Saudi Board Musculoskeletal Physical Therapy

Saudi Board
Musculoskeletal Physical
Therapy Curriculum
2021
Preface
• The primary goal of this document is to enrich the training experience of postgraduate residents by out-
lining the learning objectives to become independent and competent future practitioners.
• This curriculum may contain sections outlining some regulations of training; however, such regulations
need to comply with the most updated “General Bylaws” and “Executive Policies” of the Saudi Commis-
sion for Health Specialties (SCFHS), which can be accessed online through the official SCFHS website.
• As this curriculum is subjected to periodic refinements, please refer to the electronic version posted
online for the most updated edition:
https://www.scfhs.org.sa/MESPS/TrainingProgs/TrainingProgsStatement/Pages/index.asp
3
CONTRIBUTORS
Curriculum Development Committee
• Dr. Edan Alzahrani

• Dr. Ahmed Farrag
• Dr. Abdullah M. Al-Shenqiti
• Dr. Khaled Alzahrani
Reviewed and Approved by Specialty’s Scientific

Committee Members
• Dr. Edan Alzahrani

• Dr. Ahmed Farrag
• Dr. Abdullah M. Al-Shenqiti
• Dr. Khaled Alzahrani
• Dr. Ali Alshami
Curriculum Review Committee Members
• Dr. Sakra Balhareth, Pharm.D., BCPS, BCACP

• Dr. Faisal Althekair, MBBS, Msc.Med.ED, SBEM
Approved by Head of Curriculum Review Committee
• Dr.Ali Dr.Ali Alassiri, MBBS, Msc.MedEd. FRCSC, FACS
4
COPYRIGHT STATEMENTS
All rights reserved © 2020 Saudi Commission for Health Specialties (SCFHS).
This material may not be reproduced, displayed, modified, distributed, or used in any other manner without
prior written permission of the SCFHS, Riyadh, Kingdom of Saudi Arabia.
Any amendment to this document shall be endorsed by the Specialty Scientific Council and approved by Cen-
tral Training Committee. This document shall be considered effective from the date the updated electronic
version of this curriculum was published on the commission’s Website, unless a different implementation
date has been mentioned.
Correspondence: Saudi Commission for Health Specialties P.O. Box: 94656 Postal Code: 11614
Contact Center: 920019393
E-mail: Curricula@scfhs.org.sa
Website: www.scfhs.org.sa
• Saudi Commission for Health Specialties P.O. Box: 94656 Riyadh, 11614, Saudi Arabia. Contact
Center: 920019393
E-mail: Curricula@scfhs.org.sa
Website: www.scfhs.org.sa
5
FOREWARD
Physical therapy and rehabilitation services have been expanding exponentially over the past years,
which necessitated the need for sub-specialization in order to promote service quality. Musculoskeletal
disorders are health-related problems with significantly high incidence rate and great economic burden,
both nationally and internationally. The increased demand for musculoskeletal rehabilitation services,
in addition to the tremendous scientific advancement and diversity in musculoskeletal physical therapy
treatment procedures and approaches, has driven the need to develop a specialty clinical degree in
musculoskeletal physical therapy. In 2018, The Prince Sultan Military College of Health Sciences
(PSMCHS) took the initiative and endorsed the development of this curriculum, in collaboration with
SCFHS. This is the first clinical training program for the physical therapy profession, with specialization in
musculoskeletal system, in the Middle East region.
Described in this text is the curriculum for the Saudi Board of Musculoskeletal Physical Therapy
(MSK-PT). This curriculum describes the details of this specialized clinical degree including program
objectives, enrollment criteria, study plan and clinical practice design, and success requirements. This
program is adapting a competency-based educational approach as this could support professional
training based on recent scientific evidences, in order to develop different competencies required for a
clinician expert in musculoskeletal physical therapy. Additionally, graduates are expected to use their
well-developed knowledge for specialty practice and efficient communication skills to appropriately
educate their colleagues, and transfer their knowledge, skills, and experience to them. Furthermore, as
health care providers, graduates should be competent as health advocates and professionals to increase
community awareness and commit to patient care by applying best evidence-informed practices.
The MSK-PT program runs for three years. The program comprises didactic classes and clinical training.
It includes several didactic classes focusing on physical therapy management for musculoskeletal
dysfunction in different body regions. Emphasis is placed on spine and extremities. Additionally, clinical
practice is the major component of this program in which residents will manage different conditions
requiring musculoskeletal rehabilitation.
6
TABLE OF CONTENTS
Saudi Board Musculoskeletal Physical Therapy Curriculum 2021 1 8.2 Formative Assessment 26
I. Contributors 4 8.2.1 General Principles 26
II. Copyright Statements 5 8.2.2 Formative Assessment Tools 27
III. Forward 6 8.2.3 Program Completion Requirements 29
IV. Table of Contents 7 8.3 Summative Assessment 32
V. Introduction 8 8.3.1First Part Examination 32
5.1.Context of Practice 8 8.3.2Certification of Training-Completion 35
• Vision 9 3.1Final Specialty Examinations 36
• Mission 9 IX. Appendices 37
• Objectives 9 Junior-level Competency-Metrix: to map Competency, learn-
•General objectives 9 ing domain and Milestones 38
• Specific objectives 10 Senior-level Competency-Metrix: to map Competency, learn-
5.2.Goal and Responsibility of curriculum implementation 10 ing domain and Milestones 40
5.3.Policies and Procedures 11 Universal Topics Modules 42
5.4.Abbreviations Used in This Document 11 Core Specialty Topics 53
VI. Program Structure 12 Top Conditions in the Musculoskeletal Physical Therapy and
6.1.Program Entry Requirements 12 Rehabilitation 63
6.2.Program Duration 12 List of core skills and procedures 65
6.3.Program Rotations 13 Assessment 87
VII. Learning and Competencies 14 List of Formative Assessment Tools 87
7.1.Introduction to Learning Outcomes and Competency-Based Educa- Glossary 100
tion 14
7.2.Mapping of Milestones 15
7.3.Continuum of Learning 17
7.4.Academic Activities: 18
7.4.1.General principles 18
7.4.2.Study Plan Overview 18
7.4.3.Universal Topics 22
7.4.4.Core Specialty Topics 23
7.4.4.1.Knowledge 23
7.4.4.2.Skills 24
7.4.4.3.Attitude 25
VIII. Assessment of Learning 26
8.1 Purpose of Assessment 26
7
Introduction
5.1 Context of Practice 5.1 Context of Practice
In the field of physical therapy, the breadth and depth of knowledge and skills has
increased beyond the scope of general practice, and so have the opportunities for clinical
practice, research and academic study. Therefore, specialization in a selected area is
essential to serve the physical therapy profession in terms of the clinical setting, the body
of knowledge development and academia. Such specialization can be achieved through
graduate study programs. The Saudi Commission for Health Specialties has recognized the
importance of higher degrees in physical therapy with regard to the health care system in
the Kingdom of Saudi Arabia (KSA), and has created jobs for physical therapists with a
master’s degree (Senior Physical Therapist) and for those with a PhD degree (Consultant in
Physical Therapy). However, there still is a severe shortage of physical therapists with
higher degrees. Currently, few programs in the KSA (such as King Saud University and
Imam Abdulrahman Bin Faisal University) offer a postgraduate degree in physical therapy
for a limited number of graduates every year, which does not fulfill the great demands for
such professionals.
Specialized knowledge within a specific area of physical therapy and advanced clinical
skills are required to be practiced at a higher level in today’s musculoskeletal
rehabilitation settings. Postgraduate clinical training programs accelerate a clinician’s skill
development. The number of these programs is continuing to grow worldwide. However, in
KSA, no similar clinical training programs exist yet to serve the Physical Therapy
profession. Lacking a Physical Therapy advanced and specialized clinical training
programs might deprive the local healthcare-seeking community from receiving an
outstanding, evidence-based healthcare service. Furthermore, many clinics are faced with
a challenge when trying to secure experienced clinical instructors to provide high-level
clinical training to newly graduated therapists. The MSK-PT program will be the leading
physical therapy advanced clinical training program in the Middle East region. The
program is designed to cover the severe shortage of qualified, specialized, and highly-
8
profession. Lacking a Physical Therapy advanced and specialized clinical training
programs might deprive the local healthcare-seeking community from receiving an
outstanding, evidence-based healthcare service. Furthermore, many clinics are faced with
a challenge when trying to secure experienced clinical instructors to provide high-level
clinical training to newly graduated therapists. The MSK-PT program will be the leading
physical therapy advanced clinical training program in the Middle East region. The
program is designed to cover the severe shortage of qualified, specialized, and highly-
trained therapists for the management of musculoskeletal disorders. This three-year MSK-
PT program is comprised of two parts:
Junior level, which continues for two years, and Senior level, which continues for the
remaining year of the program. It focuses on musculoskeletal impairments of the spine
and extremities. Eligibility to advance to Senior level is based on successful completion of
Junior level.
• Vision
To become a preeminent clinical physical therapy program recognized for
groundbreaking leadership in musculoskeletal clinical practice, education and mentorship.
• Mission
To expand the availability of guidelines-based clinical practice of musculoskeletal
physical therapy in order to enhance the physical well-being and quality of life of
individuals in KSA.
• Objectives
The Saudi Board of Musculoskeletal Physical Therapy program aims to achieve the
following objectives:
General objectives
1. To integrate skill improvement in the areas of clinical reasoning with improvements in
the application of manual therapy, therapeutic exercises, neuromuscular reeducation,
and patient education.
2. To create mentors for building the next generation of Clinical Specialists in MSK-PT.
3. To produce highly skilled patient care providers for patients who have
musculoskeletal disorders generally and spinal impairments specifically.
Specific objectives
1. To cover the existing shortage of highly qualified physical therapists in the KSA.
9
musculoskeletal disorders generally and spinal impairments specifically.
Specific objectives
1. To cover the existing shortage of highly qualified physical therapists in the KSA.
2. To provide physical therapy clinicians with advanced clinical skills, through extensive
proper training, and scientific expertise based on the latest research findings in the
MSK-PT field.
3. To train residents to conduct studies and experiments using hospital databases, which
are established for this purpose, according to the appropriate rules and
methodologies.
4. To prepare young leaders who have a high level of clinical and scientific expertise to
take over the training functions in the physical therapy departments.
5. To provide health care and medical rehabilitation for patients in general, casualties of
war and military exercises in particular, instead of receiving this type of medical
rehabilitation outside the KSA.
5.1.5.1
Goal andand
Goal Responsibility of curriculum
Responsibility implementation
of Curriculum Implementation
The ultimate goal of this curriculum is to guide residents to become competent in their
specialty. This goal will require significant amount of efforts and coordination from all
stakeholders involved in postgraduate training. As an “adult-learner” residents have to
demonstrate full engagement with proactive role by: careful understanding of learning
objectives, self-directed learning, openness to reflective feedback and formative
assessment, and self-wellbeing and seeking support when needed. Program director has a
vital role to make the implementation of this curriculum most successful. Training
committee members, and particularly program administrator and chief resident, have
significant impact on the program implementation. Residents should be enabled to share
the responsibility in curriculum implementation. The SCFHS will apply the best models of
training governance to achieve the best quality of training. Academic affairs in training
centers and regional supervisory training committee will have a major role in training
supervision and implementation. The MSK-PT scientific council will be responsible to make
sure that the content of this curriculum is constantly updated to match the best-known
standards in postgraduate physical therapy clinical education.
5.2. Policies and Procedures
10
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Description
Attitude
5.3. Abbreviations
A
Abbreviation
A
Abbreviation
Used in This Document Attitude
Description
Attitude
Description
A
Abbreviation
ABPTRFE American Board of PhysicalAttitude
Description
TherapyResidency
Residency&&Fellowship
Fellowship
A
Abbreviation
ABPTRFE American Board of Physical Attitude
Description
Therapy
A
Abbreviation
Description
Therapy Residency & Fellowship
A
Abbreviation
ABPTRFE American Board of Physical Education
Attitude
Description
Education
A
A
ABPTRFE American Board of Physical Education
Attitude
A Education
Attitude
ABPTRFE
A American Board of Physical Therapy Residency & Fellowship
Education
Attitude
ABPTRFE
APTA American Board of
American Physical Therapy
Education
Physical Therapy Residency & Fellowship
Association
ABPTRFE
APTA American Board
American of Physical
Physical Therapy
Therapy
Education Residency
Association& Fellowship
ABPTRFE
APTA American BoardAmerican of Physical Therapy
Education
Physical Therapy Residency
Association& Fellowship
ABPTRFE
APTA American BoardAmerican of Physical
Physical Therapy
TherapyResidency
Education Association& Fellowship
APTA
CBE American Education
Physical
Competency-Based Therapy Association
Education
CBE
APTA Competency-Based
American Education
Physical Therapy Education
Association
CBE
American Physical Therapy Education
Association
CBE
American Physical Therapy Education
Association
CBE
EC
APTA
EC Competency-Based
American Education
Physical
Education and
andTherapy Education
Counseling
Association
Counseling
CBE
APTA
EC Competency-Based
American Physical
Education andTherapy Education
Association
Counseling
CBE
APTA
EC Competency-Based
American Physical
Education andTherapy Education
Association
Counseling
CBE
FSI
EC Competency-Based
Foundations
Educationof and Education
ofScientific
Scientific
Counseling Inquiry
CBE
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EC Competency-Based
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ITER
FSI
K In-Training
of ScientificReport
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ITER
MSK_LQ In-Training
Musculoskeletal Evaluation
Physical Therapy Report
K
ITER
MSK_LQ
K
ITER MusculoskeletalIn-Training Knowledge
Evaluation
Physical
In-Training Knowledge Therapy
Evaluation - -Lower
Report
Report
LowerQuarter
Quarter
MSK_LQ
K
ITER Musculoskeletal Physical
In-Training Knowledge Therapy
Evaluation - Lower Quarter
MSK_LQ
K Musculoskeletal Physical
Knowledge TherapyReport
- Lower Quarter
MSK_LQ
MSK_UQ
K
MSK_UQ Musculoskeletal
Musculoskeletal
Musculoskeletal Physical
Physical
Knowledge
Physical Therapy
Therapy-- -Lower
Therapy Quarter
UpperQuarter
Upper Quarter
MSK_LQ
K
MSK_UQ Musculoskeletal Physical
Musculoskeletal Physical Knowledge
Physical Therapy - Lower
Therapy -- Lower Quarter
Upper Quarter
MSK_LQ
K
Musculoskeletal Physical Knowledge
Physical Therapy
Therapy -- Lower Quarter
Upper Quarter
MSK_LQ
MSK_UQ
PSMCHS Musculoskeletal
Musculoskeletal
Prince Sultan Physical
Military Therapy
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College of - Upper
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PSMCHS
Prince Sultan MilitaryPhysical Therapy
College - Lower
of Health
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Prince Sultan MilitaryPhysical Therapy
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SI-R Saudi Commission for Health Specialties
Skill
SCFHS
SI-R
SP-R Saudi Commission
Spine
Sports for Health Specialties
rehabilitation
rehabilitation
SCFHS
SP-R
SI-R Saudi Commission
Sports
Spine for Health Specialties
rehabilitation
rehabilitation
SCFHS
SP-R
Sports
rehabilitation
rehabilitation
SCFHS
SP-R
Sports
rehabilitation
rehabilitation
SP-R
SI-R Sports
rehabilitation
SP-R
SI-R Sports rehabilitation
SP-R Sports rehabilitation
11
ure IV. Program Structure
IV. Program Structure
y Requirements
6.1 6.1Program
ProgramEntry
Entry Requirements
Requirements
Applicants must:
ychelor
from adegree
recognized
1. inHave
physical
university.
earned
therapy
a bachelor
from adegree
recognized
in physical
university.
therapy from a recognized university.
ysical Therapist
2. Be bylicensed
the SCFHS.
as Physical Therapist by the SCFHS.
nefore
examination
the program
3. and
Passan
administration.
aninterview
admission
before
examination
the program
and an
administration.
interview before the program administration.
from
clinicians
three4.
andreferences
Provide
one academician)
letters
(two from
clinicians
threeand
references
one academician)
(two clinicians and one academician)
reeducation
candidateinasPhysical
suitable
recommending
Therapy.
for higher
theeducation
candidatein
asPhysical
suitableTherapy.
for higher education in Physical Therapy.
rom
f required)
a sponsoring
5.
approving
Provide
organization
the
a letter
candidate
from
(if required)
a sponsoring
approving
organization
the candidate
(if required) approving the candidate
d
ing(3for
years),
the whole
or competency
for program
full time period
for
training
self-
(3for
years),
the whole
or competency
program period
for self-
(3 years), or competency for self-
support.
above
ove and
will
• IELTS
GPA
increase
score
of 3.5/5
the
of chance
5
or or
above
above
of and
willIELTS
increase
scorethe
of chance
5 or above
of will increase the chance of
acceptance.
hange
tific council
and/or
The reserve
SCFHS
add other
and
the the
right
admission
scientific
to changecouncil
and/orreserve
add other
the right
admission
to change and/or add other admission
requirements.
tions 6.26.2
Program Durations
Program Durations
he
endar
MSK-PT
yearsprogram
divided
The duration
into
is three
twoofcalendar
levels,
the MSK-PT
yearsprogram
divided is
into
three
two calendar
levels, years divided into two levels,
and
Each
2)year
andJunior
Senior
comprises
level
levelfour
(years
(year
3-month
3).
1 and
Each
2) year
and Senior
comprises
levelfour
(year
3-month
3). Each year comprises four 3-month
ovailability
twelve rounds.
and
rounds,
suitability
Depending
summing of training
on
into
availability
twelve rounds.
and suitability
Depending of on
training
availability and suitability of training
ughout
l rotate the
to centers,
different
programresidents
centers
duration.
throughout
will
Thus,
rotate the
to different
programcenters
duration.
throughout
Thus, the program duration. Thus,
snistrative
modifiable.
board
theThe
rotation
will
program
strive
system
administrative
to make
is modifiable.
board
Thewill
program
strive administrative
to make board will strive to make
modate
erent training
eachagreements
recruited
centers to
resident
with
accommodate
different
in a training
each recruited
centers to
resident
accommodate
in a each recruited resident in a
different training center. training center. center.
12
6.6.Progrm
Program Rotation
Rotation
Training Mandatory core rotations* Elective rotations** Annual
Year leave
Rotation name Duration Rotation name Duration Duration
Year 1 • Musculoskeletal Physical 3 months Resident enrolls to only 2

