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Clinical Instructors, BEWARE: Not all clinical placements are created equal

Sarah Wojkowski, PT, PhD(c)

Does this scenario sound familiar to you?

You receive an email or a phone call from a student who has chosen to pursue a degree in physiotherapy from an institution outside of Canada.  The individual may be a Canadian citizen, you may have worked with them in the past, or they may be related to a colleague. They are seeking a placement in Canada to help them prepare for Canadian licensure.

If this scenario sounds familiar**, take a minute to consider what this means.

It is important to realize that students who are studying physiotherapy at universities abroad and seeking a placement in Canada may have some important differences from placements arranged for entry-to-practice and bridging students who are enrolled at a Canadian institution.

So what does this mean for you as the potential clinical instructor / preceptor?

As caring individuals who work daily to help others achieve their goals, it is in our nature to want to help others.  Many physiotherapists may have said “yes” and supported the placement experience without realizing some of the potential risks and consequences of taking this on.

In an effort to help raise the awareness of some of the considerations for physiotherapists in this situation, the National Association of Clinical Education in Physiotherapy (NACEP) members generated a list of questions to ask and consider  (see below) before physiotherapists practicing in Canada say “yes” to supporting the placement request.

In an additional effort to help international partners in clinical education understand the placement process in Canada, a website with the specific steps required for a student studying at an international institution is available for your reference.

Here are seven questions NACEP members suggest physiotherapists practicing anywhere in Canada consider before saying “yes” to a placement request from a student studying abroad:

1. Does the student’s institution provide sufficient insurance for the student during their clinical rotation?

Although physiotherapists are responsible for the actions of students under their supervision, students attending Canadian physiotherapy programs also have additional insurance for omissions and errors.  This same insurance is not automatically provided at all international institutions. Clinical instructors are strongly cautioned to ensure this insurance is in place prior to accepting the placement request.

2. Is the student proficient in written and spoken English and / or French?

Physiotherapy is a medical profession with specific terminology. A student who is studying abroad may have proficient conversational skills in either of our official languages – but many not have the proficiency to chart and / or communicate with other health care professionals at an appropriate level for your setting. 

*Did you know that the Alliance of Physiotherapy Regulators has guidelines for the minimum requirements for language proficiency scores?

3. Is the student in good standing with their academic institution?

There is often additional paperwork and responsibility associated with travelling and completing a clinical placement away from the student’s home university. Thus, NACEP members recommend that students have at least an overall academic average of 75% prior to applying to complete a placement in Canada. This will not only help to ensure the student has learned material to a sufficient level – but will also contribute to the student’s overall chances of success on the placement. 

*Clinical instructors may also want to review what the student has already learned in the academic setting before accepting the student to ensure compatibility with your clinical site.

4. Are you (and the student) aware of all the mandatory pre-placement requirements?

There are a number of pre-placement requirements that students must meet prior to starting a clinical placement in different provinces and territories. Accepting a student without ensuring all of these requirements have been met may place you and / or the student at risk.

For example:

  • Mandatory Student Licensure: Some provinces have a mandatory licensing requirement with the provincial regulatory college (i.e. College of Physiotherapists of British Columbia, CPTBC). All physiotherapy students completing a placement in this province are required to obtain a student license prior to starting clinical placement. This license will only be processed if a host university (i.e. UBC) has vetted the student and their physiotherapy program. 
  • Provincial Labor Regulations/Laws: In some provinces/territories, standardized training is required to be completed by all students who will be onsite at a work place (i.e. Bill 18 in Ontario). Many of the Canadian Physiotherapy Programs educate students about what the pre-placement requirements are, and some also support their students in completing these requirements. However, if a site accepts an international placement request by a student who is studying aboard, the student may not be aware of the training that is required prior to starting the placement.

5. Have you contacted the NACEP representative in your catchment area?

Each physiotherapy program in Canada has a specific geographic area where they can independently place students. Collaboratively, NACEP members have worked hard to establish a process that provides students who are studying in Physiotherapy with the best opportunities for clinical placement experiences.

NACEP representatives communicate with one another to identify if a student from an international institution has contacted other sites (i.e. is trying to secure a placement in one or more areas). This open communication helps to ensure that if a placement is found, that the student will accept the placement. In the past students have been found to be ‘fishing’ for experiences in one or more geographic locations – creating duplicate work and / or offers.

Visit the Canadian Council of Physiotherapy University Programs website for further information.

6. Does the local physiotherapy program know I have agreed to support this student?

To support students from any institution is at the discretion of the clinical instructor and clinical site.  NACEP members do request, however, that should you choose to support a student from an international institution that you do so in collaboration with your local physiotherapy program in an effort to minimize risk to all involved.

Many physiotherapists in Canada may not know that Canadian Physiotherapy Programs routinely struggle to meet their own placement needs. Offering a placement to a student who is studying internationally can further reduce the opportunities for students who are studying in Canada.

7. So what does this mean to me as a clinical instructor?

Certainly the choice is up to you to support a student clinical placement for a student studying abroad. However, NACEP members would encourage you to remember that not all physiotherapy student placements are created equal – and some have the potential to have more risk to you compared to others.   Due diligence is important to not only protect your patients, but both the student and yourself.

These questions are meant to give you an idea of what you could encounter and should be used to help you minimize risks or consequences of taking an international student placement.

If you have further questions, please contact the Clinical Education Coordinator / Director of Clinical Education in your catchment area. The names and email addresses area available at:

**Note: this information does not apply to internationally educated physiotherapy students who are enrolled in Bridging Programs at a Canadian University.

Author: This piece was submitted to ShopTalk by Sarah Wojkowski, the Director of Clinical Education (Physiotherapy) and past Chair of the National Association for Clinical Education in Physiotherapy (NACEP) on behalf of all NACEP members. For more information about NACEP please refer to the website:



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