The Physiotherapy Practice Thresholds were reviewed and approved by the Australian and Aotearoa New Zealand Boards in 2023. Please familiarise yourself with the changes made by reading the Summarised highlights for Aotearoa New Zealand context here and by watching the video below.
Physiotherapy practice thresholds in Australia & Aotearoa New Zealand
The Physiotherapy practice thresholds describe the threshold competence required for initial registration and continuing practice as a physiotherapist in both Australia and Aotearoa New Zealand
A full PDF of the Physiotherapy practice thresholds is available here
The current Thresholds for educational institutions (current until 1 January 2025) are here.
Introduction
Background to the Physiotherapy practice thresholds
The Physiotherapy Board of Australia (PhysioBA) and the Physiotherapy Board of New Zealand (PBNZ) have worked together between 2012 and 2015 to develop and publish the Physiotherapy practice thresholds in Australia and Aotearoa New Zealand (referred to here as “Physiotherapy practice thresholds”).
The PhysioBA and PBNZ will regularly review the published Physiotherapy practice thresholds to maintain their relevance to the expectations of threshold competence required for contemporary physiotherapy practice in Australia and Aotearoa New Zealand. These were reviewed and amendments were approved by the respective Boards in October 2023.
Purpose of the Physiotherapy practice thresholds
The Physiotherapy practice thresholds describe the threshold competence required for initial registration and continuing practice as a physiotherapist in both Australia and Aotearoa New Zealand.
Format of the Physiotherapy practice thresholds
The format of the Physiotherapy practice thresholds draws on a competency framework, the CanMEDS framework, developed by the Royal College of Physicians and Surgeons of Canada (Royal College). The CanMEDS framework “describes the abilities physicians require to effectively meet the needs of the people they serve” (Frank, Snell, Sherbino et al, 2014, p 1). The CanMEDS framework emerged in the 1990s and was first launched by the Royal College in 1996. The third version was published in 2015.
The main feature of the CanMEDS framework is the thematic arrangement of competencies based on seven integrated roles of physicians in practice. The thematic arrangement of competencies based on roles of practitioners in practice, drawing on the CanMEDS framework, has gained acceptance in several other countries. The medical profession in Australia, Aotearoa New Zealand, Denmark and the Netherlands has adapted the CanMEDS framework for entry to medical practice. Other professions, including the physiotherapy profession in Canada and the Netherlands, have drawn on the CanMEDS framework to describe the competencies that are “essential” at the beginning of, and throughout, a practitioner’s career.
In applying the CanMEDS approach, the Physiotherapy practice thresholds arrange key competencies within seven integrated and thematic roles: Physiotherapy practitioner, Professional and ethical practitioner, Communicator, Reflective practitioner and self-directed learner, Collaborative practitioner, Educator and Manager/leader. Although the Physiotherapy practice thresholds arrange key competencies within separate roles, the Physiotherapy practitioner role is central to physiotherapy practice in any context, and, as practitioners, physiotherapists integrate the other roles in the Physiotherapy practice thresholds with that central role as they apply to the context of the physiotherapist’s practice.1
The Physiotherapy practice thresholds expand on each of the seven roles at three levels:
“Role definition” describes the essential characteristics of physiotherapy practice encompassed by the corresponding key competencies. When combined, the seven role definitions describe the essential characteristics of a competent registered physiotherapist in both Australia and Aotearoa New Zealand.
“Key competencies” are described for each role. The key competencies are the practices necessary for a physiotherapist to safely and effectively perform the central role of physiotherapy practitioner in a range of contexts and situations of varying levels of complexity, ambiguity and uncertainty.2 An individual should demonstrate threshold competence for all key competencies relevant to their field of practice.
“Enabling components” describe the essential and measurable characteristics of threshold competence for the corresponding key competency. Threshold competence requires an individual’s practice to comprise all the enabling components for the corresponding key competency.
The language used in the Physiotherapy practice thresholds describes behaviours that characterise threshold competence in practice. Each key competency and enabling component is prefaced by the words “Registered physiotherapists in Australia and Aotearoa New Zealand are able to”.
