Abandonment of records is the act of leaving behind records without providing for their ongoing security and protection for the duration of the mandatory retention period. This occurs in instances where the physiotherapist fails to actively provide for the secure retention, ongoing access, and appropriate destruction of records when leaving a practice or retiring, or fails to have contingency plans in place to address records management when faced with unexpected illness.
Accredited university program means an entry to practice education physiotherapy program accredited by Physiotherapy Education Accreditation Canada, the Commission on Accreditation in Physical Therapy Education, or an institution’s physiotherapy entry to practice education program recognized by the Canadian Alliance of Physiotherapy Regulators credentialling program.
Active listening is a process of attending to what the speaker is saying and repeating back to the speaker what has been heard, to confirm that the listener has correctly understood the speaker.
Adult Interdependent Partner is, subject to the Adult Interdependent Relationships Act, “a person is the adult interdependent partner of another person if:
- the person has lived with the other person in a relationship of interdependence
- for a continuous period of not less than 3 years, or
- of some permanence, if there is a child of the relationship by birth or adoption, or
- the person has entered into an adult interdependent partner agreement with the other person under section 7.”²
Adult Interdependent Relationship means the relationship between two persons who are adult interdependent partners of each other.²
Advertising is the action of calling something to the attention of the public especially by paid announcements.³
Anti-discrimination is a form of action against discrimination and the systemic racism and the oppression of marginalized groups. An anti-discrimination mindset is based on conscious efforts and actions to provide equitable opportunities for all people on an individual and systemic level.4
Beneficence is the ethical principle of doing what is good with respect to the welfare of the client. The physiotherapist should provide benefit to the client’s health.5
Best practice recommendations refers to the advice or direction provided by public health experts, Medical Officers of Health, or as reported in relevant guidance documents.
Bias is prejudice in favor of or against one thing, person, or group compared with another, usually in a way considered to be unfair. This can include both explicit and implicit bias. Implicit bias refers to having attitudes, stereotypes, or prejudices towards people or groups without being consciously aware of or recognizing them.3
Boundaries refers to the accepted social, physical or psychological space between people. Boundaries create an appropriate therapeutic or professional distance between the physiotherapist and another individual and clarify their respective roles and expectations.6
Bundled services means a program of treatment or set of physiotherapy services intended to be delivered as a comprehensive plan of care over a course of several physiotherapy interactions.
Clients are recipients of physiotherapy services, and may be individuals, families, groups, organizations, communities, or populations. An individual client may also be referred to as a patient. In some circumstances, clients/patients may be represented by their substitute decision-makers.7
Close personal relationship is one where the physiotherapist’s ability to be objective and impartial, and to fulfill their professional obligations may be impaired due to the nature of the personal relationship. Close personal relationships typically exist between an individual and their romantic or sexual partner, children, parents, and close friends, but may also exist between individuals and other relatives, business partners, past romantic partners, and others.
Collaborate means to work jointly with others or together, especially in an intellectual endeavor.3
Communication is “the imparting and exchanging information” and includes speaking, listening, written and electronic information exchange. Effective, professional, communication involves active listening, and the sharing of information using plain language and assistive methods or devices (e.g., interpreters, technology, diagrams, printed education materials) when needed to facilitate the listener’s understanding.8
Complementary therapies refer to non-conventional practices used in conjunction with conventional physiotherapy.9
Comprehensive refers to “complete; including all or nearly all elements or aspects of something.”10
Concurrent treatment or care refers to “the circumstance where more than one health professional (provider) is administering or applying remedies, including medical, surgical or other therapies, to a patient for the same or related disease or injury.”11
Confidentiality “is the assurance that certain information that may include a subject’s identity, health, behavior, or lifestyle information, or a sponsor’s proprietary information would not be disclosed without permission from the subject (or sponsor).”12
Conflict of interest exists when a reasonable person could conclude that the physiotherapist’s duty to act in the client’s best interests while exercising their professional expertise or judgment may be affected or influenced by competing interests or relationships. Competing interests may be financial, non-financial, or social in nature.13
A conflict of interest may be actual, potential, or perceived and can exist even if the physiotherapist is confident that their professional judgment is not being influenced by the conflicting interest or relationship.