Therapy-Lower Quarter one elective round:
(Junior 1) months
1
3 months • Pediatric Physical
1 month
• Musculoskeletal Physical Therapy
(4 weeks)
Therapy-Upper Quarter 1
3 months • Neurological
• Musculoskeletal Physical Physical Therapy
Therapy-Spine
• Sports Physical
Rehabilitation 1
Therapy
Year 2 • Musculoskeletal Physical 3 months

Therapy-Lower Quarter
(Junior 2)
2
3 months
• Musculoskeletal Physical
Therapy-Upper Quarter 2 1 month
3 months
• Musculoskeletal Physical -- -- (4 weeks)
Therapy-Spine
Rehabilitation 2 2 months
Therapy-Post Surgical
Rehabilitation
Year 3 • Musculoskeletal Physical 3 months

Therapy-Lower Quarter
(Senior)
3
3 months
1 month
Therapy-Upper Quarter 3
3 months -- -- (4 weeks)
Therapy-Spine
Rehabilitation 3 2 months
Therapy-Inpatient Care
(*Mandatory core rotation: Set of rotations that represent program core component and are
mandatory to do.
**Elective rotation: Set of rotations that are related to the specialty, as determined by the
scientific council/committee, and the resident is required to do some of them.
13
V. Learning and Competencies
V. Learning and Competencies
7.3 Introduction to Learning Outcomes and Competency-Based Education

7.3 Introduction to Learning Outcomes and Competency-Based Education
Training should be guided by well-defined “learning objectives” that are driven by
targeted “learning outcomes” of a the program to serve specific specialty needs. Learning
outcomes are supposed to reflect the professional “competencies” that are aimed to be
“entrusted” by residents upon graduation. This will ensure that graduates will meet the
expected demands of the healthcare system in relation to their particular specialty.
Competency-based education (CBE) is an approach of “adult-learning” that is based on
achieving pre-defined, fine-grained, and well-paced learning objectives that are driven
from complex professional competencies.
Professional competencies related to healthcare are usually complex and entertain a
mixture of multiple learning domains (knowledge, skills, and attitude). CBE is expected to
change the traditional way of postgraduate education. For instance, time of training, though
is a precious resource, should not be looked to as a proxy for competence (e.g. time of
rotation in certain hospital areas is not the primary marker of competence achievement).
Furthermore, CBE emphasizes the critical role of informed judgment of learner’s
competency progress, which is based on a staged and formative assessment that is driven
from multiple workplace-based observations. Several CBE models have been developed
for postgraduate education in healthcare (example: CanMEDs by the Royal College of
Physician and Surgeon of Canada (RCPSC), the CBME-Competency model by the
Accreditation Council for Graduate Medical Education (ACGME), tomorrow’s doctor in UK
and multiple others). The following are concepts to enhance the implementation of CBE in
this curriculum:
• Competency: Competency is a cognitive construct assessing the potential to perform
efficiently in a given situation based on the standard of the profession. Professional
roles (e.g. expert, advocate, communicator, leader, scholar, collaborator, and
professional) are used to define competency-role in order to make it mendable for
learning and assessment.
14
• Milestones: Milestones are stages along the developmental journey throughout
competency continuum. Residents throughout their learning journey, from junior and
throughout senior levels, will be assisted to transform from being (novice/supervised)
into (master/unsupervised) practitioners. This should not undermine the role of
supervisory/regulatory bodies toward malpractice of independent practitioners.
Milestones is expected to enhance learning process by pacing the training/assessment
to match the developmental level of residents (junior vs. senior).
• Learning-Domains: Whenever possible, efforts should be directed to annotate the
learning outcomes with the corresponding domain (K=Knowledge, S=Skills, and
A=Attitude). In general, it is advisable to design learning outcomes at mid-level (i.e.,
neither too broad nor too specific). For example, “Demonstrate competency in taking a
focused pediatrics history and performing a complete and appropriate physical
examination. (S)”. You might have more than one annotation for a given learning
outcome.
• Content-area Categorization: It is advisable to categorize the learning outcomes in
broad content area related to the practice of profession. For example, in pediatrics
some of the content areas are Growth, Nutrition, Development, Adolescent health
issues, Prevention, and Healthy lifestyle, Diagnosis and management of childhood
diseases.
6.3 6.3
Mapping of Milestones
Mapping of Milestones
Residents are expected to progress from novice to mastery level in certain set of
professional competencies. PSMCHS and SCFHS have endorsed the Core Competencies of
a Physical Therapist Resident prepared by the Residency Competency Work Group
established in 2014 by The American Board of Physical Therapy Residency & Fellowship
Education (ABPTRFE) of the American Physical Therapy Association (APTA). The ABPTRFE
Core Competencies of a Physical Therapist Resident includes seven core competencies,
with associated critical behaviors (learning outcomes), for physical therapy residents in all
areas of specialty practice. Each competency includes multiple behaviors with associated
15
milestones. The performance of each behavior is assessed independent of the other
behaviors for that competency. The following is a general outline of each competency
(adopted from “Core Competencies of a Physical Therapist Resident, The American Board
of Physical Therapy Residency & Fellowship Education (ABPTRFE), 2016

http://www.abptrfe.org/uploadedFiles/ABPTRFEorg/For_Programs/ABPTRFE_CoreCompetencie
sPhysicalTherapistResident.pdf)”. Please refer to Appendix A and B.
Core Competencies of a Physical Therapist Resident
1. Clinical Reasoning:
Demonstrates the ability to organize, synthesize, integrate, and apply sound clinical
rationale for patient management.
2. Knowledge for Specialty Practice:
Demonstrates the ability to organize, synthesize, integrate, and apply advanced
specialty knowledge and skills to practice.
3. Professionalism:
Conducts self in a manner consistent with the PSMCHS and SCFHS Code of Ethics, in
all professional responsibilities, inclusive of the Core Values and roles.
4. Communication:
Utilizes effective strategies to clearly and accurately disseminate and receive
information in a respectful manner that considers situational needs and results in intended
outcomes.
5. Education:
Designs, directs, and implements learner-centered instructional activities in
academic, community, or clinical settings to advance physical therapist practice.
6. Systems-based Practice:
Demonstrates an awareness of and responsiveness to the larger context and system
of health care to provide care that is of optimal value.
16
7. Patient Management:
7. 7.Patient
Patient
Management:
Management:
Provides comprehensive value-based service to patients, using a human movement
Provides
Provides comprehensive
comprehensive value-based
value-based service
service
to to
patients,
patients,using
using
a human
a human movement
movement
system team to optimize outcomes that impact the human experience framework, as an
system
system team
teamto to
optimize
optimize outcomes
outcomes that
that
impact
impact thethe
human
human experience
experienceframework,
framework, asas
anan
integral member of a collaborative inter-professional within a defined area of specialty
integral
integralmember
member of of
a collaborative
a collaborative inter-professional
inter-professional within
within a defined
a defined
area
area
of of
specialty
specialty
practice.
practice.
practice.
Please refer to “Core Competencies of a Physical Therapist Resident, The American
Please
Pleaserefer
refer
to to
“Core
“Core
Competencies
Competencies of of
a Physical
a Physical Therapist
TherapistResident,
Resident,
TheTheAmerican
American
Board of Physical Therapy Residency & Fellowship Education (ABPTRFE), 2016 -
Board
Boardof of
Physical
PhysicalTherapy
Therapy Residency
Residency & Fellowship
& Fellowship Education
Education (ABPTRFE),
(ABPTRFE), 2016
http://www.abptrfe.org/uploadedFiles/ABPTRFEorg/For_Programs/ABPTRFE_CoreCompetenciesPh 2016- -
http://www.abptrfe.org/uploadedFiles/ABPTRFEorg/For_Programs/ABPTRFE_CoreCompetenciesPh
http://www.abptrfe.org/uploadedFiles/ABPTRFEorg/For_Programs/ABPTRFE_CoreCompetenciesPh
ysicalTherapistResident.pdf)” for further details regarding the behaviors associated with each
ysicalTherapistResident.pdf)”
ysicalTherapistResident.pdf)” forfor
further
furtherdetails
detailsregarding
regarding thethe
behaviors
behaviorsassociated
associatedwith
with
each
each
Core Competency.
Core
CoreCompetency.
Competency.
6.4 Continuum of Learning
6.46.4
6.4 Continuum
Continuum
Continuum of Learning
ofofLearning
Learning
This includes learning that should take place in each key stage of progression within
This
This
includes
includes learning
learning that
thatshould
should
take
takeplace
placein in
each
each key
keystage
stageof of
progression
progression within
within
the specialty. Residents are reminded of the fact of life-long Continuous Professional
thethe
specialty. Residents
specialty. Residents are arereminded
reminded of of
thethefact of of
fact life-long
life-longContinuous
Continuous Professional
Professional
Development (CPD). Residents should keep in mind the necessity of CPD for every
Development
Development (CPD).
(CPD).Residents
Residents should keep
should keep in in
mind
mind thethenecessity
necessity of of
CPDCPDforforevery
every
healthcare provider in order to meet the demand of their vital profession. The following
healthcare
healthcareprovider
provider in in
order
order to to
meet thethe
meet demand
demand of of
their vital
their profession.
vital profession. The Thefollowing
following
table states how the role is progressively expected to develop throughout junior, senior
table states
table how
states howthetherole is is
role progressively
progressively expected
expected to todevelop
developthroughout
throughout junior, senior
junior, senior
and consultant levels of practice.
and consultant
and consultantlevels
levelsof of
practice.
practice.
Undergraduate Year 1-2 (Junior Level) Year 3 (Senior Level) Consultant
Undergraduate
Undergraduate Year Year 1-21-2(Junior
(Junior Level)
Level) Year Year3 (Senior
3 (Senior Level)
Level) Consultant
Consultant
Partially Independent
Dependent/supervised Partially
Partially Independent
Independent
Non-practicing Dependent/supervised
Dependent/supervised Independent/provide practice/provide
Non-practicing
Non-practicing practice Independent/provide
Independent/provide practice/provide
practice/provide
practice
practice partial supervision supervision
Approaching partial
partial supervision
supervision supervision
supervision
Pre-Entrustable Approaching
Approaching Approaching Entrustable Entrustable
Pre-Entrustable
Pre-Entrustable Entrustable Approaching
Approaching Entrustable
Entrustable Entrustable
Entrustable
Entrustable
Entrustable
Acquire advanced
Acquire
Acquire advanced
advanced
and up-to-date
Obtain basic
Obtain
Obtain
basic
basicand Obtain fundamental Apply knowledge to provide and
and up-to-date
up-to-date
knowledge related to
health science Obtain
Obtain fundamental
fundamental Apply
Apply knowledge
knowledge to to provide
provide
health
healthscience
science
foundational andand knowledge related to core
level
appropriate clinical care knowledge
knowledge related
core related
clinical to to
knowledge
knowledge
clinical related
related
problems to
to of the appropriate
core appropriate
core related to clinical
clinical
core care
care
clinical core
core clinical
clinical
foundational
foundational level
level
to core discipline problems of the
clinical
clinical problems
problems of
specialty of
thethe related
related to to core
core clinical
clinical
problems of the specialty problems
problems of of
thethe
to to
core
core
discipline
discipline
knowledge specialty
specialty
specialty problems
problems of of
thethe specialty
specialty specialty
specialty
knowledge
knowledge
Apply clinical skills such Compare and
Apply
Apply clinical
clinical skills
skills such
such Analyze and interpret the Compare
Compare andand
as physical examination Analyze
Analyze andand interpret
interpret the evaluate challenging,
as as physical
physical examination
examination findings from clinicalthe
skills evaluate
evaluate challenging,
challenging,
Internship to the and practical procedures findings
findings from
from clinical
clinical skills contradictory findings
skills
Internship
Internship
to to
thethe and
and practical
practical procedures
procedures to develop appropriate contradictory
contradictory findings
findings
practice of related to the core to to develop
develop appropriate
appropriate and develop
practice
practice
of of related
related to to
thethe coreand
core differential diagnoses and and
and develop
develop
discipline presenting problems differential
differential diagnoses
diagnoses andand expanded differential
discipline
discipline presenting
presenting problems
problems andand management plan for the expanded
expanded differential
differential
procedures of the management
management plan
plan forfor
thethe diagnoses and
patient
procedures
procedures of of
specialty thethe
patient
patient managementand
diagnoses
diagnoses and plan
specialty
specialty management
management plan
plan
17
6.5 6.5 Academic
Academic Activities
Activities:
6.5.1 General principles
a) Teaching will contain both:

