150 mentored hours, one-on-one with specialists (SCS, OCS, ATC, MD) with patients/clients that meet the sports requirement A minimum of 75 hours of clinical instructor interaction in non-patient care planned educational experiences.
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Interpretative Guideline: A learning experience is a planned educational event, designed to facilitate learning and build upon a resident's or fellow’s knowledge, skills and/or behaviors. A set of learning experiences is a purposeful grouping of individual learning experiences that is organized in a systematic way to attain the performance outcomes for the clinical resident or fellow. In the aggregate, these learning experiences are sequenced and progressed to facilitate the resident's or fellow’s mastery of the curriculum. The rationale for the organization of learning experiences, including the sequencing, integration, and continuity of the content, is derived from educational theory, literature, and/or experience. Evidence 3.1.2.A Utilize Form 3.1.3.A to provide the major content areas in the Program's curriculum and their relationship to the DSP/DACP/practice analysis. (Form provided in Part 4: Forms.) Appendix information and tab as Evidence 3.1.3.A. Evidence 3.1.2.B Utilize Form 3.1.3.B to provide an example of a typical weekly schedule for the resident or fellow. (Form provided in Part 4: Forms.) Appendix information and tab as Evidence 3.1.3.B. Evidence 3.1.2.C Provide an outline or flow chart of the overall sequencing of content in the Program’s curriculum across the entire time period of the residency or fellowship, including both didactic and clinical experiences. Briefly explain the rationale behind the organization and sequencing of the curricular content. The on-site visit will include observation of clinical residents or fellows engaged in learning experiences for both clinical and classroom experiences. 3.2 Implementation 3.2.1 Clinical Residencies: The postprofessional clinical residency program should be completed within a minimum of 1,500 hours, and in no fewer than nine (9) months and no more than 36 months. Programs whose timeframe falls outside of these parameters will be reviewed on a case-by-case basis. Clinical Fellowships: The postprofessional clinical fellowship program should be completed within a minimum of 1,000 hours, and in no fewer than six (6) months and no more than 36 months. Programs whose timeframe falls outside of these parameters will be reviewed on a case-by-case basis. Evidence 3.2.1.A Identify the minimum and maximum amount of time allowed for a resident or fellow to complete the Program. Provide a summary of the amount of time previous residents or fellows took to complete the Program. Evidence 3.2.1.B Utilize Form 3.2.1.B to provide a list of all residents or fellows who have graduated in the past two to three years. Include initiation and completion date, and number of hours required for completion. Explain discrepancies. (Form provided in Part 4: Forms.) Appendix information and tab as Evidence 3.2.1.B.
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3.2.2
The Program must include a variety of instructional methods (to include classroom instruction, laboratory instruction, clinical practice, and mentoring) to achieve the performance outcomes. Interpretive Guideline: Instructional methods are based on content and learning experiences and may vary according to the resident's or fellow’s needs. To ensure the safety of patients/clients and the competency of clinicians, a Program must provide clinical mentoring that includes, but is not limited to: • Residents or fellows observing faculty providing clinical care. • Faculty providing mentoring of residents or fellows that includes management of patients/clients presenting with critical and/or complex care issues that require further expert consultation or referral. Evidence 3.2.2 Use Form 3.2.2 to list the number of hours dedicated to each instructional method used to achieve the performance outcomes. Provide the average number of one-on-one mentoring hours for the previous year. (Form provided in Part 4: Forms.) Appendix information and tab as Evidence 3.2.2.
4.0
ONGOING EVALUATION INTRODUCTION: The Program conducts ongoing evaluation of the Program, the current resident/fellow, and Program graduates. Evaluation is planned, organized, and scheduled to assure ongoing quality of postprofessional specialty and subspecialty education. The performance of the postprofessional clinical resident or fellow is evaluated initially, on an ongoing basis, and at the conclusion of the Program. Data collected on the evaluation of a resident or fellow are used to further focus the resident's or fellow‟s learning and instruction, as well as to confirm achievement of the residency or fellowship performance outcomes. Data are also collected on the postgraduation performance of the residents or fellows as a whole, in order to evaluate the Program and revise the curriculum. 4.1 Evaluation of the Program 4.1.1 The Program has a system for evaluating its goals (identified in 1.2.1.1), as related to the mission statement. Evidence 4.1.1 Describe the process for regular and ongoing evaluation of the Program’s goals as stated in 1.2.1.1.A. Include how often the goals are reviewed, what would trigger a review, who is responsible for the review, etc. 4.1.2 The Program has a system for evaluating its clinical and didactic faculty, which includes assessment of teaching ability, professional activities, clinical expertise, and service. Evidence 4.1.2.A Describe the process for faculty evaluation.
