Original Research

Competencies for entry-level rural and remote physiotherapy practice: a Delphi approach


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Romany Martin1
Bachelor of Physiotherapy, PhD Candidate *

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Allison Mandrusiak2
PhD, Associate Professor

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Andric Lu3
Bachelor of Physiotherapy, Manager Affiliations

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Roma Forbes4
PhD, Senior Lecturer


1, 2, 4 School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Qld 4067, Australia

3 North West Hospital and Health Service, Queensland Health, Mount Isa, Qld 4825, Australia

ACCEPTED: 23 August 2021

early abstract:

Introduction: Rural physiotherapy is a challenging area of practice that requires clinicians to respond to the unique factors that contribute to rurality. This study aimed to outline an introductory set of competencies that contribute to effective physiotherapy practice in rural Australia.
Methods: A three round Delphi study was undertaken using a panel of expert physiotherapists. The panel was asked to provide open ended responses to the following question: ‘What unique knowledge, skills, abilities, attributes or other characteristics do physiotherapists need to possess, or learn in order to provide effective physiotherapy specifically in a rural or remote setting?’. These responses were then thematically analysed to create competencies. The competencies were evaluated in the subsequent rounds by the Delphi panel. Consensus was set at 80%.
Participants: Rural and remote “experts” were determined through criteria including duration of practice, established expert frameworks, and self or peer nomination. The publicly accessible Australian Physiotherapy Association database was used to access the contact details of 222 physiotherapists working in rural and remote locations across all Australian states and territories. Seventeen expert physiotherapists met inclusion criteria and consented to participation.
Results: Seventeen expert physiotherapists completed round one with a 100% response rate. Analysis of the expert panel responses yielded an initial 24 competencies. The second round had a response rate of 94.1%, and the third round 93.8%. A final set of 19 competencies was established. The knowledge, skills, and attributes featured in the competencies relate to responsivity to rural locality, adapting to individual community needs, and problem solving in response to challenges to practicing in rural and remote locations.
Conclusion: This study has introduced a set of competencies that may contribute towards effective physiotherapy practice in the rural setting. The competencies provide a common language for physiotherapists and their employers and may be used to guide training or mentorship in this setting.