1. AMERICAN BOARD OF PHYSICAL THERAPY SPECIALITIES: Enhancing Professional Development through Certification
Introductions of Specialty Council members
Thank the Geriatric Session for sponsoring the session
American Board of Physical Therapy Specialties
American Physical Therapy Association

2. Learning Objectives
Upon completion of this presentation, you'll be able to:
Discuss the role of specialist certification in advancing your clinical practice and importance to our profession
Describe the current areas of specialty practice
Provide an overview and describe the process for ABPTS certification and Maintenance of Specialist Certification Program
Describe the minimum eligibility requirements and role of clinical residencies
Identify top motivations to pursue ABPTS specialist certification
Talk is partitioned into two areas of focus.
Those interested in learning the nuts and bolts of initial certification
Those interested in learning about the requirements for recertification – and specifically how ABPTS will be transitioning into the MOSC cycle from the current 10 year cycle.

3. The Path to Clinical Excellence
The concept of clinical specialization has a long history – with the APTA House of Delegates first approving the concept in You may have heard that we are recognizing 30 years of specialization this year, as the first three board certified specialists were recognized in 1985.
Linda Crane, Scot Irwin and Meryl Cohen 3

4. Clinical Excellence: Dimensions
Knowledge
Virtues
Movement
Clinical Reasoning
Multidimensional
Patient centered
Philosophy of PT Practice
Caring
Commitment
Collaborative process
Reflection
Specialists embody many important dimensions that are as pertinent today as they were 30 years ago.
Central focus
Centered on function
Jensen GM et al (2000) Phys Ther 80(1):28–43

5. Clinical Excellence: Potential Pathways
Entry level degree
Years of experience
Continuing education
Post–professional residency
Post-professional degrees
Post-professional certifications
Specialization – board certification!
It’s remarkable how post professional opportunities have expanded and grown in thirty years. 5

6. What is Clinical Specialization?
A formal process established to:
recognize physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice
assist consumers and health care community in identifying physical therapists who are specialists
address a specific area of patient need
Talk about accreditation process for board certification. The National Commission for Certifying Agencies (NCCA) exists to help ensure the health, welfare, and safety of the public through the accreditation of certification programs/organizations that assess professional competence. Certification programs that receive NCCA Accreditation demonstrate compliance with the NCCA’s Standards for the Accreditation of Certification Programs, which were the first standards for professional certification programs developed by the industry.

7. Key Elements of Board Certification
Voluntary
You decide
Unrestrictive
Does not prohibit others
Coordinated
All areas of specialization managed by a central mechanism: ABPTS

8. What does Clinical Specialization Require?
Broad based foundation of physical therapy education and clinical practice
Depth and breadth of knowledge in a specialty area
Advanced clinical expertise and skills
Knowledge

9. Purpose of Board Certification
Recognize specialists through established testing methods to ensure a defensible process, and a reliable and valid examination
Promote
highest possible level of physical therapy care
ongoing development of science and art underlying each specialty practice
Inform stakeholders of physical therapists who are certified in a specialty area
There are a lot of steps behind the scenes in order to prepare an examination that is defensible for board certification. ABPTS works with the National Board of Medical Examiners. NBME has a dedicated team that supports all of the examination development – from item writing to establishing a test form and conducting standard setting meetings

10. Areas of Specialty Practice Recognized through ABPTS Board Certification
Cardiovascular & Pulmonary
Clinical Electrophysiologic
Geriatrics
Neurology
Orthopaedics
Pediatrics
Sports
Women’s Health

11. Minimum Eligibility Requirements for Clinical Specialization Certification
Current permanent/unrestricted license to practice physical therapy in the United States, District of Columbia, Puerto Rico, or Virgin Islands
2,000 hours minimum of direct patient care
as a licensed physical therapist in the specialty area
25% (500 hrs) of which must have occurred in the last 3 years.

12. Minimum Eligibility Requirements
Direct patient care must include activities:
in each element of the patient/client management model, as defined in the Guide to Physical Therapy Practice
included in the Description of Specialty Practice (DSP)
Examination
Evaluation
Diagnosis
Prognosis
Intervention 12

13. Other Eligibility Requirements
Specific to the specialty:
ACLS certification, Data Analysis Project (Cardiovascular & Pulmonary)
Patient reports (Clinical Electrophysiologic)
Emergency care certification (Sports)
Case reflections (Women’s Health)

14. Other Option to Meet the Eligibility Requirements for Specialty Certification
APTA Credentialed Clinical Residency
Program of post-professional clinical and didactic education designed to advance the physical therapist's skill in a defined practice area
Residency Curriculum - designed using the Description of Specialty Practice
Specialty councils may allow completion of an APTA-credentialed clinical residency to replace all or a portion of the practice eligibility requirements
Emphasis on that path – now switching to another path – residency programs.
If you are currently in you DPT entry level training – residencies are a way to meet the eligibility requirements in a fairly short period of time.