Evidence 4.1.2.B Provide blank forms utilized in the clinical and didactic faculty evaluation process. Appendix information and tab as Evidence 4.1.2.B.
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Samples of completed evaluations will be reviewed onsite (names may be removed). Also, faculty will be interviewed regarding the effectiveness of the evaluation process. 4.1.3 The Program has an ongoing process for periodic review of the curriculum and making appropriate revisions, based on measurable performance outcomes. Evidence 4.1.3.A Describe the ongoing process used to evaluate the Program's curriculum and to make appropriate revisions. Include a description of the mechanisms used for communication (eg, regular meetings, conference calls) and those individuals involved. Evidence 4.1.3.B Describe an example of a change made in the curriculum as a result of the ongoing review process (This may not be applicable to a new Program). The site visit will include discussion with faculty and residents or fellows on the means by which ongoing communication is facilitated. 4.2 Evaluation of Physical Therapist Resident or Fellow from Entry to Graduation The Program has measurable performance outcomes for its residents/fellows that are consistent with the Program mission and goals. Interpretive Guideline: The curriculum begins with formulation of performance goals/measures for the Program graduates, statements of measurable behaviors reflective of the practice analysis that describes the graduate’s clinical abilities and characteristics upon completion of the Program. The performance measures are consistent with the mission and goals of the Program and form the basis for evaluation of the Program and performance of the residents or fellows. Performance measures must also address factors ensuring that critical standards of safety for patients/clients are maintained. 4.2.1 The Program faculty determines that the physical therapist resident or fellow is competent and safe to function upon entry into the Program. Sports Physical Therapy Program Additional Requirement: resident or fellow must possess one of the following: a current ATC designation, a current license as an EMT, or certification as an Emergency Responder. Interpretive Guideline: The initial evaluation process should be designed to ensure that the resident and/or fellow meet admission criteria. Evidence 4.2.1 Describe the mechanisms for determining the resident's or fellow’s initial competence and safety within the clinical setting upon entry into the Program. 4.2.2 The Program faculty establishes, assesses, and evaluates resident or fellow performance on an ongoing basis, based on established assessment criteria including a minimum of one written examination and two live patient/client practical examinations over the course of the curriculum. Orthopedic Manual Therapy Fellowship Additional Requirements include a minimum of: Four technique examinations on models and/or patients/clients with a minimum of one technique demonstrated during each exam.
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One patient exam with a spinal/axial focus One patient exam with a peripheral/appendicular focus
Sports Physical Therapy Additional Requirements include a minimum of: Four technique examinations on such topics as rehabilitation techniques, advanced evaluation techniques, manual therapy techniques One patient examination in the clinic for each: knee, ankle, spinal/axial, and upper extremity One patient examination on the field for both contact and non-contact sport One patient examination for pre-participation screen One patient examination for wellness evaluation One patient examination for functional testing for return to sport for each: knee, ankle, spinal/axial, and upper extremity Interpretive Guideline: Methods of evaluating the performance of the clinical resident or fellow, relative to the set of learning experiences, should be both formative and summative, based on the performance measures, and provided in a timely manner. All programs are required to administer a minimum of one written examination and two live patient/client practical examinations over the course of the curriculum. Evidence 4.2.2.A Describe the process used to evaluate the resident's or fellow’s advancing level of competence and safety within an area of specialized practice, consistent with the practice description. Evidence 4.2.2.B Provide didactic and clinical outcome performance assessment tools (eg, testing, examination, checklists). Appendix information and tab as Evidence 4.1.2.B. Examples of completed resident or fellow performance evaluations (names may be masked) may be reviewed onsite. Evidence 4.2.2.C Provide samples of patient/client function outcome measures used in the Program as part of the program/student evaluation process. Appendix information and tab as Evidence 4.1.2.C. Typical outcome measures should reflect the resident’s/fellow’s clinical performance and could include: FIM, McGill Pain Questionnaire, NPI, Oswestry, SF 36, WOMAC, etc. Evidence 4.2.2.D Describe how the data compiled from the performance measures are used to assess the resident's or fellow's performance and affect the resident’s or fellow’s plan of study. Interpretive Guideline: Provide evidence of a process for review and modification of the resident’s/fellow’s educational plan as a result of assessment of patient/client outcomes and identification of performance strengths and weaknesses. 