Educational competencies for telehealth practice in physical therapy: preliminary results from a modified Delphi process


Todd Davenport: 0000-0001-5772-7727


Physical Therapy


Purpose/Hypothesis: Educational competencies (ECs) are important to guide the development of clinical knowledge and skills. Consensus ECs have yet to be created for telehealth physical therapy, despite its wide practice during the novel coronavirus pandemic. The purpose of this study was to determine ECs for telehealth physical therapy based on a modified Delphi process of clinicians who practice telehealth physical therapy.

Number of Subjects: Physical therapists and physical therapy assistants with experience in telehealth physical therapy practice or administration.

Materials and Methods: Institutional Review Board approval was obtained for this study. Draft ECs were created using source documents from the World Health Organization, World Physiotherapy, and the peer reviewed literature. The ECs were grouped into conceptual domains of ethics, research and development, technical skills, regulation, administration, clinical skills, and affect and communication. A survey was circulated to subjects using Google Forms, consisting of a demographic questionnaire and also solicited input on each draft EC. For each draft EC, subjects were asked whether the EC was relevant to an entry-level skill, an EC demonstrated by a Residency-trained physical therapist, or an EC consistent with advanced practice specific to telehealth physical therapy. Subjects also were asked to rate the clarity of each competency. Input on each draft EC was solicited using a 5-point Likert scale. A draft EC was accepted if its median Likert rating was consistent with ‘Very Relevant’ or ‘Extremely Relevant,’ and 80% or more respondents agreed the EC was clear. Draft ECs that scored ‘Very Relevant’ or ‘Extremely Relevant’ but had less than 80% agreement on clarity were marked for revision. Draft ECs that were neither sufficiently relevant nor clear were rejected.

Results: Twenty physical therapists responded to the first round survey (mean years of practice: 14.7, standard deviation [SD]: 7.7; mean maximum percentage of time spent per week in telehealth practice: 40.0, SD: 22.9). Among the 72 draft competencies, n=12 were identified for revision and n=24 were rejected. The panel accepted n=31 competencies for entry-level telehealth practice, n=37 competencies for Residency-level telehealth practice as it relates to existing specialty areas, and n=48 competencies for advanced practice specific to telehealth physical therapy. Approved ECs predominately related to clinical skills, communication, and ethics. Residency-level telehealth practice related to existing specialty areas required more clinical skill competencies. In addition to more clinical skill competencies than both entry-level and residency-trained physical therapists, competencies in research and development, technical skill, and administration were identified for advanced practice specific to telehealth physical therapy.

Conclusions: Preliminary results from this modified Delphi study indicate potential areas of emphasis in entry-level, existing Residency, and potential specialty practice in telehealth physical therapy.

Clinical Relevance: These data suggest consensus ECs that may improve availability and quality of telehealth physical therapy.

Document Type

Conference Presentation

Publication Date


Publication Title

American Physical Therapy Association, Combined Sections Meeting

Conference Dates

February 2-5, 2022

Conference Location

San Antonio, TX

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