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Kathy Davidson PT, Chair Steering Committee, Executive Director PEAC, Chantal Lauzon PT, Senior Practice Manager, CPA, Amy Stacey, Past President NPAA

Some of you may not know that physiotherapist assistants (PTAs) in Canada are more and more frequently educated jointly with occupational therapist assistants (OTAs) and that they graduate with a combined OTA/PTA diploma. They go on to practise either as OTAs, as PTAs or in joint roles as OTA/PTAs. Some are called OTA/PTAs, some are OTA & PTAs, many others are rehabilitation assistants, therapy assistants, or use a different title in the workplace. Some assistants work not only as OTAs and PTAs but also provide support to speech-language pathologists, or assist in recreation contexts as recreation therapist assistants.

You probably know that assistants are not regulated to practice in Canada (except in Quebec) and must work under the supervision of a registered OT or PT. But did you know that OTA/PTA education programs can choose to become accredited through the OTA & PTA education accreditation program (OTA & PTA EAP)? Twenty-nine public and private OTA/PTA education programs in Canada are either accredited or are candidates awaiting their first accreditation review. The accreditation program, available since 2012, has led to increased consistency in the skills that graduates have when they enter practice; those from accredited programs are sure to be able to demonstrate all of the competencies described in the current PTA competency profile and the OTA competency profile. If you work with an OTA/PTA from an accredited program, be sure you’re using them to their full potential – they have a lot to offer!

A few years ago, a number of us (some of us involved with accreditation and others who are stakeholders in accreditation) recognized that as the profile and competencies held by OTA/PTAs became more recognized in healthcare, there were questions arising that needed to be discussed. But there really wasn’t an organized group which spoke for OTA/PTAs, or a forum where these questions – supervision, regulation, title, advocacy, and many other topics that affect both practising OTA/PTAs and those who interact with them – could be explored.

We created a Steering Committee in early 2016 – the members represent the CPA and the National Physiotherapist Assistant Assembly (NPAA) , the Canadian Association of Occupational Therapists (CAOT), the Canadian Occupational Therapist Assistant and Physical Therapist Assistant Educators Council (COPEC), the OTA & PTA EAP, Physiotherapy Education Accreditation Canada (PEAC), the Canadian Alliance of Physiotherapy Regulators (CAPR), and the Association of Canadian Occupational Therapy Regulatory Organizations (ACOTRO), and practising OTAs and PTAs. We wanted to find a way to give a voice to OTA/PTAs, explore how their practice might evolve over the coming five to ten years, and come to a consensus about how best to maximize their contribution to Canada’s healthcare system going forward. So far we’ve completed two sub-projects (Stage 1 and Stage 2) which have garnered such engagement and positive response that we’re convinced that our objectives resonate with many.

Stage 1

In the fall of 2017, as a starting point, we circulated a survey to as many people as we could find through our stakeholder groups. The survey questions were related to topics such as practice context (where are OTA/PTAs working? where should they be working?), supervision (is indirect supervision okay, or must OTs and PTs supervise directly?), regulation (is this where we need to be mobilizing? is regulation important to stakeholders or not?), as well as resources required for current and future OTA/PTA practice. We wanted to know whether there were disparate views about how OTA/PTAs practise currently and about how they should practise in the future. We received over 1500 survey responses from OTs, PTs, and OTA/PTAs (educators, regulators, clinicians, employers) and LOTS of comments to guide our next stage.

Stage 2

In 2018, the Steering Committee was grateful to receive some funding from CPA, CAOT, and CAPR to engage iTracks, a company that conducts facilitated online focus groups. After sifting through the survey responses looking specifically for feedback that suggested differences of opinion between stakeholder groups or individuals, and with the help of Garnette Weber at iTracks, the Steering Committee developed a series of questions that would help us work to achieve consensus on topics where we saw the most diverse opinions. We secured ethics approval through the University of British Columbia and sent out a broad call for participants willing to participate in five days of online discussions (we asked for a commitment to log on at least three times each of the five days to read and respond to the questions being posed and the comments posted by other participants). We heard from over 430 individuals (employers, patients, educators in OT, PT and OTA/PTA; regulators in OT and PT; OTs; PTs; OTAs; PTAs; and OTA/PTAs) who wanted to participate. We sent out consent forms to a representative sample and received 120 back. During the online sessions, 100 of those who submitted their consent form logged in to contribute to the discussions. We were so encouraged by their engagement!

The discussions generated over 900 pages of transcript which were transformed by Garnette at iTracks into a final 50 page summary document. The Steering Committee is reviewing and digesting the information and plans to create an Executive Summary for broad circulation, along with key messages from the data. We want to be sure that our participants, funders, and stakeholders know how valuable their contributions have been. The key messages will help us generate a clear picture of what the future state of OTA/PTA practice should look like, what steps will take us there, and ultimately how OTA/PTAs can most effectively strengthen healthcare delivery in Canada.

Knowledge translation

Steering Committee members are taking advantage of a number of opportunities to describe the work taking place. The results of the 2017 survey were shared at the Therapy Assistant Association of Alberta (THAAA) education day in April 2018, at CPA Congress Montreal18 in November, and in the Nov/Dec 2018 Physiotherapy Practice magazine. A few of us are presenting at World Confederation for Physical Therapy (WCPT) Congress and the International Network of Physiotherapy Regulatory Authorities (INPTRA) event in May 2019 in Geneva. Others of us are presenting again to THAAA and to CAOT Conference in May 2019.

Thank you

The Steering Committee (Heather Cutcliffe, Kathy Davidson, Alison Douglas, Chantal Lauzon, Denis Pelletier, Amy Stacey, Grace Torrance, Amanda Walton) has many people and organizations to thank for getting us this far already. They include CPA, CAOT and CAPR for providing funding, all of the Steering Committee sponsoring organizations (ACOTRO, PEAC, CAOT, CPA, CAPR, NPAA, COPEC, OTA & PTA EAP) for providing in kind contributions (staff time to work on this project), Garnette Weber at iTracks for so efficiently facilitating and then summarizing the discussions. Last but most importantly, we would like to thank all of our participants (survey and discussion) who contributed so much time to guide the work we are doing. Your contributions will influence the work of our stakeholder organizations for years to come. We look forward to sharing more information and our key messages in the near future.

Call to action

If you work with a physiotherapist assistant, ask them if they are a member of CPA. Did you know that CPA has a membership tier for PTAs? If they are not a member, please share what CPA has been doing to advocate for PTAs; you can forward this blog post and share the article from the Excellence issue of Physiotherapy Practice (Vol 8, No 6, page 23-27.) And invite them to join CPA. We are #BetterTogether!


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