4.2.3 The Program shall establish methods to identify and remedy unsatisfactory clinical or academic performance, and shall require that such remediation methods are distributed to, and acknowledged in writing by the resident or fellow. Interpretive Guideline: The timing of the evaluation should allow sufficient opportunity for remediation when necessary. Remediation methods may include requiring that the resident or fellow spend additional hours in a clinic or complete additional didactic
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assignments to facilitate achievement of the stated goals. Part of the remediation process is clearly established criteria for dismissal from the Program. Evidence 4.2.3 Describe the Program's remediation process and the criteria for dismissal if remediation efforts are unsuccessful. 4.3 Post-Graduation Performance of Postprofessional Clinical Residents or Fellows 4.3.1 The Program regularly collects information about the post-graduation performance of the residency or fellowship graduate, which is used for Program evaluation and modification. Interpretive Guideline: An expectation exists that the Program will engage in a planning process based on the measurement of performance of its residents or fellows as it relates to the roles and responsibilities of the physical therapist. Evidence 4.3.1.A Provide a list of the measures used to evaluate the clinical abilities and characteristics of the Program's graduates, and cross-reference with the Program goals listed in Evidence 1.2.1.1.A. Interpretive Guideline: Program goals should inform the faculty of data to be collected to know if the Program has been successful. For example, if a program goal is successful achievement of specialist certification, then the Program should have a mechanism in place to follow up on graduates and determine if this goal was met. Evidence 4.3.1.B Describe how the information collected from Program graduates is used to evaluate and modify the Program. If the Program is new, describe how the information will be used. Evidence 4.3.1.C Describe an example of how the Program has been modified as a result of the information received from graduates (not applicable for new Programs). Interpretive Guideline: The goal of program assessment is ultimately to improve the Program’s ability to meet their goals. For example, if a resident reports feeling unprepared to independently manage a patient with advanced TMJ degeneration, then the Program should use that information to improve that portion of the curriculum
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PART 4: APPLICATION FORMS
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Form 1.2.3.3 Name of Clinical Residency/Fellowship Program: ____________________________________________ Residents/Fellows Currently Enrolled in Program List all currently enrolled residents or fellows.
RESIDENT/FELLOW NAME LICENSE # (with state) START DATE (MONTH/YEAR) STATUS
□ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive □ Active Full Time □ Active Part-Time □ Inactive
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Form 2.1.1
Name of Clinical Residency/Fellowship Program: ___________________________________________________
Description of Patients by Diagnostic Group/Impairment Category Diagnostic Group/Category or Impairment or Diagnostic Category* Number of Patients/Clients Seen per Year as Part of the Education Program (Not visits) Percentage of Total Number of Patients/Clients Per Year (Not Visits)
* Be as descriptive as possible in defining Diagnostic Group/Category. For example, specifically list hip, knee, ankle, etc. rather than leg or lower quarter. See examples in Application Resource Manual. Note : If the Program has limited access to certain patient categories, please indicate how the Program assures that students have adequate learning experiences in these content areas as identified in the DACP/DSP.
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Form 2.2.2/2.2.3
Name of Clinical Residency/Fellowship Program: _________________________________________________
Program Faculty Complete this form for all faculty active in the Program within the last 18 months.
NAME (with credentials) ABPTS CERTIFICATION/RECERTIFICATON (Designate year certified/Year of latest recertification) Cert. Recert. □ Cardiopulmonary □ Clinical Electrophysiology □ Geriatric □ Neurologic
TITLE PLACE OF EMPLOYMENT
% FTE (based on 40 hrs)
□ Orthopaedic
□ Pediatric □ Sports AREAS OF RESPONSIBILITY IN PROGRAM
RECENT PROFESSIONAL DEVELOPMENT ACTIVITIES (i.e., continuing education, publications, research, etc.)