15. Board Examination
Developed by the Specialty Councils, in collaboration with the
National Board of Medical Examiners®
A rigorous, criterion referenced exam that tests the application and synthesis of:
advanced knowledge
clinical skills & reasoning
Meryl - Used to be 2 days of paper and pencil testing.
Now computerized in 1 day at Prometric centers in US and around the world.

16. Where to Start? Description of Specialty Practice
Self-Assess strengths and weakness
Consider patient populations that are familiar and not as familiar
Develop a plan and strategy to prepare.
Your patients are your best teachers!

17. Description of Specialty Practice (DSP)
Describes the advanced knowledge, skills, and abilities for clinical practice in a specialty area
Based on the results of an extensive practice analysis
conducted by Specialty Councils and approved by ABPTS
Guides the development of the certification exam 17

18. Components of the Examination*
Patient Care
Teaching
Administration
Consultation
Communication
Interpretation of Research
*As defined by a specific DSP

19. Path towards Clinical Specialization
Clinical experience in specialty area
Seeking mentors
Professional Development
Board certified specialists
Knowledge and skills
Continuing education
Post professional clinical residency
Post professional education

20. Preparing for the Board Certification Examination
Continuously review and adapt your “path”
Use resources from APTA Sections
Recommended textbooks
Reading lists
Advanced Clinical Practice Courses
Join a study group
Seek the guidance of a mentor
Attend continuing education
 ABPTS does not approve or review material or course content 
Mention poster – addressed how to implement an online support / study group for preparation. Around 2105.

21. Links to APTA Academy/Section Websites
Cardiovascular & Pulmonary:
Clinical Electrophysiologic and Wound Management:
Geriatrics:
Neurology:
Orthopaedics:
Pediatrics:
Sports:
Women’s Health:

22. Specialist Certification Application Process
On-line
Application
July 1 – Cardiovascular and Pulmonary, Clinical Electrophysiology and Women's Health
July 31 – all other specialties
Deadlines for exams
APTA Postprofessional Certification and Credentialing
All applications are reviewed

23. Specialist Certification Fees
APTA Member
Non-Member
Application Review
$515
$860
Examination
$800
$1,525
Total
$1,315
$2,385
Board Certification is valid for 10 years

24. Possible Sources of Financial Assistance
Continuing education funds through employer
Scholarships
Academy of Pediatric Physical Therapy:
Carol Gildenberg Dichter Memorial Fund Scholarship

25. When is the certification exam administered?
Once per year, over a two-week exam period
Candidates may sit for the exam between February and March
2017: February 27 – March 18

26. Examination Format
Computerized exams, administered at Prometric test centers worldwide
Multiple choice questions including case scenarios, videos, and pictures 26

27. Recognition of Certified Clinical Specialists
Opening Ceremony of APTA Combined Sections Meeting
APTA sections and State chapters
Inclusion in online Directory of Certified Specialists
Only individuals who have successfully completed the ABPTS certification process may use the term:
“Board-Certified Clinical Specialist”

28. Board-Certified Clinical Specialists
Who Are They?

29. Number of Certified Specialists by Year Total as of June 2016: 20,144 individuals

30. Certified Specialists by Area
Cardiovascular & Pulmonary
254
Clinical Electrophysiologic
177
Geriatrics
2,133
Neurology
1,988
Orthopaedics
11,730
Pediatrics
1,615
Sports
1,914
Women’s Health
333
Total in 2016 = 20,144 30

31. Certified Clinical Specialists: Age
Data current as of June 2014

32. Certified Clinical Specialists: Gender
Data current as of June 2014

33. Certified Clinical Specialists: Work Settings
Private PT Offices
Health systems or hospital-based outpatient facility or clinics
Academic Institutions

34. Certified Clinical Specialists: Positions Held
Supervisor/Director of PT
Staff or Senior PT
Sole Owner/Partner PT Practice
Academic Faculty

35. Why do physical therapists become Board Certified Clinical Specialists?

36. Perspective on ABPTS Specialization
Initial Certification = Starting Point
Mind Set
Commitment
Continued practice as a Certified Specialist
Once start the process – you will part of ongoing development activities.
To stay current and advanced in PT practice
To be a lifelong learner

37. Top Motivations to Pursue ABPTS Certification
Professional career goal
Personal challenge or achievement
Earn a credential that reflects advanced practice to patients, physicians, & payers
Proof of expertise in specialty area
Career ladders within organizaitons
Source: Survey of certified specialists (2013)

38. Mentors with Passion, Patients, & Profession
Why I did it….
Staff PT
Senior PT
Academic
role
MS / NCS
PhD
Employment
0-3
3-5 7+
11+
ABPTS 10
11+
Initial
Certification
SACE / Neuro
Specialty
Council / Chair
= Years since graduation
Mentors with Passion, Patients, & Profession