Contemporaneous means occurring or originating during the same time period.3 In the physiotherapy context, contemporaneous is determined by the practice context, other expected, or predictable uses of the record. In the PT context, documentation that does not occur during the same time-period poses risk to the client and is generally seen to be less accurate and more likely to be questioned.
Conventional physiotherapy refers to the type of assessment, diagnosis, treatment, and conceptualization of illness or injury that is considered “mainstream” physiotherapy. It is sometimes referred to as “evidence-informed”.9
Courtesy Register refers to the register that physiotherapists may apply to if they are currently registered in another jurisdiction and require temporary entry to Alberta for an approved purpose.14
Credible means any evidence that reasonably would be viewed as reliable, accurate, and having basis in fact.15
Critically appraised evidence means information that has gone through the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context.16
Cultural humility is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.17
Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the health-care system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.17
Direct supervision means that the supervisor is present in the treatment room or cubicle, and able to directly observe/assess competence, provide input into the supervisee’s performance, and intervene if a safety concern arises.18
Emerging therapies refers to treatments developed within mainstream physiotherapy with support from clinical research but currently lacking in rigorous, peer reviewed evidence to support their use.9
Episodic Care refers to a single encounter with a patient focused on a presenting concern(s), where neither the physiotherapist nor patient have the expectation of an ongoing care relationship.
Episodic care does not apply if the physiotherapist has seen the patient more than once, regardless of the timing of the appointments. The individual is considered a patient for the duration of the episode of care. A physiotherapist who engages in sexual abuse or sexual misconduct while providing episodic care will be considered to have committed sexual abuse or sexual misconduct.
Evidence-informed practice is “derived from evidence-based practice and involves clinical problem solving and decision making informed by integrating best available evidence, client context and the personal knowledge and experience of the physiotherapist.”7
Female Genital Mutilation means the excision, infibulation, or mutilation, in whole or in part, of the labia majora, labia minora, clitoral hood, or clitoris of a person, except where valid consent is given, and:
- a surgical or other procedure is performed by a regulated member under this Act for the benefit of the physical health of the person or for the purpose of that person having normal reproductive functions or normal sexual appearance or function, or
- the person is at least 18 years of age and there is no resulting bodily harm.19
Health service means a service provided to people:
- To protect, promote or maintain their health,
- To prevent illness,
- To diagnose, treat or rehabilitate, or
- To take care of the health needs of the ill, disabled, injured, or dying.19
Identity, culture and individual characteristics refers to an individual’s personal traits and the communities to which a person belongs. This can include characteristics such as physical appearance, body size and shape, use of mobility aids, and identity factors such as identifying as a member of a religious, ethnic, or social group. All individuals inhabit more than one social location and possess a unique combination of identities and individual characteristics.
Indirect supervision refers to a range of methods employed to monitor the performance of a supervisee on an ongoing basis without employing direct observation. Indirect supervision is employed after a supervisor is satisfied that a supervisee has demonstrated a reasonable level of competence in a particular practice context and with a specific patient population.17
Infection prevention and control refers to “measures practiced by health-care personnel intended to prevent spread, transmission and acquisition of infectious agents or pathogens between clients, from health-care workers to clients, and from clients to health-care workers in the health-care setting.”20
Informed Consent refers to “receiving client or their legally authorized representative’s permission to proceed with an agreed course of physiotherapy service. Consent may be revoked at any time…Consent can be written or oral and may be expressed or implied. Having a written consent form does not mean there is informed consent. Informed consent involves ongoing communication between the parties involved.”21
Marketing is the process or technique of promoting, selling, and distributing a product or service.3
Material risk includes risks that occur frequently as well as those that are rare but very serious, such as death or permanent disability.22
Other benefit includes but is not limited to gifts of materials or equipment, preferential access to facilities, or provision of promotional activities that would typically be paid for by the physiotherapist.23
Patient: (for the purpose of the Sexual Abuse and Sexual Misconduct Standard of Practice) an individual is a patient of a physiotherapist when they are a recipient of physiotherapy services and a therapeutic relationship is formed. This occurs when a physiotherapist has engaged in one or more of the following activities:
- Gathered clinical information to assess an individual.