NAME (with credentials)
TITLE
% FTE (based on 40 hrs)
PLACE OF EMPLOYMENT
ABPTS CERTIFICATION/RECERTIFICATON (Designate year certified/Year of latest recertification) Cert. Recert. □ Cardiopulmonary □ Clinical Electrophysiology □ Geriatric □ Neurologic □ Orthopaedic □ Pediatric □ Sports
AREAS OF RESPONSIBILITY IN PROGRAM
RECENT PROFESSIONAL DEVELOPMENT ACTIVITIES
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Form 2.3.1.1.A Name of Clinical Residency/Fellowship Program: ____________________________________________ Clinical Facilities Utilized in Program List all clinical sites utilized in the education of Program residents or fellows.
NAME OF CLINICAL FACILITY CONTACT PERSON FACILITY ADDRESS WRITTEN AGREEMENT?
□ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ YES □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO □ NO
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Form 3.1.2.A Name of Clinical Residency/Fellowship Program: ____________________________________________ Curriculum Overview Provide the major content areas in the curriculum and their related areas of the DSP/DCAP. Also include didactic and clinical experiences in the following table:
CONTENT AREA RELATED AREA IN DSP/DACP DIDACTIC EXPERIENCES CLINICAL EXPERIENCES
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Form 3.1.2.B Name of Clinical Residency/Fellowship Program: ____________________________________________ Sample Weekly Schedule
SUNDAY 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM NOON 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM 8:00 PM 9:00 PM
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TUESDAY
WEDNESDAY
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Form 3.2.1.B Name of Clinical Residency/Fellowship Program: _______________________________________________ Program Graduates No. of Hours in Program
Name
License #
State
Date Started (Month/year)
Date Ended (Month/year)
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Form 3.2.2 Name of Clinical Residency/Fellowship Program: ____________________________________________ Instructional Methods and Hours Instructional Method Classroom Instruction (List Courses) Total Hours in Program
Journal Club Research Activities Home Study Grand Rounds Clinical Mentoring 1:1 clinical mentoring/instruction from clinical faculty while treating patients 1:1 patient/client related planning/discussion/review of diagnostic tests, evaluation, plan of care, etc. Clinical Practice (mentor accessible onsite) Clinical Observation Athletic Venue Coverage Other: (Please list) TOTAL HOURS IN PROGRAM
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PART 5: ADDITIONAL INFORMATION
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EVIDENCE CHECKLIST
1.O ORGANIZATION Clinical Residency or Fellowship Umbrella Organization Evidence 1.1.1.1 Provide the statement of mission and goals of that umbrella organization which most directly influences the Program. Evidence 1.1.1.2 Describe the umbrella organization‟s ongoing methods used to evaluate the effectiveness of the umbrella organization‟s performance. Include evidence of any external agency accreditations (eg, JCAHO, CARF, Medicare provider, or provider network standards, if applicable). Clinical Residency or Fellowship Program Evidence 1.2.1.1.A Provide the Program‟s mission statement, goals, and objectives. Evidence 1.2.1.1.B Describe how the Program‟s mission statement and goals are consistent with one another. Evidence 1.2.1.1.C Describe how the Program‟s missions and goals are consistent with the mission of the umbrella organization. Program Policies & Procedures Evidence 1.2.2.1 Provide the table of contents for the Program or umbrella organization‟s policy and procedure manual(s) that includes the policies and procedures listed above. Resident/Fellow Policies and Procedures Evidence 1.2.3.1.A Provide the recruitment materials. Evidence 1.2.3.1.B Provide the policies and procedures related to admissions/retention. Evidence 1.2.3.2 Provide a copy of a blank contract or agreement or letter of appointment. Evidence 1.2.3.3 Utilize Form 1.2.3.3 to provide the name, physical therapy license number and state, and status (active or inactive) for all currently enrolled residents or fellows (Available in Part 4: Forms). RESOURCES Patient/Client Population Evidence 2.1.1 Utilize Form 2.1.1 to summarize the patient/client population available to the