i. Structured didactic-based component, and
ii. Practice-based component.
b) Efforts should be directed to enhance residents toward more responsibility for self-
directed learning.
c) Formal training time will include the following formal teaching activities:
i. Universal topics.
ii. Core specialty topics.
d) Formal training time should be supplemented by other practice-based learning (PBL)
such as:
i. Morning report or case presentations
ii. Journal clubs
iii. Continuous professional activities (CPD) relevant to specialty
6.5.2 Study Plan Overview
Ø Junior level (Years 1 and 2)
• Junior level continues for the first two years of the program. It is divided into four 6-
month educational modules, which can be described as:
Module I: First 6-month period of the first year
Module II: Second 6-month period of the first year
Module III: First 6-month period of the second year
Module IV: Second 6-month period of the second year
• Each junior resident will be a fulltime working therapist (40 hours/week) throughout
the two-year duration of junior level and be involved in patient care practices during
all working hours, except for the hours that the resident is participating in
classroom/lab training.
• Each junior resident will be evaluating and providing interventions for patients with
musculoskeletal disorders, with emphasis on peripheral joints musculoskeletal
conditions.
18
• Each junior resident will receive a 1-hour period of 1:1 clinical supervision while
treating patients per day provided by experienced clinical supervisors from each
training center.
• Each junior resident will enroll in an intensive didactic education including 6

classroom/lab training courses/seminars that are distributed over the four modules
of the junior level.
• Each junior resident will receive two 6-hour clinical performance evaluations while
evaluating and treating patients each Module (four evaluations / year). These
performance evaluations will take place during the scheduled clinical supervision
periods and performed approximately during week numbers 10 to 12 (end of the first
three-month round) as well as during week numbers 20 – 22 (end of the second three-
month round).
• Each junior resident will provide 4 periods of clinical supervision for physical therapy
interns during modules 3 and 4 of the program and be evaluated using the Clinical
Faculty Evaluation Form (Appendix N). A feedback period will consist of 4 weeks of
clinical supervision/mentorship (2H/week) provided to the same intern.
• Each junior resident shall submit a research proposal by the end of the first year that
should be conducted and completed before graduation (end of third year).
• Each junior resident will participate in a case study project that includes 1) pre-
operative care and counseling, 2) observation of surgical procedures, and 3) post-
operative physical therapy, for 8 or more of the surgical condition categories as listed
below - at least one from each category:
i. Cervical foraminectomy or cervical fusion

ii. Rotator cuff repair or acromioplasty
iii. Carpal tunnel release or radial tunnel release or cubital tunnel release
iv. Lumbar microdiscectomy or lumbar fusion
v. Total hip arthroplasty or ORIF of a hip fracture
vi. Total knee arthroplasty
vii. Anterior cruciate reconstruction
viii. Menisectomy or meniscal repair
• The measure of completion for this project is, a case report for each of the 8 condition
categories listed above. Each case report will contain:
i. A copy of the patient's medical record of the episode of care
19
• The measure of completion for this project is, a case report for each of the 8 condition
categories listed above. Each case report will contain:
i. A copy of the patient's medical record of the episode of care
ii. Description of the outcome measures that were used pre-operatively

and post-operatively to assess the patient's progress over the episode
of care
iii. Description of the pre-operative management
iv. Description of the surgical procedure
v. Description of the post-operative management plan and procedures
Study plan for Junior level of the program
FSI: Foundations of Scientific Inquiry

MSK-LQ: Musculoskeletal Physical Therapy - Lower Quarter
MSK-UQ: Musculoskeletal Physical Therapy - Upper Quarter
1st year
Elements Module I Module II

(6 months, 24 weeks) (6 months, 24 weeks)
Clinical • 1:1 clinical supervision (120 h) • 1:1 supervision (120 h)

Practice • Independent clinical practice (636 h) • Independent clinical practice (636 h)
Didactic • SI-R: 42 hours (6-day class) • MSK_LQ: 42 hours (6-day class)

Education • FSI: 42 hours (6-day class) • MSK-UQ: 42 hours (6-day class)
Elements 2nd year
Clinical Module III Module IV

Practice (6 months, 24 weeks) (6 months, 24 weeks)
Clinical • 1:1 supervision (120 h) • 1:1 supervision (120 h)

Practice • Independent clinical practice (678 h) • Independent clinical practice (678 h)
• 2 periods of clinical supervision of • 2 periods of clinical supervision of

Mentorship
physical therapy interns physical therapy interns
• ROC: 42 hours (6-day class) • SP-R: 28 hours (4-day class)

Didactic
• Case Study Presentation: 14 hours
Education
(2-day class)
ROC: Management and Rehabilitation of Post-operative Conditions
SI-R: Spine rehabilitation
SP-R: Sports rehabilitation
20
3rd year
Elements Module V 3rd year Module VI

Elements (6 months,Module V
24 weeks) Module
(6 months, VI
24 weeks)
Clinical • 1:1 clinical (6 months, 24(120

supervision weeks)
h) (6 months,
• 1:1 supervision (120 h)24 weeks)
Practice
Clinical • Independent
• 1:1 clinicalclinical
supervision (120
practice h) h)
(650 • 1:1 supervision
• Independent clinical(120 h) (594 h)
practice
Practice
• Independent
Mentorship • Co-instructor forclinical practice
the junior level (650 h) • Co-instructor
• Independent
forclinical practice
the junior level (594 h)
Mentorship didactic classes infor
• Co-instructor Module I (42level
the junior h) didactic classes infor
• Co-instructor Module II (84level
the junior h)
didactic
• 4 periods ofclasses
clinicalinsupervision
Module I (42
of h) didactic
• 4 periods ofclasses
clinicalinsupervision
Module II (84of h)
junior resident
• 4 periods of clinical supervision of junior resident
• 4 periods of clinical supervision of
Didactic • EC: junior resident
28 hours (4-day class) junior resident
• Musculoskeletal Imaging: 28 hours
Education (4-day class)
Didactic • EC: 28 hours (4-day class) • Musculoskeletal Imaging: 28 hours
Education • Case(4-day
Studyclass)
Presentation: 14 hours
(2-day
• Caseclass)
Study Presentation: 14 hours
(2-day class)
Ø Senior level (Year 3)

Ø Senior level (Year 3)
• Residents MUST fulfill all requirements of junior level before advancing to senior level
•of the programMUST
Residents and ranked
fulfill allasrequirements
Senior Resident.
of junior level before advancing to senior level
• of the
Senior program
level and ranked
is a one-year as Senior
curriculum Resident.
divided into two 6-month educational modules,
•which can level
Senior be described as: curriculum divided into two 6-month educational modules,
is a one-year
which
Module V: can be described
First as:period of the third year
6-month
Module
Module VI: V: Second
First6-month
6-monthperiod
periodof
ofthe
thethird
thirdyear
year
• Module
Each seniorVI: Second
resident 6-month
will be period
a fulltime of the
working third year
therapist (40 hours/week) and be
•involved in patient
Each senior care activities
resident will be a during
fulltimeallworking
workingtherapist
hours, except for the hours
(40 hours/week) andthat
be
the involved
resident in
is patient
participating in classroom/lab
care activities during alltraining.
working hours, except for the hours that
• thesenior
Each resident is participating
resident in classroom/lab
will be evaluating training.
and providing interventions for patients with
•musculoskeletal disorders,
Each senior resident willwith emphasis and
be evaluating on spinal musculoskeletal
providing interventionsconditions.
for patients with
• musculoskeletal
Each senior residentdisorders, with
will receive emphasis
a 1-hour on of
period spinal musculoskeletal
1:1 clinical conditions.
supervision while
•treating
Each patients per daywill
senior resident provided byaexperienced
receive clinical
1-hour period of 1:1supervisors from each
clinical supervision while
training center.
treating patients per day provided by experienced clinical supervisors from each
• training
Each seniorcenter.
resident will participate in an intensive didactic education including 2
Each seniortraining
•classroom/lab residentcourses/seminars thatintensive
will participate in an are distributed
didacticover the twoincluding
education modules2of
the classroom/lab
program. training courses/seminars that are distributed over the two modules of
• thesenior
Each program.
resident will receive two 6-hour clinical performance evaluations while
•evaluating and treating
Each senior residentpatients eachtwo
will receive Module (four
6-hour evaluations
clinical / year).evaluations
performance These while
performance
evaluatingevaluations
and treatingwill take place
patients each during
Modulethe scheduled
(four clinical
evaluations supervision
/ year). These
periods and performed
performance approximately
evaluations duringduring
will take place week the
numbers 10 toclinical
scheduled 12 as well as
supervision
during weekand
periods numbers 20 - approximately
performed 22. during week numbers 10 to 12 as well as
during week numbers 20 - 22.
21
• Each senior resident will provide 8 feedback periods for junior residents of the
program and be evaluated using the Clinical Faculty Evaluation Form (Appendix N). A
feedback period will consist of 4 weeks of clinical supervision/mentorship (2H/week)
provided to the same resident.
• Each senior resident will act as a co-instructor for didactic classes provided for junior
residents of the program and be evaluated using the Classroom/lab evaluation form
(Appendix O).
• Each senior resident shall submit a research manuscript for publication in a scientific
journal or present research data in a scientific conference.
Study plan for Senior level of the program
EC: Education and Counseling
6.5.3 Universal Topics
1. Universal topics are educational activities that are developed and aimed for all
specialties (Appendix C).
2. Priority will be given to topics that are:
o of high value
o interdisciplinary and integrated
o require expertise that might be beyond the availability of the local clinical training
sites
3. Each universal topic will have a self-assessment at the end of the module.
4. As indicated in the “executive policies of continuous assessment and annual

promotion” (please refer to www.scfhs.org), universal topics will be a mandatory
component of the criteria for the annual promotion of residents from their current
level of training to the subsequent level.
22
6.5.4 Core Specialty Topics
1. Core specialty topics are determined and approved by the specialty’s scientific council
aligned with the specialty defined competencies and teaching methods (Appendix D).
2. Core specialty topics will ensure that important clinical problems of the specialty are
well taught.
3. Unlike Universal Topics, the format of core specialty topics is encouraged to be in

interactive, case-based discussion format with pre-learning materials.
4. Whenever applicable, core specialty topics should include workshops, team-based

learning (TBL) and simulation to develop skills in core procedures.
5. Learning objectives of each core topic need to be clearly defined.
6. Regional supervisory committees in coordination with academic and training affairs,

program directors, and chief residents should work together to ensure planning and
implementation of academic activities as indicated in the curriculum.
a) There should be an active involvement of the resident in the development and

delivery of the topics under faculty supervision; the involvement might be in the
form of: delivery, content development, research…etc.
7. Core specialty can be stratified into three categories based on the dominant learning
domain: knowledge, skill, and attitude.
6.5.4.1 Knowledge
This section will address topics of knowledge nature that are related to
“health”, “disease”, and “preventive” aspects of the specialty that are not generally
covered under practice-based teaching (see appendix-D for Core specialty
knowledge topics). Generic Problems/Issues that are relevant might include:
a. Updated musculoskeletal guidelines
b. Clinical reasoning
c. Signs and symptoms of disease/injury
d. Kinesiology/clinical biomechanics
e. Red and yellow flags for different musculoskeletal disorders
f. Pain theories and output mechanisms
g. Problem-related updated scientific evidence
23
h. Surgical and nonsurgical interventions and their implications
i. Exercise physiology
j. Manual therapy approaches and theories
k. Motor control and motor learning
l. Imaging studies
m. Ergonomics
n. Tissue healing and inflammation
o. Theories and applications of orthosis and prosthesis
6.5.4.2 Skills
Procedures List
Procedures list should be divided into three categories (see appendix-F

for procedure list):
1. Category I: Assumed competent
These are procedures assumed to be previously learned. Category I procedures

might include history taking and recording, range of motion assessment and
application of Electrophysical agents.
2. Category II: Foundational Core Specialty Procedures
These are the specialty foundational procedures that are required to be learned
and practiced under supervision during the training. Expected completion for
Category II procedures should be during junior level of training.
24
3. Category III: Mastery level procedures
These are core specialty procedures that residents are expected to be

competent performing unsupervised at the end of training.
For Category II and III procedures, the following must be specified:
1. Number of procedures observed/participated, performed under supervision, and

those certified by the supervisor to be performed with full competency.
2. Each resident needs to maintain a logbook documenting the procedures observed,

performed under supervision, and performed independently.
3. It would be prudent to determine the minimum number of procedures to be

performed before certified being competent and the minimum number needed to
maintain competency.
4. Residents need to declare that he/she is competent in Category I procedures. If

for any reason, a resident is not competent in any given Category I procedures
he/she should be provided with extended supervised training.
6.5.4.3 Attitude
List of Behavioral/Communication Skills
This could be categorized into two:
a) Category I: Assumed or Universal
Category I includes previously learned behavioral and communication skills and skills that
are universal in nature (e.g., clear provision of therapeutic instructions, proper
communication with colleagues).
Category II: Core specialty
Category II includes specialty specific behavioral and communication skills (e.g. informed
consent for a given procedure, patient education).
25
VI. VI. Assessment
Assessment of
of Learning Learning
8.1 8.1
Purpose of Assessment
Purpose of Assessment
Evaluations and assessments throughout the program are conducted in accordance
with the Commission’s training and examination rules and regulations. Assessment will
guide residents and trainers to achieve the targeted learning objectives. The assessment
process is designed to assess the different learning domains of the program including the
knowledge, skills and attitude domains. The assessment plan will include both formative
and summative assessment. Formative assessment will be carried out throughout the
duration of the program, as well as at the end of each round.
8.2 Formative Assessment