- Contributed to a health record or file for the individual.
- Provided a diagnosis.
- Provided physiotherapy advice or treatment.
- Charged or received payment from the individual or third party on behalf of the individual for physiotherapy services provided.
- Received consent from an individual for recommended physiotherapy services.
A person is deemed discharged and no longer a patient if there have been no physiotherapy services provided for one year (365 days).
For the purposes of sexual abuse and sexual misconduct provisions in the Health Professions Act, an individual is not considered a patient if an ongoing sexual, spousal, or adult interdependent partner relationship that pre-exists the therapeutic relationship exists between the individual and the physiotherapist at the time the physiotherapist provides physiotherapy services.
OR
The physiotherapist has provided episodic care to a patient where neither the physiotherapist nor the patient have the expectation of an ongoing care relationship,
AND
48 hours have elapsed between the episode of care and the start of the sexual relationship or communication for the purpose of starting the sexual relationship.
Patient Safety Incident refers to any event or circumstance which could have resulted or did result in unnecessary harm to a patient. Patient Safety Incidents consist of near miss events, no-harm incidents, and harmful incidents.24
Personal protective equipment (PPE) refers to items in place for infection prevention and control, such as masks, gloves, gowns, and goggles.25
Physiotherapist intern: a regulated member of the College of Physiotherapists of Alberta, registered on the Provisional Register. A practice permit is issued with the condition that the physiotherapist intern practice under supervision.18
Physiotherapy student: an individual enrolled in a physiotherapy entry to practice education program is considered a physiotherapy student when they are engaged in activities related to their entry to practice education program.18
Physiotherapist support worker is an unregulated health provider working under the supervision and direction of a physiotherapist. PTSWs have a range of educational backgrounds and experience. May be referred to as physiotherapist assistant, rehabilitation assistant, therapy assistant, rehabilitation aide, or kinesiologist when working as a supervisee.18
Physiotherapy practice as defined in Schedule 20 s. 3 of the Health Professions Act, is when physiotherapists do one or more of the following:
- assess physical function,
- diagnose and treat dysfunction caused by a pain, injury, disease or condition in order to develop, maintain and maximize independence and prevent dysfunction,
- engage in research, education and administration with respect to health services delivery and the science, techniques and practice of physiotherapy, and
- provide restricted activities authorized by the regulations.19
Physiotherapy services are “services provided by or under the direction of a physiotherapist. This includes client assessment and treatment, and related communication with and reporting to various parties for the purposes of delivering client care.”7
Plain language refers to “communication your audience can understand the first time they read or hear it. Language that is plain to one set of readers may not be plain to others. Written material is in plain language if your audience can:
- Find what they need
- Understand what they find
- Use what they find to meet their needs”26
Point of Care Risk Assessment (PoCRA) is a routine practice that should be conducted by a physiotherapist before every client interaction to assess the likelihood of exposing themselves and/ or others to infectious agents. The Point of Care Risk Assessment informs the physiotherapist’s use of PPE and other infection control measures.27
Primary or Home Jurisdiction refers to the province or territory where the physiotherapist is registered and from which the physiotherapist delivers physiotherapy services.