residents or fellows over the past year. New programs provide data to date. Categorize these patients/clients in a manner that clearly captures the intent of the DACP/DSP or practice analysis upon which the Program is based (categorize by diagnosis, impairment, body region, and/or practice location, as needed). This chart should also provide a summary of the approximate number of clients seen each year in each category and the percentage of the total patient/client population represented in this category. If there is limited access to certain patient categories, please indicate how the Program assures that students have adequate learning experiences in these areas. (Form provided) Faculty Evidence 2.2.1.A Provide the Program director‟s or coordinator's job description. Evidence 2.2.1.B Provide the program director or coordinator‟s resume. Evidence 2.2.2 Utilize Form 2.2.2/2.2.3 for each faculty member that meets the description (fulltime or part-time) in the “Interpretative Guideline” above. Provide names, credentials, title, primary place of employment, areas of responsibility, recent professional development activities, and percentage of FTE dedicated to the Program, based on 40 hours. (Available in Part 4: Forms) Evidence 2.2.3 Identify all ABPTS-certified faculty. Include the area(s) of specialty and the year of certification and/or recertification. (Same form as 2.2.2) Evidence 2.2.4 Provide a summary of professional development opportunities and resources that allow faculty to maintain and improve their effectiveness as clinicians and educators. APTA September 2008 55
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Services to Physical Therapists Residents or Fellows Evidence 2.3.1.1.A Utilize Form 2.3.1.1.A to list clinics utilized for resident/fellow education. Evidence 2.3.1.1.B Provide agreements with clinical facilities. Evidence 2.3.1.2 Document malpractice insurance coverage and health insurance coverage, if available through the umbrella organization. If not available, describe the process for accessing health insurance coverage for all residents or fellows. Evidence 2.3.1.3 Describe the availability of, and accessibility to educational advising and counseling. Financial Resources Evidence 2.4.1.A Describe the sources of program funding. Evidence 2.4.1.B Describe how the Program will assure continued financial viability through the period of credentialing. Support Staff and Services Evidence 2.5.1 Describe the available support staff and services. Educational Resources Evidence 2.6.1 Describe the educational resources, including methods of access, available to faculty and residents or fellows. Evidence 2.6.2 Describe the facilities which house the Program. Equipment and Materials Evidence 2.7.1 List the equipment and materials available to meet the goals of the Program. CURRICULUM Curriculum Development Evidence 3.1.1 Identify the year and version of the DSP/DACP or practice analysis used to develop the curriculum. If the curriculum is not in an ABPTS specialty area, provide a copy of the practice analysis that was used to plan the Program. Evidence 3.1.2.A Utilize Form 3.1.2.A to provide the major content areas in the Program's curriculum and their relationship to the DSP/DACP/practice analysis. Evidence 3.1.2.B Utilize Form 3.1.2.B to provide an example of a typical weekly schedule for the resident or fellow. Evidence 3.1.2.C Provide an outline or flow chart of the overall sequencing of content in the Program curriculum across the entire time period of the residency or fellowship, including both didactic and clinical experiences. Briefly explain the rationale behind the organization and sequencing of the curricular content. Implementation Evidence 3.2.1.A Identify the minimum and maximum amount of time allowed for a resident or fellow to complete the Program. Provide a summary of the amount of time previous residents or fellows took to complete the Program. Evidence 3.2.1.B Utilize Form 3.2.1.B to provide a list of all residents or fellows who have graduated in the past two to three years. Include initiation and completion date, and number of hours required for completion. Explain discrepancies. (Available in Part 4: Forms) Evidence 3.2.2 List the number of hours dedicated to each instructional method used to achieve the performance outcomes. Provide the average number of one-on-one mentoring hours for the previous year.