8.2 Formative Assessment
8.2.1 General Principles
Continuous assessment is distributed throughout the academic year aiming primarily
to provide residents with effective feedback. Input from the overall formative assessment
tools will be utilized at the end of the year to make the decision of promoting each
individual resident from current-to-subsequent training level.
Residents should play an active role seeking feedback during their training. On the
other hand, trainers are expected to provide timely and formative assessment. SCFHS will
provide an e-portfolio system to enhance communication and analysis of data arising from
formative assessment.
26
8.2.2 Formative Assessment Tools
Skills
Resident’s skill development and mastering will be followed up and assessed onsite using
the:
• Weekly Feedback Form. (Appendix J)
• Musculoskeletal Physical Therapy Procedures Performance Assessment Tool
(Appendix G)
• Clinical Performance Evaluation Tool (Appendix N)
• Patient Demographic Data From (Appendix L)
• Body Region Logbook (Appendix M)
• Research Activity
During the three years period of the program, each resident will receive a 6-hour
clinical performance evaluation, while evaluating and treating patients, each round (four
evaluations / year) using the Clinical Performance Evaluation Tool. These performance
evaluations will occur during the scheduled clinical supervision periods. Different core
skills will be evaluated using the Musculoskeletal Physical Therapy Procedures
Performance Assessment Tool. Evaluations will be based on accomplishment of the
minimum requirements for the procedures and clinical skills. Residents should keep
record of the Patient Demographic Data From and Body Region Log Book and submit it by
the end of each round. Timely and specific feedback for the resident will be provided. Each
resident should be involved in preparation and conduction of a research project.
Successful performance criteria are illustrated in the Program Completion Requirements.
27
Knowledge
Resident’s knowledge will be assessed using:
• Written exams for each didactic class
• Structured academic activities (assignments, presentations, discussions, case study
report)
• Structured Oral Exams
Each core specialty didactic course will be evaluated using written exams in form of
multiple choice and essay questions. Structured academic activities will be designed
according to each core specialty course requirements. Structured oral exams will take
place at the end of each clinical rotation. Questions will be designed in accordance with the
subject of the clinical rotation. Evaluations will be based on accomplishment of the
minimum requirements for the knowledge skills. Successful performance criteria are
illustrated in the Program Completion Requirements.
Attitude
Resident’s attitude will be assessed using:
• Musculoskeletal Physical Therapy Counseling and Exercise Education Assessment
Tool (Appendix H)
• Clinical Faculty Evaluation Form (Appendix N)
• Classroom / Lab. Presentation Evaluation Form (Appendix O)
• Weekly Feedback Form. (Appendix J)
Residents’ attitude will be evaluated using different evaluation forms. Core specialty
attitudes, in terms of patient communication and effective education, will be evaluated
using the Orthopeadic Physical Therapy Counseling and Exercise Education Assessment
Tool. Residents’ mentoring and skills will be evaluated using the Clinical Faculty Evaluation
Form and the Classroom / Lab. Presentation Evaluation Form. Successful performance
criteria are illustrated in the Program Completion Requirements.
28
8.2.3 Program Completion Requirements (Formative Assessment)
• Junior level (years 1 and 2): To successfully complete this level, the resident must
achieve/complete the following:
1. Participate in the following clinical education (Total = 3360 hours):
252 hours of classroom/lab instruction

480 hours of 1:1 clinical supervision
2596 hours of unsupervised clinical practice
32 hours of clinical supervision for physical therapy interns
• A maximum of 10% discrepancy is allowed due to absence, permission to leave or any
unexpected incidents to the trainee.
2. Score a minimum of 65% in the written exam for the following courses:
Musculoskeletal Physical Therapy - Lower Quarter

Musculoskeletal Physical Therapy - Upper Quarter
Foundations of Scientific Inquiry
Management and Rehabilitation of Post-operative Conditions
Spine Rehabilitation
Sports Rehabilitation
3. Score a minimum of 65% in the First Part Written Exam.
4. Demonstrate satisfactory performance during the eight clinical examinations using

the Musculoskeletal Physical Therapy Clinical Performance Evaluation Tool.
Passing Criteria for this clinical program is attaining a total of 580 percentage points on
the eight Clinical Performance Evaluation. The Passing Criteria is based on the
following performance expectations:
1st and 2nd Clinical Performance Satisfactory or Superior Performance on 60% of Practice
Evaluation Dimensions Observed
3rd and 4th Clinical Performance Satisfactory or Superior Performance on 70% of Practice
5th and 6th Clinical Performance Satisfactory or Superior Performance on 80% of Practice
7th and 8th Clinical Performance Satisfactory or Superior Performance on 80% of Practice
29
Attaining a Cumulative Total for the first six Clinical Performance Evaluations of less
than 420 percentage points will place the resident on probation and result in the
resident being required to add an additional round and a 9th Clinical Performance
Evaluation to his/her clinical training program.
5. Satisfactorily perform 100% of the 127 procedures listed on the Musculoskeletal

Physical Therapy Procedures Performance Assessment Tool. In addition, all
unsatisfactory performance scores will need to have a Satisfactory or Superior
performance score recorded on the same procedure at a later date.
6. Score “consistently” on 7 out of 10 categories on the Clinical Faculty Evaluation Form

for 4 different feedback periods on the feedback that the physical therapy interns
provide for the junior resident. A feedback period will consist of 4 weeks (2 hours per
week) of clinical supervision/mentorship provided to the same intern. The minimal
satisfactory performance criteria for the junior resident are “consistently” to be
checked on at least 70% of the categories on the sum of the four (4) Clinical Faculty
Evaluation Forms over four (4) different clinical feedback periods.
7. Submit completed reports for eight (8) different case study condition categories.
8. Submit a research proposal to be conducted during Senior level of the program.
9. Maintain and submit the “Body Region Log” (Appendix M) and complete the “Patient
Demographic Data” (Appendix L).
• Senior level (year 3): To successfully complete this program, the resident must
achieve/complete the following:
1. Participate in the following clinical education (Total = 1680 hours):

70 hours of classroom/lab instruction
240 hours of 1:1 clinical supervision
1180 hours of unsupervised clinical practice
126 hours as an instructor of continuing education seminars for physical
therapists
64 hours of clinical supervision for junior residents
• A maximum of 10% discrepancy is allowed due to absence, permission to leave or any
unexpected incidents to the trainee
2. Score a minimum of 65% in the written exam for the following courses:
Education and Counseling for Patients with Neck and Back Pain
Musculoskeletal Imaging
3. Demonstrate satisfactory performance during the four clinical examinations using the
Musculoskeletal Physical Therapy Clinical Performance Evaluation Tool.
30
Passing Criteria for this clinical program is attaining a total of 330 percentage points on
the four Clinical Performance Evaluations. The Passing Criteria is based on the
1st and 2nd Clinical Performance Satisfactory or Superior Performance on 80% of Practice
3rd and 4th Clinical Performance Satisfactory or Superior Performance on 85% of Practice
following performance expectations:
Attaining a Cumulative Total for the first three Clinical Performance Evaluations of less
than 245 percentage points will place the resident on probation and result in the resident
being required to add an additional clinical round and a 5th Clinical Performance
Evaluation to his/her clinical training program.
4. Satisfactorily perform 100% of the 48 procedures listed on the Musculoskeletal

Physical Therapy Counseling and Exercise Education Assessment Tool. In addition, all
unsatisfactory performance scores will need to have a Satisfactory or Superior
performance score recorded on the same procedure at a later date.
5. Demonstrate 70% or better inter-rater reliability with clinical faculty members on

grading of a junior resident’s Clinical Performance Evaluation for 3 separate
evaluation periods. The reliability will be assessed by comparing the consistency of
the observed practice dimensions selected by the clinical faculty versus the fellow; as
well as the judgments on the performance (unsatisfactory vs. satisfactory/superior) of
the resident on each of the selected practice dimensions.
6. Score “consistently” on 7 out of 10 categories on the Clinical Faculty Evaluation Form

for 8 different feedback periods on the feedback that the junior resident provides for
the senior resident. A feedback period will consist of 4 weeks (2 hours per week) of
clinical supervision/mentorship provided to the same resident. The minimal
satisfactory performance criteria for the senior resident are “consistency” to be
checked on at least 70% of the categories on the sum of the 8 Clinical Faculty
Evaluation Forms over 8 different clinical feedback periods.
7. Score of “consistently” on 7 out of 10 categories on the Classroom/Lab Evaluation

Form for 4 different feedback periods. A Classroom/Lab Evaluation Form will be
given to participants following completion of Didactic classes for junior residents or
third-year senior residents. The minimal satisfactory performance criterion for the
resident is “consistency” to be checked on at least 70% of the categories on the sum of
the 4 Classroom/Lab Evaluation Forms from 4 different seminars.
8. Submit a research paper manuscript for publication in a scientific journal or present

research data in a scientific conference.
9. Maintain and submit the “New Patient Log” (Appendix K) and complete the “Patient
Demographic Data” (Appendix L).
31
8.3 Summative Assessment
8.3 Summative Assessment
8.3.1 First Part Examination
It is a written examination conducted in multiple choice question formats, is held at
least once a year to promote resident from “junior” to “senior” level of training. The
examination will focus on applied basic science knowledge related to the musculoskeletal
Physical Therapy. The number of exam items, eligibility, and passing score will be in
accordance with the Commission’s training and examination rules and regulations.
Examination details and blueprints will be published on the commission website:
www.scfhs.org.sa
Blueprint of first part exam for the Saudi Board for Musculoskeletal Physical Therapy is
shown in the following table (numbers in each cell represent number of exam questions):
32
Contents
Basic medical
Categories Sections Proportions Assessment Intervention Diagnosis Outcomes
knowledge
Cervical region 12% 2 3 3 2 2
Spine 35% Thoracic region 5% 0 1 2 1 1
Lumbar region 18% 4 4 5 3 2
Shoulder girdle 12% 3 3 2 2 2

Upper
Quadrant 20% Elbow, wrist and 1 2 2 1 2
8%
hand
Pelvis and hip 8% 1 2 2 2 1

Lower
knee 15% 2 4 4 3 2
Quadrant 30%
Foot and ankle 7% 1 2 2 1 1
Critical Inquiry 7% 2 2 2 0 1
Scholarly
Activities and Professional rules,
others 15% values and 8% 3 3 2 0 0
responsibilities
Total 100% 19 26 26 15 14
8.3.2 Final Specialty Examinations
Final specialty examination is the summative assessment component that grant
residents the specialty’s certification. It has two elements:
A) Final written exam: in order to be eligible for this exam, residents are required to
have “Certification of Training-Completion”.
B) Final clinical/practical exam: Residents will be required to pass the final written
exam in order to be eligible to set for the final clinical/practical exam.
Blueprint of the final written exam is shown in the following table (numbers in each cell
represent number of exam questions):
33
Contents
Basic
Assessme
Categories Sections Proportions medical Intervention Diagnosis Outcomes
nt
knowledge
Cervical region 14% 2 4 3 3 2
Spine 40% Thoracic region 6% 0 2 2 1 1
Lumbar region 20% 2 5 5 5 3
Shoulder girdle 12% 3 3 2 2 2

Upper
Quadrant
Elbow, wrist and 1 2 2 1 2
20% 8%
hand
Pelvis and hip 8% 1 2 2 2 1

Lower
Quadrant knee 15% 2 4 4 3 2
30%
Foot and ankle 7% 1 2 2 1 1
Critical Inquiry 5% 1 1 2 0 1
Scholarly
Activities
Professional
and others
rules, values and 5% 1 2 2 0 0
10%
responsibilities
Total 100% 14 27 26 18 15
34
Blueprint of the final clinical/practical exams are shown in the following table:
DIMENSIONS OF CARE
H e a lth
P r o m o t io n & A c u te C h ro n ic P s y c h o l o g ic a l
Illn e s s 5±1 7±1 A s p e c ts # Station(s)

P r e v e n t io n S t a t io n ( s ) S t a t io n ( s ) 1 ± 1 S ta tio n (s )
1 ± 1 S ta tio n (s )
Patient Care
1 2 4 1 8
7±1 Station(s)
DOMAINS FOR INTEGRATED CLINICAL ENCOUNTER
Patient Safety &
Procedural
2 1 3
Skills
1±1 Station(s)
Communication
& Interpersonal
1 1 1 3
Skills
2±1 Station(s)
Professional
Behaviors 1 1
0±1 Station(s)
Total Stations 1 5 7 2 15
8.3.3 Certification of Training-Completion
In order to be eligible to set for final specialty examinations, each resident is required to
obtain “Certification of Training-Completion”. Based on the training bylaws and executive
policy (please refer to www.scfhs.org), residents will be granted “Certification of Training-
Completion” once the following criteria is fulfilled:
a. Successful completion of all training rotations.

b. Completion of training and educational requirements as outlined in the
Program Completion Requirements shown above.
c. Clearance from SCFHS training affairs, that ensures compliance with
tuitions payment and completion of universal topics.
“Certification of Training-Completion” will be issued and approved by the local

supervisory committee or its equivalent according to SCFHS policies.
35
Resident evaluations of the program
Training program evaluations are part of the PSMCHS and SCFHS commitment to excellence
in teaching and learning. Program evaluation guides training improvement by evaluating the
effectiveness of the educational program in an ongoing manner using residents’ evaluations.
Residents are asked to complete an evaluation form for each completed rotation, which the
director reviews (Appendix P). The residency coordinator tabulates the responses and
comments, which faculty discuss at the educational retreat. In this way, program directors
and scientific council carefully weigh the program’s overall effectiveness at meeting goals
and objectives, as well as each rotation’s effectiveness and each institution’s contribution to
the program.
36
IX. IX. Appendices
Appendices
A. Junior-level Competency-Metrix
B. Senior-level Competency-Metrix
C. Universal Topics Modules
D. Core Specialty Topics Modules
E. Top Conditions and procedures in the Specialty
F. List of Core Skills and Procedures
G. Musculoskeletal Physical Therapy Procedures Performance Assessment Tool
H. Musculoskeletal Physical Therapy Counseling and Exercise Education Assessment
Tool
I. List of Formative Assessment Tools
J. DAILY/WEEKLY FEEDBACK FORM
K. Clinical Performance Evaluation Tool
L. Patient Demographic Data
M. Body Regions Log
N. Clinical Faculty Evaluation Form
O. CLASSROOM / LAB PRESENTATION EVALUATION FORM
P. PROGRAM EVALUATION FORM
Q. Glossary
37
Appendix-A
Appendix A
Junior-level Competency-Metrix: to map Competency, learning domain and Milestones
Competency- Professional Activities Related to Musculoskeletal Rehabilitation

Training Year level
Roles
Conducting a Effective Reasonable Appropriate Efficient patient Adherence to
(with annotation of comprehensiv management plan justification for clinical application of communication policies for
learning domains e patient for decisions treatment proper
involved: K: clinical musculoskeletal modalities collaboration,
knowledge, S:
assessment disorders documentation
Skills, A: Attitude)
and reporting
Identifies Establishes/modifi Presents a rationale Applies evidence- Identifies

relevant and es the plan of care for simple clinical based practice, components of
appropriate of simple decisions, and gives considers patient a
information conditions and consideration to perspective and biopsychosocial
when making situations to patient needs or the value of model in
Clinical clinical ensure care is values. K, S, A service, and clinical
Reasoning judgments. K, efficient, patient- integrates these reasoning. K, A
S, A focused and value into practice in
based. K, S all simple
situations and
some complex
situations. K, S
Identifies gaps in Demonstrates the Incorporates, Writing,

advanced process of critical with feedback, dictation, and
knowledge of inquiry principles and new technology, presentation
Junior
foundational and methods with skills, and skills. K, S