39. Positive Impact of Board Certification
Sense of personal achievement
Self-confidence & professional growth
Patient care, including better outcomes
Increased credibility with patients & referral sources
Recognition in clinical, academic and community settings
Source: Survey of certified specialists (2007)

40. How has board specialty certification influenced the careers of Specialists?
Opened doors for professional growth
Consultations
Invited Presentations
New job opportunities
Leadership & service
Teaching opportunities
Research collaboration
Networking

41. Service Opportunities Related to Specialization
ABPTS
Oversees all specialties
Specialty Councils
Oversee exam development process, MOSC, practice analysis
SME
Conduct exam standard setting and specialty practice analysis
CCE
Edit exam items
Mentor SACE
SACE
Write exam items

42. Employer Support of ABPTS Certification
53% pay at least some of the costs associated with obtaining clinical specialization.
43% give priority in hiring to job applicants who are board certified.
Employers value the expertise of specialist.
Have high patient care standards
Serve as mentors for others
Provide team leadership

43. Value of ABPTS Certification to Certified Specialists
79% report that certification is an indicator of clinical competence
90% report that certification is an indicator of depth and breadth of knowledge in an area of specialty practice
High rate (68%) of specialists choose to recertify
Source: Survey of certified specialists (2007)

44. Specialist Recertification: Purpose
Verify current competence as an advanced practitioner in a specialty area
Encourage ongoing education and professional growth

45. Specialist Recertification: Requirements
For specialists certified before 2013:
Direct patient care hours in specialty (2,000 hr)
AND
Professional Development Portfolio OR
Current written examination OR
Graduation from a credentialed APTA clinical residency 45

46. Professional Development Portfolio (PDP)
Documentation of professional development activities and advanced clinical practice related to specialty practice, since initial certification
Examples:
Continuing Education courses
Clinical Supervision
College/University courses
Teaching continuing education or college courses
Research presentations
Presentations to professional groups or in-services
Presentations to community or client-based groups
Author or editor of book chapters, journal articles, grant proposals
Committee membership in professional organization
Consultation

47. MOSC: Purpose and Model
More effectively verify current competence as an advanced practitioner in the specialty area
More effectively evaluate professional development and clinical experience
Better encourage ongoing education and professional growth
Keep pace with the rapidly expanding specialty knowledge base and scientific evidence that guides clinical decision-making
Promote improved health outcomes related to physical therapy specialty services

48. Maintenance of Specialist Certification
Licensure & Professional Standing
Practice Performance & Clinical Care and Reasoning
Cognitive Expertise
Lifelong Learning & Professional Development
Certification Cycle
Year 3
MOSC 6 9 10

49. Minimum Eligibility Requirements of MOSC
1. Professional Standing and Direct Patient Care Hours
Evidence of Current Licensure as a physical therapist in the United States, the District of Columbia, Puerto Rico or the Virgin Islands
Direct Patient Care in the Specialty Area
Evidence of 200 hours of direct patient care in the specialty practice within each three (3) year submission period
Hours accrued in year 10 applied to the next three year submission period
Direct patient care in the specialty area must include activities in each of the elements of patient/client management applicable to the specialty practice and included in the Description of Specialty Practice.

50. Minimum Eligibility Requirements of MOSC
2. Commitment to Life Long Learning through Professional Development
Mimics the information captured in the current PDP (professional services, continuing education coursework, publications, presentations, clinical supervision and consultation, research, clinical instruction, teaching)
Minimum requirements for each three (3) submission period across three (3)designated activity areas
Minimum of 10 MOSC credits, within 2 of the 3 designated activity categories, in years 3, 6, and 9. By year 9, a specialist must have accrued a minimum of 30 MOSC credits, and demonstrated professional development in each of the 3 designated activity categories.
A web-based submission/tracking system
Recommendations:
1.      Demonstration of a certified specialist’s commitment to life-long learning should mimic the information captured in the current PDP.
2.      The PDP current point system should not be continued in the new model.
3.      Recommend increased flexibility and more direct examples of what would be acceptable while maintaining the current categories for research and practice.
a.      Acceptable activities would need to go beyond simple attendance at continuing education workshops. Activities should include: continuing education coursework, publications, presentations, clinical instruction, or teaching.
4.      An individual must demonstrate how their participation in the various activities contributed in some way to the profession.
5.      Documentation of activities should be submitted on an annual basis, covering multiple activities. However, if special circumstances arise for candidates that prohibit an annual submission, it should be taken this into consideration and a extension or waiver for the year would be appropriately granted.
6.      Staff will put together a proposed schedule, including activity areas to be covered by certified specialists, based on the current activity listings in specialty PDP summary worksheets.
7.      Staff will continue to work with APTA’s IT Department to determine how best to secure a web-based system to track continuing competence in a specialty area.
                                                  i.    The web-based system should provide an individual account tracking
mechanism for each specialist to record professional development activities during years 1-7 of their certification cycle.
                                                ii.      System should be a component of APTA’s Learning Center. However, the
development of this module within the Learning Center is currently on hold. Staff will continue to communicate with APTA’s Professional Development Committee to assure we are kept up-to-date on current timelines and developments.
8.      There is NOT an hour requirement in this area but the specialist must show evidence of
professional development activities with, at minimum, annual documentation of
professional development activities.  These activities include continuing education
coursework, publications, presentations, clinical instruction, or teaching.