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4.0
ONGOING EVALUATION Evaluation of the Program Evidence 4.1.1 Describe the process for regular and ongoing evaluation of the Program‟s goals as stated in 1.2.1.1.A. Include how often the goals are reviewed, what would trigger a review, who is responsible for the review, etc. Evidence 4.1.2.A Describe the process for faculty evaluation. Evidence 4.1.2.B Provide blank forms utilized in the clinical and didactic faculty evaluation process. Evidence 4.1.3.A Describe the ongoing process used to evaluate the Program‟s curriculum and to make appropriate revisions. Include a description of the mechanisms used for communication (eg, regular meetings, conference calls) and those individuals involved. Evidence 4.1.3.B Describe an example of a change made in the curriculum as a result of the ongoing review process. Evaluation of Physical Therapist Resident or Fellow from Entry to Graduation Evidence 4.2.1 Describe the mechanisms for determining the resident's or fellow‟s initial competence and safety within the clinical setting upon entry into the Program. Evidence 4.2.2.A Describe the process used to evaluate the resident's or fellow‟s advancing level of competence and safety within an area of specialized practice, consistent with the practice description. Evidence 4.2.2.B Provide didactic and clinical outcome performance assessment tools (eg, testing, examination, checklists). Evidence 4.2.2.C Provide samples of patient/client outcome measures used in the Program as part of the program/student evaluation process. Evidence 4.2.2.D Describe how the data compiled from the outcomes measures are used to assess the resident's or fellow's performance and affect the resident‟s or fellow‟s plan of study. Evidence 4.2.3 Describe the Program's remediation process and the criteria for dismissal if remediation efforts are unsuccessful. Post-Graduation Performance of Postprofessional Clinical Residents or Fellows Evidence 4.3.1.A Provide a list of the measures used to evaluate the clinical abilities and characteristics of the Program‟s graduates and cross reference with the Program goals listed in Evidence 1.2.1.1.A. Evidence 4.3.1.B Describe how the information collected from Program graduates is used to evaluate and modify the Program. If the Program is new, describe how the information will be used. Evidence 4.3.1.C Describe an example of how the Program has been modified as a result of the information received from graduates (not applicable to new Programs).
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GLOSSARY OF TERMS
The following definitions have been adopted by the Committee on Clinical Residency and Fellowship Program Credentialing and are intended to minimize misinterpretation of information in this document. The Committee recognizes that individual programs may have different definitions than those identified below; however, for the purposes of the application and any related credentialing activities, the following terms and definitions should be used. Active Currently enrolled. American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) The American Academy of Orthopaedic Manual Physical Therapists is a voluntary organization of orthopaedic manual physical therapists that serves its members by promoting excellence in orthopaedic manual physical therapy practice, education and research, and collaborates with national and international associations American Board of Physical Therapy Specialties (ABPTS) The governing body for certification and recertification of physical therapy clinical specialists. Currently, the ABPTS specialty areas are: Cardiopulmonary Physical Therapy, Clinical Electrophysiologic Physical Therapy, Geriatric Physical Therapy, Neurologic Physical Therapy, Orthopaedic Physical Therapy, Pediatric Physical Therapy, and Sports Physical Therapy. American Physical Therapy Association (APTA) A national professional association representing more than 65,000 members. APTA‟s goal is to foster advancements in physical therapy practice, research, and education. Assess To evaluate or make a judgment. Clinical Fellowship Program A postprofessional planned learning experience in a focused area of clinical practice for physical therapists who are frequently post-residency prepared or boardcertified. A clinical fellowship combines opportunities for ongoing clinical mentoring with a theoretical basis for advanced practice and scientific inquiry in a defined area of subspecialization beyond the generally accepted Description of Specialty Practice (see definition below). A fellowship program must possess a curriculum that: 1) is focused with advanced clinical and didactic instruction within a subspecialty area of practice; 2) is intensive and includes extensive clinical experience; and 3) provides a sufficient and appropriate patient/client population to create an environment for advanced clinical skill building. Clinical Residency Program A planned Program of postprofessional clinical and didactic education for physical therapists that is designed to significantly advance the resident's preparation as a provider of patient/client care services in a defined area of clinical practice. It combines opportunities for ongoing clinical mentoring, with a theoretical basis for advanced practice and scientific inquiry. Neither 'clinical residency' nor 'clinical fellowship' is synonymous with the terms „clinical internship.' Committee on Clinical Residency and Fellowship Program Credentialing (Committee) The APTA Committee responsible for the review and credentialing of clinical residency and fellowship programs. APTA‟s Board of Directors appoints the members of the Committee.
