Clinician's Commentary on Jelley et al.

Jelley and colleagues¹ conducted a province-wide online survey of physiotherapists and physiotherapist assistants to identify the essential competencies for effective and efficient intraprofessional practice. Ten competency elements were consistently rated highest by respondents; of these top 10, 5 were consistently at the top, regardless of where the respondents worked, their gender, their years of experience, or their role:

1. Recognizes, responds, and communicates appropriately all significant changes in a patient's health.

2. Demonstrates active listening, using verbal and non-verbal communication.

3. Maintains confidentiality and respect for the integrity of the intraprofessional team.

4. Expresses ideas and viewpoints in a respectful, confident, and concise language.

5. Shares and exchanges information effectively.

Crucially, four of these top five items were categorized within the Communication competency. Results of two focus groups held after analysis of the survey data showed agreement with the survey results.

There are several important points to note from this study. Physiotherapists and physiotherapist assistants agree on the essential competencies for effective and efficient intraprofessional practice, and communication within the profession is key. There has been exceptional attention in the literature to the importance of communication in improving patient safety. In fact, the strategic plan of the Canadian Patient Safety Institute (CPSI), launched in 2010, focused on communication and introduced their main guiding theme: “Ask.Listen.Talk—Good healthcare starts with good communication.”² The CPSI also launched a working group to develop the Canadian Framework for Teamwork and Communication.³ Research evidence supports the importance of communication in improving patient safety in medicine^4–6 and rehabilitation.^7,8 Recent research with the traumatic brain injury population⁷ and in rehabilitation of adults who have had an amputation⁸ has specifically cited communication between interdisciplinary team members, as well as patient and caregiver education, as crucial to executing a safe treatment plan.

Much of the patient safety literature reinforcing the importance of communication centres on handoff. While this term has typically been associated with the surgical and anaesthesiology professions, handoff also occurs when a physiotherapist assigns a patient's care to a physiotherapist assistant under the physiotherapist's supervision. Communication of critical information is a key factor in maintaining patient safety in handoff situations.⁹ Tools,¹⁰ tickets,⁹ and checklists¹¹ have all been developed to enhance communication around handoffs. Given how important this communication is, perhaps we should consider formalizing the process of assigning and communicating about patient care within our profession?

Jelley and colleagues' study also has implications for how we educate our future physiotherapists and physiotherapist assistants. Given that both physiotherapists and physiotherapist assistants perceive communication as crucial to effective and efficient intraprofessional practice, and given its importance for patient safety, there would be benefit in ensuring that these competencies are explicitly taught within both curricula.

Jelley and colleagues' study is particularly useful in that it provides valuable information about the essential intraprofessional competencies for effective and efficient physiotherapy care. Communication and collaboration are most important. Intraprofessional competencies that contribute to effective and efficient care have implications for educational programmes that prepare physiotherapists and physiotherapist assistants; ultimately, they also have the potential to affect patient safety and the care we deliver to our patients.