Junior
Knowledge for clinical sciences feedback in the understanding of

Specialty for clinical management of the art, science
Practice practice. K, S patients within the and ethics,
musculoskeletal applicable to the
rehabilitation. K, S, A musculoskeletal
rehabilitation. K,
S
Describes Recognize possible Recognizes Demonstrates Interprofessiona

rationale for the solutions to ethical relevant emerging l communication
intent of local, issues in clinical resources within characteristics in terms of
regional, and practice and their the specialty area of an effective referring and
Professionalism national potential impact on that contribute to leader and receiving patient
regulations. K, A patient outcomes, competency communicator. with
public trust, and development. K, S, A musculoskeletal
patient/therapist S, A disorders. A
safety. K, A
38
Develops Develops strategies to Develops Explores and Demonstrates
active adapt to diverse strategies for develops emerging
listening and communication styles self-reflection to strategies for effective
nonverbal during patient and enhance engaging in communication
skills with professional communication challenging strategies within
Communication minimal interactions. K, S, A and facilitate encounters to interprofessiona
feedback expected negotiate l relationships in
during outcomes. K, S, positive simple clinical
anticipated A outcomes. K, S, situations. S, A
situations. S, A
A
Explores available Explores and Identifies

resources to develops various
design and educational methods to
implement strategies in effectively
Education effective consideration of assess the
management learner and learner’s level
programs setting of
considering characteristics. comprehension
patient education. K, S, A . K, S
K, S
Modifies treatment Modifies treatment Participates in Incorporates

based on based on emerging systems-related policies and
emerging data data within the cost- quality procedures
within the cost- versus-risk benefit improvement and critical to meet
Systems-based versus-risk benefit framework for patient safety initiatives the needs of the
Practice framework for care. K, A critical to practice setting
patient care. K, A meeting the or broader
needs of the system. K, A
practice setting.
K
Performs a Establishes a plan Performs Performs Requires

musculoskelet of care that musculoskeletal musculoskeleta feedback to
al examination accurately interventions and l interventions generate
and evaluation predicts goal education with and education documentation
with feedback achievement, feedback in with feedback to justify an
in simple and frequency, and simple and in simple and episode of care
Patient complex duration of an complex clinical complex that is cost-
Management clinical episode of care for situations. K, S clinical effective and
situations to simple clinical situations. K, S value-based. K,
establish a situations. K, S S, A
diagnosis and
prognosis. K,
S
39
Appendix B
Appendix-B
Senior-level Competency-Metrix: to map Competency, learning domain and Milestones
Competency- Professional Activities Related to to Musculoskeletal Rehabilitation

Roles
Training Year level
Conducting a Effective Reasonable Appropriate Efficient patient Mentorship for

(with annotation comprehensive management plan justification for application of communication junior
of learning
patient clinical for musculoskeletal clinical treatment residents
domains
involved: K: assessment disorders decisions modalities
knowledge, S:
Skills, A:
Attitude)
Clinical Efficiently and Anticipates Presents a Evaluates evidence- Integrates into Supports,
strategically gathers, expected and logical based practice, for patient care a encourages
Reasoning
interprets, and unexpected rationale for all all simple and comprehensive and facilitates
synthesizes outcomes of the clinical complex situations, biopsychosocial clinical
essential and patient’s current decisions while and effectively model in clinical decisions of
accurate information clinical condition incorporating reflects upon the reasoning. K, A junior
from multiple across varied patient’s needs application of residents
resources to make practice settings or and values, evidence across all justified by
more effective diverse patient within the situations and plausible
clinical judgments. populations. K, S context of modifies clinical
K, S, A ethical clinical accordingly. K, S reasoning. S, A
practice. K, S,
A
Knowledge for Integrates Integrates Discriminates the Guides junior

comprehensive critical inquiry efficiency, efficacy, residents,
Specialty
knowledge in principles and and value of new colleagues and
Practice foundational and methods in the technology, skills, patients to
Senior
Junior
clinical sciences, management and understanding reliable

within the of patients with of the art, science, sources for
musculoskeletal musculoskelet and ethics relevant
rehabilitation al disorders. K, applicable to the professional
across diverse S, A musculoskeletal and
patient populations rehabilitation. K, S educational
or practice settings. information. K,
K, S A
Professionalis Integrates Seeks optimal Integrates Integrates Exhibits

m knowledge of laws resolution of resources within a effective professional
and regulations to ethical issues specialty area and communication responsibilities
optimize broad in clinical identifies areas of skills to modify of a
patient outcomes situations to involvement patient beliefs. musculoskelet
and advocate for promote relevant to K, S, A al practitioner,
patients to provide positive professional which include
comprehensive outcomes and association(s) and personal well-
level of care. K, S public trust. K, continued being. A
S, A competence. K, S
40
Communicatio Integrates active Seamlessly Integrates self- Discriminates Serves as a
listening and and intuitively reflection to and role model and
n
effective nonverbal adapts to enhance incorporates is able to
skills to facilitate diverse communication appropriate mentor others
reciprocal communication strategies and strategies to to develop
communication styles during facilitate expected engage in communication
patterns during both both outcomes across challenging competencies
anticipated and anticipated and multiple settings encounters with across
unanticipated unanticipated and in complex patients and different
situations. S, A patient and situations. S, A others to clinical settings
professional negotiate and in variable
interactions. K, positive situations. S, A
S, A outcomes. S, A
Education Adapts appropriate Integrates Assesses the Effectively

resources to appropriate learner’s delivers
design, deliver, and educational comprehension comprehensive
evaluate strategies that are and content to
instructional congruent with the demonstrates improve
activities. K, S setting and needs of the ability to knowledge and
the learner, integrate the skills of
inclusive of findings into residents in
technologies. S, A educational clinical or
activities. S, A academic
settings. K, S,
A
Systems- Analyzes societal Analyzes Integrates

based Practice and patient needs societal and knowledge of
to consistently patient needs systems-related
provide cost- to consistently quality
effective and provide cost- improvement and
efficient patient effective and safety initiatives to
care. K, A efficient patient enhance patient,
care. K, A organizational, and
societal outcomes.
K
Patient Accurately, Establishes a cost- Accurately, Accurately, Is able to

comprehensively, effective and value- comprehensively, comprehensivel mentor others
Management
and efficiently based plan of care and efficiently y, and efficiently to develop
performs a that accurately chooses and chooses and patient
musculoskeletal predicts goal modifies modifies management
examination and achievement, interventions and interventions competencies
evaluation in simple frequency, and education to guide and education to across
and complex clinical duration of an patient guide patient different
situations to episode of care for management for management clinical settings
establish a diagnosis simple and complex successful patient for successful for successful
and prognosis. K, S clinical situations. outcomes. K, S patient patient
K, S outcomes. K, S outcomes. S, A
41
Appendix-C
Appendix-C
Universal Topics Modules

Intent:
These are high value, interdisciplinary topics of outmost importance to the resident. The
reason for delivering the topics centrally is to ensure that every resident receives high quality
teaching and develops essential core knowledge. These topics are common to all specialties.
Topics included here meet one or more of the following criteria:
• Impactful: these are topics that are common or life-threatening
• Interdisciplinary: hence topics that are difficult to teach by a single discipline
• Orphan: topics that are poorly represented in the undergraduate curriculum
• Practical: topics that residents will encounter in hospital practice
Development and Delivery:
Universal topics will be developed and delivered centrally by the Commission through e-
learning platform. A set of preliminary learning outcomes for each topic will be developed.
Content experts, in collaboration with the central team, may modify the learning outcomes.
These topics will be didactic in nature with focus on practical aspects of care. These topics will
have more content-heavy as compared to workshops and other face-to-face interactive
session planned.
The suggested duration of each topic is 1.30 hours.
Assessment:
The topics will be delivered in a modular fashion. At the end of each Learning Unit there will be
on-line formative assessment. After completion of all topics there will be a combined
summative assessment in the form of context-rich MCQ. All residents must attain minimum
competency in the summative assessment. Alternatively, these topics can be assessed in a
summative manner along with specialty examination.
Some ideas: may include case studies, high quality images, worked examples of prescribing
drugs in disease states, and internet resources.
42
Module 1: Introduction
1. Safe drug prescribing
2. Hospital acquired infections
3. Sepsis; SIRS; DIVC
4. Antibiotic stewardship
5. Blood transfusion
Safe drug prescribing: At the end of the Learning Unit, you should be able to
a) Recognize importance of safe drug prescribing in the healthcare
b) Describe the various Adverse Drug Reactions with examples of commonly prescribed
drugs that can cause such reactions
c) Apply principles of drug-drug interactions, drug-disease interactions, and drug-food
interactions into common situations
d) Apply principles of prescribing drugs in special situations such as renal failure and
liver failure
e) Apply principles of prescribing drugs in elderly, pediatrics age group patents, and in
pregnancy and lactation
f) Promote evidence-based cost-effective prescribing
g) Discuss ethical and legal framework governing safe-drug prescribing in Saudi Arabia
Hospital Acquired Infections (HAI): At the end of the Learning Unit, you should be able to
a) Discuss the epidemiology of HAI with special reference to HAI in Saudi Arabia
b) Recognize HAI as one of the major emerging threats in healthcare
c) Identify the common sources and set-ups of HAI
d) Describe the risk factors of common HAIs such as ventilator associated pneumonia,
MRSA, CLABSI, Vancomycin Resistant Enterococcus (VRE)
e) Identify the role of healthcare workers in the prevention of HAI
43
f) Determine appropriate pharmacological (e.g., selected antibiotic) and
non-pharmacological (e.g., removal of indwelling catheter) measures in the treatment
of HAI
g) Propose a plan to prevent HAI in the workplace
Sepsis, SIRS, DIVC: At the end of the Learning Unit, you should be able to
a) Explain the pathogenesis of sepsis, SIRS, and DIVC
b) Identify patient-related and non-patient related predisposing factors of sepsis, SIRS,
and DIVC
c) Recognize a patient at risk of developing sepsis, SIRS, and DIVC
d) Describe the complications of sepsis, SIRS, and DIVC
e) Apply the principles of management of patients with sepsis, SIRS, and DIVC
f) Describe the prognosis of sepsis, SIRS, and DIVC
Antibiotic Stewardship: At the end of the Learning Unit, you should be able to:
a) Recognize antibiotic resistance as one of the most pressing public health threats
globally
b) Describe the mechanism of antibiotic resistance
c) Determine the appropriate and inappropriate use of antibiotics
d) Develop a plan for safe and proper antibiotic usage including right indications, duration,
types of antibiotic, and discontinuation.
e) Appraise of the local guidelines in the prevention of antibiotic resistance
Blood Transfusion: At the end of the Learning Unit, you should be able to:
a) Review the different components of blood products available for transfusion

b) Recognize the indications and contraindications of blood product transfusion
c) Discuss the benefits, risks, and alternative to transfusion
d) Undertake consent for specific blood product transfusion
e) Perform steps necessary for safe transfusion
f) Develop understanding of special precautions and procedures necessary during
massive transfusions
g) Recognize transfusion associated reactions and provide immediate management
44
Module 2: Cancer
1. Principles of management of cancer

2. Side effects of chemotherapy and radiation therapy
3. Oncologic emergencies
4. Cancer prevention
5. Surveillance Follow-up of cancer patients
Principles of Management of Cancer: At the end of the Learning Unit, you should be able to:
a) Discuss the basic principles of staging and grading of cancers

b) Enumerate the basic principles, (e.g., indications, mechanism, types) of
a. Cancer surgery
b. Chemotherapy
c. Radiotherapy
d. Immunotherapy
e. Hormone therapy
Side Effects of Chemotherapy and Radiation Therapy: At the end of the Learning Unit, you
should be able to:
a) Describe important side effects (e.g., frequent or life or organ threatening) of common
chemotherapy drugs
b) Explain principles of monitoring of side-effects in a patient undergoing chemotherapy
c) Describe measures (pharmacological and non-pharmacological) available to ameliorate
side-effects of commonly prescribed chemotherapy drugs
d) Describe important (e.g., common and life-threatening) side effects of radiation therapy
e) Describe measures (pharmacological and non-pharmacological) available to ameliorate
side-effects of radiotherapy
Oncologic Emergencies: At the end of the Learning Unit, you should be able to:
a) Enumerate important oncologic emergencies encountered both in hospital and

ambulatory settings
b) Discuss the pathogenesis of important oncologic emergencies
c) Recognize the oncologic emergencies
d) Institute immediate measures when treating a patient with oncologic emergencies
e) Counsel the patients in anticipatory manner to recognize and prevent oncologic
emergencies
45
Cancer Prevention: At the end of Learning Unit, you should be able to:
a) Conclude that many major cancers are preventable

b) Identify smoking prevention and life-style modifications are major preventable
measures
c) Recognize cancers that are preventable
d) Discuss the major cancer prevention strategies at the individual as well as national
level
e) Counsel patients and families in proactive manner regarding cancer prevention
including screening
Surveillance and Follow-Up of Cancer Patients: At the end of the Learning Unit, you should
be able to:
a) Describe the principles of surveillance and follow-up of patients with cancers

b) Enumerate the surveillance and follow-up plan for common forms of cancer
c) Describe the role of primary care physicians, family physicians, and similar others in
the surveillance and follow-up of cancer patients
d) Liaise with oncologists to provide surveillance and follow-up for patients with cancer
Module 3: Diabetes and Metabolic Disorders
1. Recognition and management of diabetic emergencies