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Credentialing A voluntary process used to evaluate, enhance, and publicly recognize quality in education. The Program, through its faculty, seek independent judgment by its peers regarding the Program‟s compliance with a set of standards and criteria that have been accepted by the profession, as well as the Program‟s ability to achieve the stated mission and goals. The American Physical Therapy Association awards the credential status. Curriculum A plan for learning, designed by the faculty and resident/fellow, to achieve the explicit goals of the Program and the individual resident or fellow. Describe To give account of, depict, or trace the outline of, in words. Description of Specialty Practice (DSP) Formerly called, Description of Advanced Clinical Practice (DACP), the published results of a practice analysis. Each of the seven (7) ABPTSrecognized specialty areas has a DSP that provides a blueprint for the content of the specialty examination. This publication also provides an outline of the content that can be used as the basis for a Program's curriculum; however, the fellowship curriculum must extend beyond the DSP as it is intended to provide advanced clinical competency in a subspecialty. This publication also can provide a framework for a clinical competency evaluation tool to use in assessing the clinical skills of the residents or fellows (see “Practice Analysis”). Document Evidence or information to support a claim. Educational Objectives Written statements that describe what participants will know, or be able to do as a result of a Program. Educational objective should be written in measurable terms, observable, and specify one action the participant will take to demonstrate that he/she has accomplished the outcome. Effective Date A date, to be determined by the Committee, for each Committee decision reached. Faculty of Clinical Residency or Fellowship Program Physical therapists and non-physical therapists who may participate as instructors in the didactic and clinical education of residents or fellows enrolled in a Program. Faculty members must have expertise in their area of clinical practice and teaching responsibility, effective teaching and evaluative skills, and a record of involvement in scholarly and professional activities. Fellow A licensed physical therapist enrolled in a clinical fellowship Program. Fellow of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT) A physical therapist who has demonstrated advanced clinical, analytical, and hands-on skills in the treatment of musculoskeletal (orthopaedic) disorders and has completed a credentialed fellowship program in orthopaedic manual physical therapy or demonstrated the equivalent level of competence by successfully passing a portfolio review process and oral/practical examination. Fellowship A postprofessional funded and planned learning experience in a focused area of clinical practice (not infrequently post-doctoral or for post-residency prepared, or board-certified therapists). Formative Evaluation Evaluation methods used in providing feedback to learners during the learning experience to promote learning and to predict final evaluation results.
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Goal Goals are developed from mission statements and summarize the development, administrative, or other major accomplishments/outcomes the organization/Program hopes to achieve to fulfill its mission. Goals can be short or long-term, usually set for 1-3 year time frame, and are evaluated annually. Goals should be written to be “SMART” (Specific, Measurable, Achievable, Reviewable, and Trackable). Example: The Program will prepare graduates to serve as primary care providers in the area of specialization. Inactive On leave or not on site as an active student. Individual Clinical Mentoring The direct, on-site guidance and management of the physical therapist clinical resident or fellow by members of the clinical faculty. Internship A clinical education experience that is part of the requirements for graduation from a physical therapist professional education program (degree could be awarded before, during, or after the internship). Mentor The six functions frequently used to describe the role of a mentor are teacher, sponsor, host and guide, exemplar, and counselor. One who facilitates the mentee's dream or vision of self through effective implementation of each of these roles. Mentorship A relationship based on mutual respect, commitment, and shared values that develops over time between a faculty member and a resident or fellow. Mission Statement The mission statement is the philosophical expression of why the organization exists and what it hopes to accomplish. It is normally succinct containing just a few sentences that communicate the essence of the organization/program to its stakeholders and the public. Example: The Program‟s mission is “to prepare physical therapists with advanced knowledge and skills in orthopedic physical therapy integrated with a foundation in the basic and applied sciences and scientific inquiry.” Objective Objectives describe the essential activities that need to be completed to achieve each goal and also need to be written to be “SMART” (Specific, Measurable, Achievable, Reviewable, and Trackable). Objectives may be identified as activities that take 1, 2, or 3+ years to accomplish and are usually instrumental in planning for the program. Example: Qualified applicants will be recruited. Performance Outcome Statements of measurable behaviors reflective of a practice analysis. Postprofessional Clinical Fellowship Program See “Clinical Fellowship Program.” Postprofessional Clinical Residency Program See “Clinical Residency Program.” Practice Analysis A systematic process which provides a recognized group of subject matter experts and consultants the ability to describe the essential knowledge areas, skill areas, and responsibility areas of a competent clinician in a specified area of clinical practice. Practice Outcomes/Performance Outcomes Measurable knowledge, skills, or behaviors that indicate the resident or fellow has attained competency in a practice domain.