Privacy refers to “a person’s desire to control the access of others to themselves. Privacy protects access to the person, whereas confidentiality protects access to the data.”12
Procure means to obtain something by particular care and effort.3
Proficiency means performance consistent with the established standards in the profession.1
Promotional activities include any effort made by an individual or business to communicate with potential customers. Promotional activities have two main purposes: to inform customers about your products, prices, and services and to persuade customers to buy the products and services you sell. Includes personal selling, direct marketing, advertising, sales promotion, publicity, and public relations.28
Promptly means with little or no delay.29
Protected title refers to the titles identified under Alberta’s Health Professions Act as being restricted to those who are registered and authorized to practice physiotherapy within Alberta. These include the titles physiotherapist, physical therapist, physiotherapist intern, physical therapist intern, or the acronyms PT or PT Intern.19
Quality is the degree to which a product or service satisfies a specified set of attributes or requirements.30
Regulated Member refers to an individual registered with a regulatory organization governed under the Health Professions Act, including physiotherapists.19
Risk refers to something that may cause injury or harm or the state of not being protected from injury or harm. Clients encounter risk of harm each time they seek health-care services. Some risks are directly related to assessment procedures and interventions, while others relate to environmental factors or are sector specific.23
Safe means free from harm or risk; secure from threat or danger.3
Sexual abuse is defined in the Health Professions Act, and “means the threatened, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature and includes any of the following conduct:
- Sexual intercourse between a regulated member and a patient of that regulated member;
- Genital to genital, genital to anal, oral to genital, or oral to anal contact between a regulated member and a patient of that regulated member;
- Masturbation of a regulated member by, or in the presence of, a patient or that regulated member;
- Masturbation of a regulated member’s patient by that regulated member;
- Encouraging a regulated member’s patient to masturbate in the presence of that regulated member;
- Touching of a sexual nature of a client’s genitals, anus, breasts or buttocks by a regulated member.”
Sexual misconduct, as defined in the Health Professions Act, “means any incident or repeated incidents of objectionable or unwelcome conduct, behaviour or remarks of a sexual nature by a regulated member towards a patient that the regulated member knows or ought reasonably to know will or would cause offence or humiliation to the patient or adversely affect the patient’s health and well-being but does not include sexual abuse.”
Sexual nature: does not include conduct, behaviour, or remarks that are appropriate to the physiotherapy service provided.19
Social justice refers to fairness as it manifests within society and includes fairness in health care. Social justice depends on four key principles or goals: human rights, access, participation, and equity.31
Special risk a risk or risks that are particularly relevant to the specific client, when typically these may not be seen as material. Consent discussion and requirements extend to what the physiotherapist knows or ought reasonably know their client would deem relevant to making a decision about whether or not to undergo a treatment.22
Spouse is defined as “a party to a marriage.” (Family Law Act, 46(g))32 or “A legal marriage partner. This term includes both opposite- and same-sex relationships but does not include common-law partnerships.”33
Standardized measures refer to measurement tools that are designed for a specific purpose in a given population. Information is provided regarding the administration, scoring, interpretation, and psychometric properties for each measure.34
Superlative: “an expression of abundant praise.”35 “Excessive or exaggerated; of the highest order, quality, or degree; surpassing or superior to all others.”36 In physiotherapy practice, statements such as “expert”, “best”, or “number 1” are examples of superlative statements.
Supervisee means an individual who is working under supervision.
Supervision means the action or process of watching and directing what someone does or how something is done.3
Systems of oppression refers to society level norms or structures that give advantage or disadvantage to individuals or groups, regardless of whether individuals want or are aware of it. These systems can result in dire health effects. This can include but is not limited to racism, sexism, heterosexism, cisgenderism, ableism, classism, anti-Semitism, Islamophobia, and anti-fatness. Individuals inhabit more than one social location, meaning that each person’s lived experience includes a combination of intersecting systems of oppression.37,38
Timely refers to “happening at the correct or most useful time: not happening too late.”3
Therapeutic Relationship refers to the relationship that exists between a physiotherapist and a patient during the course of physiotherapy services. The relationship is based on trust, respect, and the expectation that the physiotherapist will establish and maintain the relationship according to applicable legislation and regulatory requirements and will not harm or exploit the patient in any way.
Due to the nature of physiotherapy practice, there is always an inherent power imbalance between the patient and their physiotherapist. Because of the existence of an inherent power imbalance, sexual relationships are prohibited for the duration of the therapeutic relationship even if the patient consents to the sexual relationship.
The therapeutic relationship extends from the time of initial professional contact between the physiotherapist and the patient until one year (365 days) from the date of the last documented physiotherapy service.39
Transparent (transparently) refers to the quality of being easy to perceive, obvious, clear, and unambiguous.
Virtual care is the delivery of physiotherapy services using any technology that enables communication between individuals in different locations, including teleconferencing, video conferencing, email, or text communications.40