51. Minimum Eligibility Requirements of MOSC
3. Practice Performance through Examples of Clinical Care and Clinical Reasoning
Online submission of one (1) Reflective Portfolio for each three (3) year submission period
Demonstrate the clinical care and reasoning utilized and reflect how a patient case(s) has impacted practice
Not scored, but screened for completion of required information and reflection
Case reflection based on the Women’s Health initial certification case study requirement including an evidence-based component possibly a clinical bottom-line format.

52. Minimum Eligibility Requirements of MOSC
4. Cognitive Expertise through Examination
Recertification examination, comprised of approximately 100 items in year ten.
Exam blueprint will mirror that of initial certification exam/DPS, but will reflect contemporary specialist practice and allow a specialist to demonstrate continued competency in general areas of the profession (professional roles, responsibilities, values)
Successful completion of requirements 1-3 at each three (3) year submission period are prerequisites
Permitted two attempts without loss of credential
Demonstrate continued competency in general areas of the profession, such as knowledge areas, professional roles and responsibilities, coordination/communication/ documentation, and patient/client related instruction. 

53. MOSC: Timeline Recertification Model MOSC Model Transition Period
prior to 2013
Transition Period
started 2013
MOSC Model
Full implementation in 2016
Will present the transition from the PDP to MOSC timeline in 3 formats: figure / text / table – people learn in various ways. All are repeating the same thing. So 2/3 may help you – or 1/3 or all 3!

54. Transition & Implementation Phase: 2013-16
All individuals who are newly certified or recertified as of 2013 will be subject to the new MOSC process.
This will include a waiver of the first 3-year requirements, meaning that
board-certified specialists certified or recertified in 2013 and 2014, and those who will certify and recertify in 2015, will be required to fulfill the year 6 (second 3-year) requirements beginning in 2016, 2017, and 2018 respectively. 
As of 2016, all individuals who will newly certify or recertify will be subject to the MOSC process, as described, in its entirety.

55. Timeline for MOSC Implementation
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2012 4 5 6 7 8 9
10-PDP 1 2
MOSC
2013 3
10-Exam
2014
2015
PDP

56. For more information contact:
APTA
Postprofessional Certification and Credentialing
1111 North Fairfax Street
Alexandria, VA
800/ , ext 8520

57. Questions

58. Literature about Specialization or Specialists
Conrad S. Taking on the Specialist Certification Exam - And Winning. Perspectives for New Professionals of the American Physical Therapy Association. February, 2013.
Stepp DD. Focus your career: Specialist Certification. Perspectives for New Professionals of the American Physical Therapy Association. May, 2010.
Bryan J, Blake A. How do other health care professionals view specialist certification? PT Magazine. 2004;12(9):54-57.
Bryan J, Gill-Body K, Blake A. How employers view specialist certification. PT Magazine. 2003;11(1):50-51.
Thompson M. The role of higher education in the career paths of board-certified clinical specialists in geriatric physical therapy: implications for professional and post professional education. J Phys Ther Educ. 2001;15(2):10-16.

59. Literature about Specialization or Specialists
Hart DL, Dobrzykowski EZ. Influence of orthopaedic clinical specialist certification on clinical outcomes. J Orthop Sports Phys Ther. 2000;30(4):
Milidonis MK, Godges JJ, Jensen GM. Nature of clinical practice for specialists in orthopaedic physical therapy. J Orthop Sports Phys Ther. 1999;29(4):
Ellison J, Becker M, Nelson AJ. Attitudes of physical therapists who possess sports specialist certification. J Orthop Sports Phys Ther. 1997;25(6):

60. Literature about Specialization or Specialists
Smith LC. The decision to specialize. PT Magazine. 2001;9(6):52-59
Edmonds MM. What if? PT Magazine. 1999;7(4):44-49
Wynn KE. Why recertify? PT Magazine. 1996;4(11):68-70
Williams DO. Answering the bell: PTs & school sports. PT Magazine. 1996;4(12):36-39
Woods EN. What’s so special about specialist certification? PT Magazine ;2(2):46-51
Ferrier MPB. One stage in professional evolution. Clinical Management. 1991;11(2):66-70