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Program Director or Coordinator See “Residency or Fellowship Program Director or Coordinator.” Resident A licensed physical therapist enrolled in a clinical residency program. Residency See "Clinical Residency Program." Residency or Fellowship Program Director/Coordinator The physical therapist that has administrative (including financial, clinical, and educational) responsibility for the Program. Review Team Members Application Review Team Members Consists of two to four individuals. Team members review the application materials, two members visit the site and provide a report to the Committee. The third team member reviews the application materials, provides input to the site visit team and serves as an alternate to the site visit team. Site Review Team Members Two team members who visit a site as part of the credentialing process and provide a subsequent report to Committee. Specialization A process established by APTA to recognize individuals certified in an area of advanced clinical practice identified by ABPTS (see “American Board of Physical Therapy Specialties”). Standards A criterion; a degree or level of requirement, excellence, or attainment; a rule or test on which a judgement or decision can be based. Subspecialty A clinical practice area within a recognized specialty area (e.g., Neonatal Physical Therapy is a subspecialty of Pediatric Physical Therapy), or, a portion of a recognized specialty area (e.g., Orthopaedic Manual Physical Therapy is a subspecialty of Orthopaedic Physical Therapy). Summative Evaluation Evaluation methods used to summarize performance at the end of the learning experience to determine success and to set standards for formative evaluation methods. Support Staff Employees of the Program, facility, or umbrella organization (other than the faculty) who are responsible for some aspect of the administration and/or operation of the Program or facility. Umbrella Organization An organization or foundation, especially one dedicated to health care, public service, or education. The larger corporation or organization that most directly influences the Program.
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RESOURCES
Adams E, Corleo G, DeBloise L, et al. Legal considerations in evaluating the clinical performance of students. In: Considerations in clinical evaluation: Instructors, student, legal issues, data. New York, NY: National League of Nursing; 1979. American Academy of Orthopaedic Manual Physical Therapists. Guidelines for Postprofessional Residencies in Orthopaedic Physical Therapy & Orthopedic Manual Physical Therapy. Available through the Orthopaedic Section of the American Physical Therapy Association , 800-444-3982; 2001. Bloom BS, ed. Taxonomy of educational objectives, I: Cognitive domain. New York, NY: David McKay; 1956. Bloom BS, Hasting JT, Maduas GF. Handbook of formative and summative evaluation of student learning. New York, NY: McGraw-Hill Inc.; 1971. Bradford L, ed. Human forces in teaching and learning. La Jolla, Calif: La Jolla University Associates; 1976. Irby DM, Fantil JI, Milam DS, Schwarz MR. Legal guidelines for evaluating and dismissing medical students. N Eng J Med 1987;304:180-184. Kassenbaum DG. The measurement of outcomes in the assessment of education program effectiveness. Acad Med 1990;65:293-296. Milidonis, MK, Ritter, RC, Sweeney, MA et al. Practice analysis survey: Revalidations of advanced clinical practice in orthopaedic physical therapy. JOSPT 1996;25:163-170. Miller GE. The assessment of clinical skills/competence/performance. Cad Med 1990;65:563-567. Shephard KF. Jensen GM. Handbook of teaching physical therapists. Oxford: Butterworth Heinemann; 1997. Tyler R. Basic Principles of Curriculum and Instruction. Chicago, Ill: The University of Chicago Press; 1971. Watts N. Handbook of Clinical Teaching. New York, NY: Churchill Livingstone Inc.; 1991. Zachazewski JE, Felder CR, Knortz K, Thein L, Quillen WS. Competency revalidation study: A description of advanced clinical practice in sports physical therapy. JOSPT 1994;20:110-124.
The following documents can be obtained through the APTA Service Center at 800-999-APTA, ext. 3395 or through the website at www.apta.org: Descriptions of Advanced Clinical Practice (DACP)/Descriptions of Specialty Practice: (Please be sure that you are ordering the most current edition.) - Cardiovascular – Pulmonary Clinical Electrophysiologic - Geriatric Neurologic - Orthopaedic Pediatric
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Sports Physical Therapy
Women’s Health
Enhancing teaching and learning resource guide. Alexandria, Va: American Physical Therapy Association; 1998. Guide to physical therapist practice. Alexandria, Va: American Physical Therapy Association; 2001. Self-assessment tools for physical therapists – cardiopulmonary, clinical electrophysiologic, geriatrics, neurologic, orthopaedic, pediatrics, sports physical therapy. Alexandria, Va: American Physical Therapy Association. Clinical skills performance evaluation tools for physical therapists – cardiovascular and pulmonary, clinical electrophysiology, geriatrics, neurology, orthopaedics, pediatrics, sports physical therapy. Alexandria, Va: American Physical Therapy Association.
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