2. Management of diabetic complications
3. Comorbidities of obesity
4. Abnormal ECG
Recognition and Management of Diabetic Emergencies: At the end of the Learning Unit,
you should be able to:
a) Describe pathogenesis of common diabetic emergencies including their complications

b) Identify risk factors and groups of patients vulnerable to such emergencies
c) Recognize a patient presenting with diabetic emergencies
d) Institute immediate management
e) Refer the patient to appropriate next level of care
f) Counsel patient and families to prevent such emergencies
46
Management of Diabetic Complications: At the end of the Learning Unit, you should be able Management of Diabe
to:
Management of Diabetic Complications: At the end of the Learning Unit, you should be able to:
to:
a) Describe the pathogenesis of important complications of Type 2 diabetes mellitus a) Describe the pat
b) Screen patients for such complications b) Screen patients
a) Describe the pathogenesis of important complications of Type 2 diabetes mellitus
c) Provide preventive measures for such complications c) Provide preventi
b) Screen patients for such complications
d) Treat such complications d) Treat such comp
c) Provide preventive measures for such complications
e) Counsel patients and families with special emphasis on prevention e) Counsel patients
d) Treat such complications
e) Counsel of
Comorbidities patients andAt
Obesity: families
the endwith special
of the emphasis
Learning on prevention
Unit, you should be able to: Comorbidities of Obes
Comorbidities of Obesity: At the end of the Learning Unit, you should be able to:
a) Screen patients for presence of common and important comorbidities of obesity a) Screen patients
b) Manage obesity related comorbidities b) Manage obesity r
a) Screen patients for presence of common and important comorbidities of obesity
c) Provide dietary and life-style advice for prevention and management of obesity c) Provide dietary a
b) Manage obesity related comorbidities
c) Provide
Abnormal ECG:dietary
At the and
end life-style advice Unit,
of the Learning for prevention
you shouldand
be management
able to: of obesity Abnormal ECG: At the e
Abnormal ECG: At the end of the Learning Unit, you should be able to:
a) Recognize common and important ECG abnormalities a) Recognize comm
b) Institute immediate management, if necessary b) Institute immedi
a) Recognize common and important ECG abnormalities
b) Institute
Module immediateand
4: Medical management,
SurgicalifEmergencies
necessary
Module 4: Medica
Module 4: Medical
1. Management andchest
of acute Surgical
pain Emergencies 1. Management of a
2. Management of acute breathlessness 2. Management of a
1. Management of acute chest pain
3. Management of altered sensorium 3. Management of a
2. Management of acute breathlessness
4. Management of hypotension and hypertension 4. Management of h
3. Management of altered sensorium
5. Management of upper GI bleeding 5. Management of u
4. Management of hypotension and hypertension
6. Management of lower GI bleeding 6. Management of l
5. Management of upper GI bleeding
For all the above, following learning outcomes apply. For all the above, follow
6. Management of lower GI bleeding
For all the above, following learning outcomes apply.
At the end of the Learning Unit, you should be able to: At the end of the Learnin
At the end of the Learning Unit, you should be able to:

a) Triage and categorize patients a) Triage and categ
b) Identify patients who need prompt medical and surgical attention b) Identify patients
a) Triage and categorize patients
c) Generate preliminary diagnoses based history and physical examination c) Generate prelim
b) Identify patients who need prompt medical and surgical attention
d) Order and interpret urgent investigations d) Order and interp
c) Generate preliminary diagnoses based history and physical examination
e) Provide appropriate immediate management to patients e) Provide appropr
d) Order and interpret urgent investigations
f) Refer the patients to next level of care, if needed f) Refer the patient
e) Provide appropriate immediate management to patients
f) Refer the patients to next level of care, if needed
47
Module 5: Acute Care
1. Pre-operative assessment
2. Post-operative care
3. Acute pain management
4. Chronic pain management
5. Management of fluid in the hospitalized patient
6. Management of electrolyte imbalances
Pre-Operative Assessment: At the end of the Learning Unit, you should be able to:
a) Describe the basic principles of pre-operative assessment

b) Preform pre-operative assessment in uncomplicated patient with special emphasis on:
i. General health assessment
ii. Cardiorespiratory assessment
iii. Medications and medical device assessment
iv. Drug allergy
v. Pain relief needs
c) Categorize patients according to risks
Post-Operative Care: At the end of the Learning Unit, you should be able to:
a) Devise a post-operative care plan including monitoring of vitals, pain management,

fluid management, medications, and laboratory investigations
b) Hand-over the patients properly to appropriate facilities
c) Describe the process of post-operative recovery in a patient
d) Identify common post-operative complications
e) Monitor patients for possible post-operative complications
f) Institute immediate management for post-operative complications
Acute Pain Management: At the end of the Learning Unit, you should be able to:
a) Review the physiological basis of pain perception

b) Proactively identify patients who might be in acute pain
c) Assess a patient with acute pain
d) Apply various pharmacological and non-pharmacological modalities available for acute
pain management
e) Provide adequate pain relief for uncomplicated patients with acute pain
f) Identify and refer patients with acute pain who can be benefitted from specialized pain
services
48
Chronic Pain Management: At the end of the Learning Unit, you should be able to:
a) Review bio-psychosocial and physiological basis of chronic pain perception

b) Discuss various pharmacological and non-pharmacological options available for
chronic pain management
c) Provide adequate pain relief for uncomplicated patients with chronic pain
d) Identify and refer patients with chronic pain who can be benefitted from specialized
pain services
Management of Fluid in Hospitalized Patients: At the end of the Learning Unit, you should
be able to:
a) Review physiological basis of water balance in the body

b) Assess a patient for his/her hydration status
c) Recognize a patient with over and under hydration
d) Order fluid therapy (oral as well as intravenous) for a hospitalized patient
e) Monitor fluid status and response to therapy through history, physical examination
and selected laboratory investigations
Management of Acid-Base Electrolyte Imbalances: At the end of the Learning Unit, you
should be able to:
a) Review physiological basis of electrolyte and acid-base balance in the body

b) Identify diseases and conditions that are likely to cause or associated with
acid/base and electrolyte imbalances
c) Correct electrolyte and acid-base imbalances
d) Perform careful calculations, checks, and other safety measures while correcting
acid-base and electrolyte imbalances
e) Monitor response to therapy through history, physical examination and selected
laboratory investigations
49
Module 6: Frail Elderly
1. Assessment of frail elderly
2. Mini-mental state examination
3. Prescribing drugs in the elderly
4. Care of the elderly
Assessment of Frail Elderly: At the of the Learning Unit, you should be able to
a) Enumerate the differences and similarities between comprehensive assessment

elderly and assessment of other patients
b) Perform comprehensive assessment, in conjunction with other members of health care
team, of a frail elderly with special emphasis on social factors, functional status, quality
of life, diet and nutrition, and medication history
c) Develop a problem list based on the assessment of the elderly
Mini-Mental State Examination: At the end of the Learning Unit, you should be able to
a) Review the appropriate usages, advantages, and potential pitfalls of Mini-MSE

b) Identify patients suitable for mini-MSE
c) Screen patients for cognitive impairment through mini-MSE
Prescribing Drugs in the Elderly: At the end of the Learning Unit, you should be able to
a) Discuss the principles of prescribing in the elderly

b) Recognize poly-pharmacy, prescribing cascade, inappropriate dosages, inappropriate
drugs, and deliberate drug exclusion as major causes of morbidity in the elderly
c) Describe the physiological and functional declines in the elderly that contribute to
increased drug related adverse events
d) Discuss drug-drug interactions and drug-disease interactions among the elderly
e) Familiar with Beers criteria
f) Develop rational prescribing habit for the elderly
g) Counsel elderly patient and family on the safe medication usage
Care of the Elderly: At the end of the Learning Unit, you should be able to:
a) Describe the factors that need to be considered while planning care for the elderly
b) Recognize the needs and well-being of care-givers
c) Identify the local and community resources available in the care of the elderly
d) Develop, with inputs from other health care professionals, individualized care plan for
an elderly patient
50
Module 7: Ethics and Healthcare
1. Occupational hazards of HCW
2. Evidence-based approach to smoking cessation
3. Patient advocacy
4. Ethical issues: transplantation/organ harvesting; withdrawal of care
5. Ethical issues: treatment refusal; patient autonomy
6. Role of doctors in death and dying
Occupation Hazards of Health Care Workers (HCW): At the end of the Learning Unit, you
should be able to:
a) Recognize common sources and risk factors of occupational hazards among the HCW
b) Describe common occupational hazards in the workplace
c) Develop familiarity with legal and regulatory frameworks governing occupational
hazards among the HCW
d) Develop a proactive attitude to promote workplace safety
e) Protect yourself and colleagues against potential occupational hazards in the
workplace
Evidence Based Approach to Smoking Cessation: At the end of the Learning Unit, you
should be able to:
a) Describe the epidemiology of smoking and tobacco usages in Saudi Arabia

b) Review the effects of smoking on the smoker and family members
c) Effectively use pharmacologic and non-pharmacologic measures to treat tobacco usage
and dependence among special population groups such as pregnant ladies, adolescent,
and patients with psychiatric disorders
Patient Advocacy: At the end of the Learning Unit, you should be able to:
a) Define patient advocacy

b) Recognize patient advocacy as a core value governing medical practice
c) Describe the role of patient advocates in the care of the patients
d) Develop a positive attitude towards patient advocacy
e) Be a patient advocate in conflicting situations
f) Be familiar with local and national patient advocacy groups
51
Ethical issues: transplantation/organ harvesting; withdrawal of care: At the end of the
Learning Unit, you should be able to:
a) Apply key ethical and religious principles governing organ transplantation and
withdrawal of care
b) Be familiar with the legal and regulatory guidelines regarding organ transplantation
and withdrawal of care
c) Counsel patients and families in the light of applicable ethical and religious principles
d) Guide patients and families to make informed decision
Ethical issues: treatment refusal; patient autonomy: At the end of the Learning Unit, you
should be able to:
a) Predict situations where a patient or family is likely to decline prescribed treatment

b) Describe the concept of ‘rational adult’ in the context of patient autonomy and
treatment refusal
c) Analyze key ethical, moral, and regulatory dilemmas in treatment refusal
d) Recognize the importance of patient autonomy in the decision making process
e) Counsel patients and families declining medical treatment in the light of best interest of
patients
Role of Doctors in Death and Dying: At the end of the Learning Unit, you should be able to:
a) Recognize the important role a doctor can play during a dying process
b) Provide emotional as well as physical care to a dying patient and family
c) Provide appropriate pain management in a dying patient
d) Identify suitable patients and refer to patient to palliative care services
52
Appendix-D
Appendix-D
Core Specialty Topics
Intent:
These topics are designed to ensure high quality education and essential core skills
development. The topics are selected to fulfill the knowledge and skill requirements for a
competent musculoskeletal physical therapy specialist.
Topics included here meet one or more of the following criteria:
• Impactful: These topics are common in daily clinical practice.
• Specialized: focus primarily on musculoskeletal rehabilitation knowledge and skills.
• Advanced: topics that are superficially represented in the undergraduate curriculum
• Practical: conditions that residents will encounter in a clinical practice setting.
Development and Delivery:
Core specialty topics will be developed and delivered by the PSMCHS, in collaboration with the
SCHS. A set of preliminary learning outcomes for each topic will be developed.
These topics will be didactic in nature with focus on practical aspects of care. Delivery mode will
be primarily face-to-face interactive lectures and workshops, in addition to distant-learning using
reading materials.
The topics will be distributed over the duration of the program. These topics will encompass
didactic classes and hands-on skill training. The duration of each topic will vary depending on the
allocated days. However, it ranges between 2 – 6 days. Each topic will be conducted in one session
or divided into two or more sessions depending on its duration.
53
Junior Level Senior Level
1st year 2nd year 3rd year
• SI-R: 42 hours (6-day class) • ROC: 42 hours (6-day class) • EC: 28 hours (4-day class)
• FSI: 42 hours (6-day class) • SP-R: 28 hours (4-day class) • Musculoskeletal Imaging: 28
hours (4-day class)
• OLQ: 42 hours (6-day class) • Case Study Presentation: 14 hours (2-
Topics day class) • Case Study Presentation: 14
• OUQ: 42 hours (6-day class)
hours (2-day class)
Assessment:
At the end of each topic, a summative assessment will be conducted in the form of context-rich
MCQ. Furthermore, formative assessment in the form of presentations, assignments, Group
discussion and brain storming activities will take place throughout the course.
Core topics distribution plan
EC: Education and Counseling

FSI: Foundations of Scientific Inquiry
MSK_LQ: Musculoskeletal Physical Therapy - Lower Quarter
MSK_UQ: Musculoskeletal Physical Therapy - Upper Quarter
ROC: Management and Rehabilitation of Post-operative Conditions

SI-R: Spine rehabilitation
SP-R: Sports rehabilitation
54
Detailed Clinical training and study plan
A. Junior Level:
1. Clinical Practice and Supervision
1. Experienced clinical supervisors from each training center (in collaboration with faculty
from PSMCHS) will provide 1:1 clinical supervision for the Junior Residents.
2. Each First-Year Junior Resident will receive a 1-hour period of 1:1 clinical supervision
while treating patients per day for a total of 480 hours per resident during Junior level of
the program.
3. Each second-Year Junior Resident will provide four 4-week periods (2 hours per week) of
clinical supervision for physical therapy interns at the clinical training center.
2. Core Specialty Topics
1. Spine Rehabilitation
At the completion of this course, the residents should be able to:
• Utilize a systematic approach to analyze common functional movements and

implement corrective exercises and reeducation procedures for management of
pelvic girdle, low back, thorax, and neck disorders
• Complete a reliable mobility examination of the spine and implement at least three
manipulative/mobilizing procedures for each region of the spine, along with the
reasoning of “when,” “who” and “why to” perform the manipulative procedure
• Interpret clinical findings of a patient to correctly classify spinal patients into one or
more of the ICF-based diagnostic categories and implement the matched treatments
associated with those impairment-based categories
• Employ effective clinical reasoning strategies to progress the patient during follow
up treatments based upon the patient's response to treatment and emerging clinical
findings
• Gain the knowledge, skills and ability to apply the highest level of evidence-based
care (as represented in the Orthopaedic Section's ICF-based Clinical Practice
Guidelines) for patients with neck, thorax, or low back musculoskeletal conditions
• Improve skills with movement analysis and movement reeducation for patients with
neck and back pain with movement coordination impairments
• Improve patient education and counseling skills to provide the optimal interventions
for patients with chronic neck and back pain
2. Foundations of Scientific Inquiry
• Discuss the rationale for undertaking research in physical therapy.

• Determine the barriers to research in physical therapy and devise means to
overcome the barriers to research in physical therapy.
55
• Develop an informed consent statement.
• Improve patient education and counseling skills to provide the optimal interventions
for patients with chronic neck and back pain
2. Foundations of Scientific Inquiry
• Discuss the rationale for undertaking research in physical therapy.

