Competency-based physiotherapy education: The need for a European view?

Dear Sir

Although the use of competency-based education (CBE) in medical education seems to be well described (Frank et al. 2010), there exists, to the best of our knowledge, no literature about the specific use of CBE in physiotherapy education. In Europe there is a lot of difference in the diploma and the credits needed to start working as a physiotherapist, ranging from 180 to 300 ECTS credits. In Flanders, the Dutch-speaking part of Belgium, physiotherapists graduate as an master of science in rehabilitation sciences and physiotherapy. They enrol in a five-year educational programme of the second cycle, which consists of a three-year bachelor programme (180 ECTS Credits) and a two-year master programme (120 ECTS Credits).

In 2006, CBE was introduced in the physiotherapy educational programme of the University of Antwerp (formerly: Artesis University College of Antwerp), Belgium. A framework was proposed, based on roles and competencies, to rebuild the curriculum. These roles (clinician, scientist and professional) were based on the CanMEDS roles and turned out to be congruent to the roles proposed by the Belgian National Council for Physiotherapy in 2010. Within each role, competencies were defined and cross-checked with the Dublin descriptors as described in the Bologna framework. For every competency, behavioural indicators were formulated, allowing assessment of the competencies attained by a student.

A group of stakeholders, including representatives of the profession, evaluated the proposed roles and competencies, in general, as a strong characteristic. The scores of the individual competencies, however, demonstrated that the scientific competencies are perceived somewhat less important than clinical and professional competencies. This can be regarded as a signal to increase communication and discussion with the profession on the role of scientist that a physiotherapist could fulfil. In the first place, there clearly is a need for scientific evidence in order to practise evidence-based physiotherapy (Nieuwboer 2004). Physiotherapist should be the driving forces for the innovation of the profession and should therefore acquire the needed scientific competencies. Also when it comes to health insurance, it is important that a request for reimbursement of physiotherapy can be made based on the available scientific evidence.

A European position standing on key competencies for physiotherapists would be welcomed and could contribute to a more comparable level (bachelor, bachelor of science or master of science) of physiotherapy education, ensuring graduates meet entry-level standards of physiotherapy throughout Europe.