When searching for a physiotherapist, you may notice that some are listed as being on the Provisional Register. Similarly, when showing up for or scheduling your physiotherapy appointment, you may be provided with the option of seeing a physiotherapist intern. When you are considering seeing a physiotherapist intern on the Provisional Register, it's important to understand what that means.
Who are physiotherapist interns?
Physiotherapist interns are regulated members of Physiotherapy Alberta who have been admitted to the Provisional Register. This means that they are subject to the same Standards of Practice and Code of Ethical Conduct as all other physiotherapists within the province of Alberta; however, they must practice under the supervision of a fully licensed physiotherapist on the General Register.
In most cases, physiotherapist interns are recent graduates of Canadian physiotherapy education programs or are applicants who were internationally educated. Before a recent Canadian graduate or internationally educated individual is admitted to the Provisional Register, they have fulfilled nearly all the requirements for admission to the General Register.
The only outstanding registration requirement for this group is the successful completion of a clinical competency examination approved by the Council of the College of Physiotherapists of Alberta.
The Provisional Register exists because without the ability to practice under supervision, a physiotherapist intern would be required to wait several weeks or months before successfully fulfilling all registration requirements and being added to the General Register. By enabling these individuals to practice under supervision before all registration requirements are fulfilled, a balance is struck between public protection and public access to physiotherapy services.
Once the physiotherapist intern has successfully completed the clinical examination approved by Council, they are added to the General Register and the supervision condition is removed from their practice permit.
What does supervision look like in practice?
The requirement that the physiotherapist intern works under supervision means that there is a physiotherapist on the General Register who is assigned the task of overseeing the physiotherapist intern’s work. This can take many different forms and does not always mean that the supervising physiotherapist is in the treatment room when the physiotherapist intern is providing care.
Direct supervision
When the physiotherapist intern is new to a practice setting or has just entered a supervision relationship with a new supervisor, the supervisor is required to provide a period of direct supervision. This means that the supervisor is present in the treatment room, and able to directly observe the physiotherapist intern, provide input into the supervisee’s performance and intervene if a safety concern arises. Supervising physiotherapists are expected to spend time assessing the skills of the physiotherapist intern so that they can get a sense of the intern’s skills and their need for ongoing assistance and support as they enter practice.
The supervisor is also required to provide direct supervision any time a physiotherapist intern is performing an internal pelvic examination, completing suctioning (e.g., in an intensive care unit), or performing wound debridement.
Indirect supervision
Indirect supervision occurs when the supervising physiotherapist uses a strategy to oversee the physiotherapist intern’s work without being directly involved in your care. For example, the supervisor may fulfill the supervision requirement through ongoing case discussions with the intern, by reviewing the intern’s chart notes and asking them questions about their plan to address your needs, or by using other supervision methods.
After assessing the physiotherapist intern’s skills, the supervisor may step back and allow the intern to practice with less direct oversight. Although the supervisor may not be directly involved in your day-to-day care, they remain responsible for continuing to supervise the physiotherapist intern and for providing guidance and support to the physiotherapist intern, when and if they need it.
How do physiotherapist interns and their supervisors work together?
Physiotherapist interns and their supervisors work together to make sure that you, the patient, get the best care possible.
As regulated members of the College of Physiotherapists of Alberta, physiotherapist interns assess their patients, determine the plan of care, provide patient care services, and modify the plan of care as appropriate. While the supervisor is responsible for providing supervision appropriate for the physiotherapist intern’s individual skills, setting, and patient factors, the physiotherapist intern is accountable and responsible for any care they provide.
Is there anything a physiotherapist intern is not allowed to do?
There are certain interventions that physiotherapist interns are not allowed to provide. These are activities that are restricted under the physiotherapy profession’s governing legislation and require additional authorization from the College of Physiotherapists of Alberta to perform. Physiotherapist interns are not eligible to apply for authorization to use needles in practice (acupuncture/dry needling), perform spinal manipulations, or order diagnostic imagining.
Pelvic health internal examinations, inserting and removing catheters, reducing a dislocated joint, suctioning, and wound debridement and care are restricted activities that can be performed by a physiotherapist intern under specific circumstances and with direct supervision from a physiotherapist who is authorized and competent to perform the activity.
Can physiotherapist interns bill for their services?
Physiotherapists registered on the Provisional Register are providing physiotherapy services, following the same Standards of Practice and Code of Ethical conduct as physiotherapists on the General Register and can bill for their services using their own registration number on the receipts they issue for those services.
How do I benefit from the physiotherapist intern being supervised?
When you are being treated by a physiotherapist intern, you can be confident that someone is overseeing their work and guiding them during their transition to an independent clinician. The supervising physiotherapist is helping them put into practice all that they have learned while ensuring you are receiving the care you require. This is a situation where two heads are better than one.
Physiotherapists are required to identify themselves using the appropriate title. You should know if you are being treated by a physiotherapist intern. You can check to see if your physiotherapist is an intern or a member on the General Register by using the Verify a Physiotherapist tool.
To ensure safe, effective and quality care, anyone using the title physiotherapist, physical therapist or P.T. in Alberta must be registered with the College of Physiotherapists of Alberta. Use our Verify a Physiotherapist feature to confirm you're receiving treatment from a registered physiotherapist.