The key competencies and enabling components embed the complex conceptual, analytical and behavioural elements that integrate foundational abilities, such as the knowledge, skills, attitudes, values and judgements, that may be learnt in entry-level programmes. The Physiotherapy practice thresholds do not explicitly identify the corresponding foundational abilities (knowledge, skills, attitudes, values and judgements) that may be learnt in entry-level programmes at the level of task-oriented elements that, in isolation, do not assure threshold competence in practice.3
Uses of the Physiotherapy practice thresholds
The PhysioBA and PBNZ each have statutory functions as regulators of the physiotherapy profession in Australia and Aotearoa New Zealand respectively. One statutory function of the PhysioBA is “to register suitably qualified and competent persons in the health profession”.4 One of the statutory functions of the PBNZ is “to set standards of clinical competence, cultural competence (including competencies that will enable effective and respectful interaction with Māori), and ethical conduct to be observed by health practitioners of the profession”.5
The PhysioBA and PBNZ use the Physiotherapy practice thresholds as a reference point of threshold competence when exercising their statutory functions, including for:
- registration of individuals who completed an approved physiotherapy programme in Australia or a prescribed physiotherapy qualification in Aotearoa New Zealand (see section headed “Physiotherapy practice thresholds and accreditation of physiotherapy education in Australia and Aotearoa New Zealand” for more details)
- registration of individuals who complete their initial physiotherapy qualifications in other countries
- re-registration of individuals who were previously registered as a physiotherapist in Australia or Aotearoa New Zealand, and
- evaluation of a registrant whose level of competence to practise may pose a risk of harm to the public, for example, if the PBNZ or PhysioBA receives a complaint or notification about that
The PhysioBA and PBNZ recognise that other organisations and individuals may use the Physiotherapy practice thresholds as a reference point of threshold competence for other purposes. This could include registrants’ self-assessment of their competence, employers’ performance evaluation and management of physiotherapists in the workplace, and the development of health policy and health workforce strategy by agencies responsible for such work.
Physiotherapy practice thresholds and accreditation of physiotherapy education in Australia and Aotearoa New Zealand
The PhysioBA and PBNZ do not generally directly examine or assess the competence of applicants for registration who completed their physiotherapy studies in Australia or
Aotearoa New Zealand, if the programme of study is approved (Australia) or their qualification is prescribed (Aotearoa New Zealand). Instead, the PhysioBA and PBNZ have approved accreditation and/or audit arrangements that enable them to consider these applicants suitably competent for registration as a physiotherapist in the respective country.
As part of the accreditation/audit arrangements, the PhysioBA appoint an accreditation and/or audit body to assess if the physiotherapy programme, and the institution that delivers it, provides students with the knowledge, skills and professional attributes to practise physiotherapy. In Australia, the PhysioBA has approved the accreditation standards developed and used by its accreditation body – the Australian Physiotherapy Council. In Aotearoa New Zealand, PBNZ set the accreditation standards assess and accredit institutions and programmes under relevant legislation.
The Physiotherapy practice thresholds are not accreditation standards but are, as noted, a reference point for the threshold competence required for initial registration and continuing practice as a physiotherapist in both Australia and Aotearoa New Zealand. The language used in the Physiotherapy practice thresholds describes abilities in practice. The Physiotherapy practice thresholds do not explicitly identify the corresponding foundational abilities (knowledge, skills, attitudes, values and judgements) that may be learnt in entry-level programmes.
(1) The integration of the central role of the Physiotherapy practitioner with the other roles is best illustrated by the CanMEDS diagram.
(2) The context of a physiotherapist’s practice may not be limited to (and may not include) direct clinical Many of the abilities described in the key competencies are required in direct non-clinical relationships with patients or clients. The abilities are also required when registered physiotherapists work in management, administration, education, research, policy development, advisory contexts, regulatory contexts or other contexts impacting on public health and safety.
(3) Unlike the Australian Standards for Physiotherapy (2006) and the Physiotherapy Competencies for Physiotherapy Practice in New Zealand (2009), the Physiotherapy practice thresholds do not “deconstruct” the key competencies or enabling components into task-oriented performance criteria or examples of
(4) Section 35(1)(a) of the Health Practitioner Regulation National Law Act as in force in each state and territory in Australia
(5) Section 118 of the Health Practitioners Competence Assurance Act 2003 (NZ).