• Determine the barriers to research in physical therapy and devise means to
overcome the barriers to research in physical therapy.
• Develop an informed consent statement.
• Identify the potential risks to research subjects.
• Conduct a literature search using off- and online databases.
• Critically appraise evidence-based documents for reliability, validity, and clinical
utility
• Design a clinical study using data mined from patient records during clinical practice
• Collect and analyze examination, diagnosis, and treatment outcome data on patients
seen by the residents and clinical faculty of this clinical training program
• Submit and publish practice-based clinical outcome studies from data collected by
the residents and clinical faculty of this clinical training program
3. Musculoskeletal Physical Therapy - Lower Quadrant
• Discuss the role of the International Classification of Functioning as it relates to

the physical therapy profession
• Recognize pelvic girdle, lumbar spine, hip, knee, ankle and foot anatomy as it
relates to clinical practice
• Discuss the best available evidence behind pelvic girdle, lumbar spine, hip, knee,
ankle and foot clinical examination and treatment
• Analyze standing, walking, bending and lifting-related activities, identifying
normal versus abnormal functional movements and implement reeducation
strategies to normalize movement coordination impairments
• Demonstrate a complete pelvic girdle, lumbar spine, hip, knee, ankle and foot
examination
• Interpret pelvic girdle, lumbar spine, hip, knee, ankle and foot examination
findings in order to come up with a logical treatment plan.
56
• Discuss strategies to identify the source of lower quarter somatic pain,
considering published research pertaining to referred pain and radicular pain
• Demonstrate manual interventions to address pelvic girdle, lumbar spine, hip,
knee, ankle and foot impairments
• Demonstrate therapeutic exercises used to prescribe a therapeutic exercise
regimen aimed at normalizing common pelvic girdle, lumbar spine, hip, knee,
ankle and foot region impairments
• Integrate concepts of lower quarter pain management in to physical therapy
patient education strategies with the best available evidence.
4. Musculoskeletal Physical Therapy – Upper Quadrant
• Recognize thorax, neck, shoulder, elbow, wrist and hand anatomy as it relates to
clinical practice
• Discuss the best available evidence behind thorax, neck, shoulder, elbow, wrist
and hand clinical examination and treatment
• Analyze respiration, turning the head, reaching, and grasping-related activities,
identifying normal versus abnormal functional movements and implement
reeducation strategies to normalize movement coordination impairments
• Demonstrate a complete thorax, neck, shoulder, elbow, wrist and hand
examination
• Interpret thorax, neck, shoulder, elbow, wrist and hand examination findings in
order to come up with a logical treatment plan.
• Discuss strategies to identify the source of upper quarter somatic pain,
considering published research pertaining to referred pain and radicular pain
• Demonstrate manual interventions to address thorax, neck, shoulder, elbow,
wrist and hand impairments
• Demonstrate therapeutic exercises used to prescribe a therapeutic exercise
regimen aimed at normalizing common thorax, neck, shoulder, elbow, wrist and
hand region impairments
• Integrate concepts of upper quarter pain management in to physical therapy
patient education strategies with the best available evidence
57
5. Management and Rehabilitation of Post-operative Conditions
• Recognize the principles of different tissue disorders.

• Demonstrate the phases of postoperative tissue repair.
• Identify functional deficits associated with tissue injury.
• Examine functional performance measures that are relevant to the affected tissue.
• Assess clinical findings associated with different tissue insult.
• Perform pertinent objective tests and measurements.
• Develop postoperative rehabilitation protocol appropriate for the managed disorder
and its phase.
• Design a progressive loading rehabilitation program that fits the managed tissue
disorder.
• Integrate clinical guidelines with rehabilitation protocols.
6. Sports Rehabilitation
• Identify signs and symptoms of an acute concussion, perform an on-field and ongoing
concussion assessment, and implement post-injury management of concussions
• Perform an on-field assessment of an athlete suspected of an injury and determine
the appropriate action plan
• Identify the clinical findings suggesting an overuse syndrome and implement
management strategies of address the musculoskeletal impairments and other
relevant factors responsible for the tissue injury
• Provide education and counseling to an individual or athlete that promotes an active
and healthy lifestyle as well as optimal performance in athletic events
• Discuss normal movement patterns of acceleration / sprinting, jumping, directional
change / cutting, lateral movements, deceleration, distance running, cycling,
throwing / overhead striking.
• Analyze common sport-related activities and identify abnormal movement strategies.
• Utilize physical therapy interventions to address the abnormal movement strategies
and assist the athlete in development of more optimal movement patterns
58
7. 7.
Case
Case
Study
Study
Presentation
Presentation
At the
At the
completion
completion
of this
of this
course,
course,
the the
residents
residents
should
should
be able
be able
to: to:
• Demonstrate
• Demonstrate
efficient
efficient
examination
examination
andand
treatment
treatment
abilities
abilities
withwith
regard
regard
to complex
to complex
cases.
cases.
• Capture
• Capture
andand
utilize
utilize
relevant
relevant
knowledge
knowledge
andand
ideas,
ideas,
andand
apply
apply
them
them
appropriately
appropriately
to to
patient
patient
management.
management.
• Analyze
• Analyze
andand
understand
understand
medical
medical
and/or
and/or
surgical
surgical
factors
factors
important
important
to the
to etiology,
the etiology,
care,
care,
andand
outcome
outcome
of the
of patient's
the patient's
problems
problems
as they
as they
relate
relate
to ato
physical
a physical
therapy
therapy
planplan
of care.
of care.
• Apply
• Apply
the principles
the principles
of evidence-based
of evidence-based
practice
practice
andand
clinical
clinical
decision-making
decision-making
processes
processes
to selected
to selected
patient
patient
cases
cases
across
across
a variety
a variety
of physical
of physical
therapy
therapy
diagnoses.
diagnoses.
• Justify
• Justify
clinical
clinical
decisions
decisions
(assessment
(assessment
andand
treatment)
treatment)
based
based
on best
on best
available
available
evidence.
evidence.
• Determine
• Determine
a physical
a physical
therapy
therapy
diagnosis
diagnosis
andand
prognosis
prognosis
based
based
on best
on best
available
available
evidence.
evidence.
• Perform
• Perform
appropriate
appropriate
discharge
discharge
planning
planning
based
based
on best
on best
available
available
evidence.
evidence.
• Present
• Present
cases
cases
to peers
to peers
andand
defend
defend
clinical
clinical
decisions
decisions
based
based
on best
on best
available
available
evidence.
evidence.
• Lead
• Lead
a group
a group
discussion.
discussion.
• Write
• Write
a professional
a professional
casecase
report.
report.
• Develop
• Develop
appropriate
appropriate
timetime
management
management
skills.
skills.
B. B. Senior
Senior Level:
Level:
1. 1. Clinical
Clinical Practice
Practice andand Supervision
Supervision
1. 1. Experienced
Experienced clinical
clinical supervisors
supervisors fromfrom
eacheach training
training center
center (in collaboration
(in collaboration withwith
faculty
faculty from
from PSMCHS)
PSMCHS) willwill provide
provide 1:1 1:1 clinical
clinical supervision
supervision for the
for the Senior
Senior Residents.
Residents.
2. 2.
EachEach Senior
Senior Resident
Resident willwill receive
receive a 1-hour
a 1-hour period
period of 1:1
of 1:1 clinical
clinical supervision
supervision while
while
treating
treating patients
patients per per
dayday
for afor a total
total of 240
of 240 hours
hours in the
in the Senior
Senior level
level of the
of the program.
program.
3. 3.
EachEach senior
senior resident
resident willwill be involved
be involved in clinical
in clinical supervision
supervision of junior
of junior residents.
residents. Senior
Senior
residents
residents willwill provide
provide eight
eight 4-week
4-week periods
periods (2 hours
(2 hours per per week)
week) of clinical
of clinical supervision
supervision
to junior
to junior residents.
residents.
59
2. Core Specialty topics
1. Education and Counseling for Patients with Neck and Back Pain
Patient education and counseling strategies discussed and practiced during this course
will equip therapists with fundamental skills to address 1) personality disorders, such
paranoid, avoidant, borderline or dependent disorders, 2) cognitive tendencies, such as
anxiety or fear, 3) affective tendencies, such as depression, 4) pain catastrophizing,
such as exaggerated pain experiences, and 5) generalized pain, such as maladaptive
central nervous system sensitivity.
• Acquire and apply knowledge of pain science to the assessment and management of
pain disorders
• Describe the role of a physical therapist in the management of pain
• Identify strategies for managing patients with pain
• Identify the biological and psychosocial factors that contribute to pain, physical
dysfunction and disability using valid and reliable assessment tools
• Develop and utilize an evidence-based physical therapy management program to
modify pain responses, promote proper tissue healing and restore function
• Develop and utilize effective strategies for patient education, behavioral changes,
activity pacing, graded motor imagery and application of electrophysiological agents
when appropriate
• Recognize the advantages of a multi-disciplinary program to enhance physical
therapy interventions
• Identify patients at risk for becoming disabled with back and neck pain, including
assessment of cognitive and affective tendencies associated with recurrence of
spinal pain and the progression of acute spinal pain to chronic, disabling conditions.
• Incorporate interviewing strategies to optimally structure therapist-patient
relationships that enhance the patient’s self-responsibility and self-efficacy
• Implement patient education and counseling strategies intended to prevent the
progression of acute pain to chronic, disabling conditions
• Implement patient education, counseling, and exercise strategies to address fear-
avoidance beliefs and depressive disorders commonly co-existing with low back pain
60
2. Musculoskeletal Imaging
• Engage in the diagnostic process using musculoskeletal imaging procedures

when appropriate to establish differential diagnoses across systems and across
the lifespan.
• Determine the most appropriate musculoskeletal imaging procedure according to
the patient/client presentation and the current best evidence for diagnosis.
• Determine the most appropriate radiographic views according to patient/client
presentation, and current best evidence for diagnosis.
• Describe a systematic approach to the analysis of plain film radiography,
magnetic resonance imaging, bone scans, and computed tomography and
determine the relevance of visualized pathology to clinical decision-making.
• Use evidence-based diagnostic imaging procedures as appropriate to help
determine the patient/client who would benefit from physical therapy
interventions and the patient/client who requires referral for medical services.
• Review diagnostic test studies on musculoskeletal imaging according to
evidence-based criteria for validity.
• Understand basic concepts of musculoskeletal image acquisition and
interpretation.
• Recognize the appearance of normal anatomy and common pathology on
musculoskeletal images to facilitate diagnostic accuracy and appropriate
intervention strategies and forces.
61
3. Case Study Presentation
• Demonstrate efficient examination and treatment abilities with regard to complex

cases.
• Capture and utilize relevant knowledge and ideas, and apply them appropriately
to patient management.
• Analyze and understand medical and/or surgical factors important to the
etiology, care, and outcome of the patient's problems as they relate to a physical
therapy plan of care.
• Apply the principles of evidence-based practice and clinical decision-making
processes to selected patient cases across a variety of physical therapy
diagnoses.
• Justify clinical decisions (assessment and treatment) based on best available
evidence.
• Determine a physical therapy diagnosis and prognosis based on best available
evidence.
• Perform appropriate discharge planning based on best available evidence.
• Present cases to peers and defend clinical decisions based on best available
evidence.
• Lead a group discussion.
• Write a professional case report.
• Develop appropriate time management skills.
62
Appendix-E
Appendix-E
Top Conditions in the Musculoskeletal Physical Therapy and Rehabilitation
Top Conditions and procedures in the Specialty

Top conditions requiring musculoskeletal rehabilitation
Relative Cumulative
Conditions
Frequency Frequency
1. Low Back Pain w/ or w/o radiculopathy 15% 15%
2. Knee Osteoarthritis 15% 30%
3. Total Knee and/or Hip Replacement 10% 40%
4. Neck Pain w/ or w/o radiculopathy 10% 50%
5. Knee Ligamentous Repair 10% 60%
6. Shoulder Adhesive Capsulitis 10% 70%
7. Rotator Cuff / Impingement Syndrome 10% 80%
8. Long Bones Fractures 5% 85%
9. Pelvis/ Hip Pain 5% 90%
10. Tennis Elbow 5% 95%
100
11. Ankle Sprain 5%
Top Ten Causes of Out-Patient rehabilitation in Saudi Arabia
Conditions Relative Cumulative
Frequency Frequency
1. Back pain 20% 20%
2. Knee pain 15% 35%
3. Neck pain 10% 45%
4. Hip pain 10% 55%
5. Limited joint movement 10% 65%
63
6. Shoulder pain 10% 75%
7. Fractures 10% 85%
8. Ankle dysfunction 5% 90%
9. Post-surgical follow-up 5% 95%
10. Congenital/idiopathic deformities 5% 100%
Top Ten Causes of In-patient Admissions in Saudi Arabia
Conditions Relative Cumulative
Frequency Frequency
1. Knee
1. arthroplasty 20% 20%
2. Traffic
1. accidents 15% 35%
3. Lumbar/cervical
2. Discectomy 15% 50%
4. Hip
3. arthroplasty 10% 60%
5. Anterior
4. cruciate ligament repair 10% 70%
6. Femoral
5. neck fracture 10% 80%
7. Shoulder
6. joint surgeries 5% 85%
8. Spinal
7. fixation 5% 90%
9. Foot
8. and ankle surgeries 5% 95%
10. Elbow
9. and hand surgeries 5% 100%
64
Appendix-F
Appendix-F
List of core skills and procedures
1. Category I: Assumed competency
• Obtain and record patient’s subjective information
• Active and passive range of movement assessment of different body joints
• Muscle strength assessment
• Prepare and apply different Electrophysical treatment modalities
• Pain assessment using visual analogue scale
• Detection of common bony landmarks (e.g. ASIS, C7, scapular spine, ….)
• Palpate peripheral muscles belly and tendon
• Describe phases of human gait and perform basic gait assessment
• Perform basic sensory assessment
• Identify poor posture
• Maintenance of a sterile field
• Appropriate dress code
• Basic interview skills
• English language proficiency
• Basic computer skills
65
2. during Junior level of the program.
Appendix-G:
Appendix G:Musculoskeletal
MusculoskeletalPhysical
PhysicalTherapy
TherapyProcedures
ProceduresPerformance
PerformanceAssessment
AssessmentTool
Tool
BODY AREA Number to UNSATISFACTOR SATISFACTORY SUPERIOR

(CI
achieve Y PERFORMANCE PERFORMANCE PERFORMANCE
UPPER CERVICAL competency (Date) (Date) (Date)
initials)
Movement Analysis & Reeducation:

3
(1)Head and Neck Alignment
(2)Vertebrobasilar Insufficiency Eval 3
(3)Ligament Integrity Tests:
Alar 3
Sharp-Purser
(4)Suboccipital Myof. Provocation/STM 3
(5)C1 Lateral Translation 3
(6)C1 Anterior Glide/Occ. Post. Glide 3
(7) Occiput/C1 Contract/Relax of
Segmental Extensors & 3
Sidebenders
(8)Occipital Distraction 3
(9)C1/C2 Rotation Contract/Relax 3
(10)C1/C2 Rotation Mobilization 4
(11)C2-C3 Superior/Anterior Glides 4
(12)C2-C3 Inferior/Posterior Glides 3
(13)Upper Quarter Neuro Status Exam 3
(14) Neck Rotation ROM, Movement /
4
Pain Relations & Overpressures
(15)Provocation of Involved
3
Segment(s)
(16)C2-C7 Sup/Ant Glides (rotation) 3
(17)C2-C7 Inf/Post Glides (sidebend) 3
(18)STM: Segmental Myofascia 3
(19)Natural Apophyseal Glides (NAGs) 4
(20)Sustained Apophyseal Glides
4
(SNAGs)
(21)Rotation in Neutral Manipulation 3
(22)Sidebending in Neutral Manip. 3
(23)Inferior/Post. Glides/Sidebending 3
(24)Contract/Relax
3
Flexors/Sidebenders
Number to UNSATISFACTORY SATISFACTORY SUPERIOR
UPPER THORACIC achieve PERFORMANCE PERFORMANCE PERFORMANCE
(CI initials)
66
(22)Sidebending in Neutral Manip. 3
(23)Inferior/Post. Glides/Sidebending 3
(24)Contract/Relax
3
Flexors/Sidebenders
UPPER THORACIC achieve PERFORMANCE PERFORMANCE PERFORMANCE
(CI initials)
competency (Date) (Date) (Date)
Movement Analysis & Reeducation: 3
(25)Neck Rotation
(26)TP Symmetry in Flexion/Extension 3
(27) Unilat. PA & Transverse Pressures 4
(28)STM: Segmental Myofascia 3
(29) STM: Scaleni Myofascia 3
(30) Unilat PAs-sup/ant glides using 4
TPs
(31) Rotation in Neutral (using adj 3
SP’s)
(32)Rotation in Neutral (neutral gap) 3
(33)Rotation/Sidebending in Extension 3
(34)1st Rib Inferior Glide 3
SHOULDER achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
(35)Reaching Overhead
(36)Upper Limb Nerve Mobility Exam: 3
Median
Radial
Ulnar
(37)Shoulder Special Tests: 3
Resistive Tests
Impingement Assessment
Labral Assessment
(38)Muscle Length Tests: 3
Pectoralis Minor & Major
Latissimus Dorsi & Teres Major
Subscapularis
(39)Glenohumeral ROM Exam 3
External Rotation
Internal Rotation
Flexion
Abduction
Horizontal Adduction
(40)Accessory Movement Tests: 3
Acromioclavicular Post & Ant
Mvts
Sternoclavicular Glides
Glenohumeral Posterior Glides
GH Inferior & Anterior Glides
(41)STM to Nerve Entrapment Sites 3
(42)Soft Tissue Mobilization & PNF: 3
Subscapularis STM
Extensors/Internal Rotators C/R
67
Facilitation of Flexors/Ext Rotators
Infraspinatus STM
(43)MWMs: Elevation 4
Hand-Behind-Back
(44)Joint Mobilization: 4
Humeral Inferior Glide
Humeral Posterior Glide in neutral
Humeral Post Glide in flex/adduction
ELBOW achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
(45)Elbow Special Tests: 3
Resistive Tests (ECRB & ECRL)
Extensor Tendon Provocation
Valgus Stress Test
(46)Accessory Movement Tests: 3
Ulnar Distraction
Radial Posterior Glide
Radial Anterior Glide
Radial Compression & Distraction
(48)MWMs: Elbow Flexion 3
Elbow Extension
Ulnar Distraction
Radial Posterior Glide
Radial Anterior Glide
WRIST and HAND achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
(50)Resistive Tests: 3
Abductor Pollicis Brevis
1st Dorsal Interosseous
Abductor Pollicis Longus
Extensor Pollicis Brevis
(51)Wrist & Hand Special Tests: 3
Provocation of APL & EPB
Tendons
Finkelstein’s Test
Provocation of Guyon’s Tunnel
1st MP Valgus Stress Test
(52)Wrist Accessory Movement Tests: 3
Distal Radioulnar Joint
Ulnomeniscotriquetral Joints
Radiocarpal Joints
Intercarpal Joints
(53)MWMs: Forearm Pronation 3
Wrist Extension
68
Interphalangeal
Radius & Ulna Glides
Proximal Carpal Row Glides
Scaphoid & Lunate Glides
Hamate & Capitate Glides
Other Intercarpal Glides
Phalangeal Bi & Unicondylar Glides
THORACIC achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
(55)Thorax Rotation
(56)Slump Exam - including long sitting 4
(57)TP Symmetry in Flexion/Extension 3
(58)Unilateral PAs 3
(59)Rib Positional Symmetry 3
(60)Rib AP & PAs Pressures 3
(61)Soft Tissue Mob. & Contract/Relax: 3
Multifidi/Segmental Myofascia
Segmental Extensors and
Sidebenders
Intercostal Myofascia
Segmental Flexors and Sidebenders
(62)Rotation/Sidebending in Flexion 3
(63)Rotation/Sidebending in Extension 3
(64)Rib Posterior Glides with Isometric 3
Mobilizations
(65)Rib Anterior Glides with Isometric 3
Mobilizations
PELVIC GIRDLE achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
(66)Movement Analysis & 3
Reeducation:
Standing Pelvis/Trunk Symmetry
Sitting Weight Shift
March Test
Flare Test
(67)PSIS/ASIS Palpation for Symmetry 3
(68) SI Ligament Provocation: 3
Long Posterior SI Ligament
Short Posterior SI Ligament
Sacrotuberous SI Ligament
69
(69)SIJ/ASIS Compression / Distraction 3
(70)STM & C/R: Quadratus 3
Lumborum Iliacus
(71)Lumbopelvic Region Manipulation 3
(72)Innominate Inferior Translation 3
(73)Sagittal Plane Isometric 3
Mobilization
using hip flexors/extensors
using hip adductors/extensors
(74)Innominate Posterior Rotation 3
Mobs
(75)Innominate Anterior Rotation Mobs 3
(76) Innominate External & Internal 3
Rotation Mobilizations
(77) Sacral Flexion Mobilizations 3
LUMBAR achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
Reeducation:
Lumbar Forward Bending
Lumbar Sidebending
Lumbar Movement/Pain
Relations
Lifting
(79)Movement Analysis & Muscle 3
Power:
Trunk Flexors/Abdominals
Trunk Sidebenders/Lateral
Abds
Trunk Extensors/Erector
Spinae
Trunk
Rotators/Multifidi/TA/Obliq
ues
(80) Lower Quarter Neuro Status Exam 3
(81)TP Assessment in Flexion/Extension 3
(82)Unilateral PAs 4
(83)Sciatic Nerve Tension Test 4
(84)Slump Test 4
(85)Lateral Shift Correction 4
(86)STM: Multifidi/Segmental 3
Myofascia
70
(87) STM: Psoas 3
(88)Sidebending/Rotation in Neutral 3
(89)Sidebending/Rotation in Extension 3
(90)PAs in Combined Movements 3
HIP achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)

(91)Walking
(92)Piriformis Stretch Test & 4
Provocation
(93)Mobility & Muscle Flexibility: 3
Hip Flexion
Hip Internal Rotation
Hip External Rotation
Hip Abduction
Hip Extension
(94)Lower Limb Nerve Mobility 4
(95)Resistive & Stretch Tests: 3
Lateral Hamstring/Biceps
Femoris
Medial Hamstrings
Hip Adductors
Rectus Femoris
(96)Soft Tissue Mob. & Contract/Relax: 3
Piriformis
Gluteus Maximus & Medius
Other Hip External Rotators
(97)MWMs: Hip Flexion 4
Hip Internal Rotation
(98)Joint Mobs: Femoral Anterior 4
Glides
KNEE achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
(99)Single Leg Squat
(100)Knee Special Tests: Valgus/Varus 3
Lachman’s Test
McMurray’s
(101)Knee Extension Exam: Terminal Ext 3
Ant. Glides
(102)Knee Flexion Exam: Hyperflexion 3
Posterior Glides
(103) Patellofemoral/Lower Extr 3
Alignment
(104)Patellar Medial/Lateral Glides 3
(105)ITB Exam: Length & Provocation 3
71
(106) Proximal Tibiofibular Accessory 3
Movements
(107)Provocation: Medial Joint Line 3
Pes Anserine Bursa
Patellar Tendon
(108) Soft Tissue Mobilization: 3
Lateral Thigh/Iliotibial Band
Lateral Retinaculum
Quadriceps Femoris
Lateral Leg Nerve Entrapment
Sites
(109)Joint Mobilization 4
Patella Medial Glides
Tibiofemoral Extension
Tibial Anterior Glide
Knee Flexion MWM
Fibular Posterior/Medial Glide
Fibular Anterior/Lateral Glide
ANKLE achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
Reeducation:
Talocrural, Talocalcaneal,
Talonavicular, Calcaneocuboid,
& 1st MTP functioning during
Initial Contact, Loading
Response, Mid-Stance,
Terminal Stance, & Pre-Swing
(111)Ant Talofibular Ligament 3
Provocation
(112)Inversion Stress Test (Talar Tilt) 3
(113) Talar Anterior Drawer 3
(114)Ankle Sprain MWM 4
(115)Lower Limb Nerve Tension: 3
Tibial
Sural
Fibular
(116)Nerve Entrapment Site 3
Provocation
(118)MWMs: Distal Tibiofibular 4
Ankle Dorsiflexion
Talar Posterior Glide
Ankle Plantar Flexion
(119)Joint Mobs: Distal Fibular Post. 4
72
Glide
Talar Posterior Glide
Talar Anterior Glide
FOOT achieve PERFORMANCE PERFORMANCE PERFORMANCE (CI initials)
Reeducation:
Tibial Internal and External Rotation
1/4 Squat
Heel Raise
(121)Calcaneal Position &Eversion ROM 3
(122) Mid-Tarsal Accessory Mvt Tests 3
Talus – Navicular
Navicular – 1st Cuneiform
Calcaneus – Cuboid
Navicular/3rd Cuneiform –
Cuboid
(123) 1st MTP Extension ROM and 3
Accessory Movements
(124) Longitudinal MT Mobility 3
w/Evr&Inv
(125)Oblique Mid-Tarsal Mob w/ Evr & 3
Inv
(126)Joint Mobilizations: 4
Calcaneal Lateral Glides
Navicular Dorsal & Plantar
Glides
Cuboid Dorsal and Plantar
Glides
1st MTP Dorsal Glides & MWMs
(127)Cuboid Whip 3
KEY:
• Unsatisfactory: Application of procedure is deficient, which leads to less than optimal

patient outcomes.
• Satisfactory: Utilizes procedural implementation that is consistent with what is 1)

described in clinical practice guidelines for common musculoskeletal conditions, and 2)
instructed during the lab portion of the residency curriculum.
• Superior: Clinical reasoning and procedures are utilized consistently with a high level of
skill or with a patient for which a high level of skill was required to achieve the desired
outcome.
73
3. Category III: Mastery level procedures. Residents are expected to be competent by the
end of Junior level of the program
Appendix-H: MusculoskeletalPhysical
Appendix H: Musculoskeletal Physical TherapyCOUNSELING
THERAPY Counsling and
and Exercise Education
Exercise Education
Assessment Tool
Assessment Tool
UNSATISFACT SUPERIOR
SATISFACTORY
Number to achieve ORY PERFORMANC (CI
CONDITION PERFORMANCE
competency PERFORMANCE E initials)
(Date)
(Date) (Date)
Neck Pain With Mobility
Deficits
Segmental Somatic
Dysfunction
(1) Patient Education and
Counseling:
Integrate movements into
3
end ranges of neck
motions while performing
daily activities
(2) Exercise Training:
Self SNAG stretch 4
Levator scapular stretching
UNSATISFACTOR
Neck Pain With Movement SATISFACTORY SUPERIOR
Number to achieve Y (CI
Coordination Impairments PERFORMANCE PERFORMANCE
competency PERFORMANCE initials)
Whiplash (Date) (Date)
(Date)
Counseling:
Progressive return to
3
normal activities
Reassurance that full
recovery usually occurs
Deep neck flexors
strengthening
Upper back extensors
4
strengthening
Scalene stretching
Mid-back / Thorax self
mobilization
Neck Pain With Headache Number to achieve UNSATISFACTOR SATISFACTORY SUPERIOR (CI
74
4
strengthening
Scalene stretching
mobilization
Neck Pain With Headache Number to achieve UNSATISFACTOR SATISFACTORY SUPERIOR (CI
Cervicogenic Headache competency Y PERFORMANCE PERFORMANCE initials)
PERFORMANCE (Date) (Date)
(Date)
Counseling:
Neutral (gentle flexion) 3
head position with
activities
Deep neck flexors
strengthening
4
C1-C2 Self SNAG stretch
Scalene stretching
Upper trapezius stretching
UNSATISFACTOR
SATISFACTORY SUPERIOR
Neck Pain With Radiating Pain Number to achieve Y (CI
PERFORMANCE PERFORMANCE
Cervical Radiculopathy competency PERFORMANCE initials)
(Date) (Date)
(Date)
Counseling:
Avoid positions and
movements that:
1) put the neck in extension 3
with end range side-
bending and rotation
2) put the upper limb in
nerve tension positions
Median, radial, and ulnar
nerve mobility
4
Scalene stretching
mobilization
UNSATISFACTOR
Shoulder Pain and Mobility SATISFACTORY SUPERIOR
Deficits PERFORMANCE PERFORMANCE
Adhesive Capsulitis (Date) (Date)
(Date)
Counseling:
1) Positions of comfort and
avoidance of end range 4
movements that may
increase tissue irritability
2) Progressing activities to
75
gain motion without
producing tissue
inflammation
3) Progression to
performing more high
demand activities
Glenohumeral external
rotation stretching
Glenohumeral internal
rotation stretching
Overhead / Latissimus
dorsi stretching
UNSATISFACTOR
Shoulder Subacromial Pain Number to achieve Y (CI
Rotator Cuff Syndrome competency PERFORMANCE initials)
(Date) (Date)
(Date)
Counseling:
1) Avoidance of overhead
movements that may
increase tissue
irritability
perform with normal, 3
pain free
scapulohumeral motion
3) Progression to
demand activities as
strength and
coordination improve
Pectoralis major & minor
stretching
Mid-back / thorax self
mobilization
Rotator cuff / 4
supraspinatus
strengthening
Rotator cuff / infraspinatus
strengthening
Scapular rotators / lower
trapezius strengthening
Shoulder Stability and Movement UNSATISFACTOR
Coordination Impairments Number to achieve Y (CI
Shoulder Instability competency PERFORMANCE initials)
(Date) (Date)
(Date)
Counseling: 76
1) Avoidance of
Shoulder Stability and Movement UNSATISFACTOR
Shoulder Instability competency PERFORMANCE initials)
(Date) (Date)
(Date)
Counseling:
1) Avoidance of
movements that may
increase tissue
irritability
perform with normal,
pain free 3
scapulohumeral
positions and
movements
3) Progression to
strength and
coordination improve
Pectoralis major & minor
stretching
Mid-back / thorax self
mobilization
Glenohumeral internal
rotation stretching
Rotator cuff /
subscapularis
3
strengthening
Scapular rotators / lower
Scapular stabilizers /
middle trapezius
strengthening
Scapular rotators /
serratus anterior
strengthening
UNSATISFACTOR
Elbow Epicondylitis PERFORMANCE PERFORMANCE
(Date) (Date)
(Date)
77
middle trapezius
strengthening
Scapular rotators /
serratus anterior
strengthening
UNSATISFACTOR
Elbow Epicondylitis PERFORMANCE PERFORMANCE
(Date) (Date)
(Date)
Counseling:
1) Avoidance of or altering
grasping activities
related to tissue
irritability 3
2) Progression to
strength and nerve
mobility improve
Median, radial, and ulnar
nerve mobility
Wrist extensors - eccentric
and concentric
strengthening
3
Scapular stabilizers /
middle trapezius
strengthening
Scapular rotators /
serratus anterior
strengthening
UNSATISFACTOR
Carpal Tunnel Syndrome PERFORMANCE PERFORMANCE
(Date) (Date)
(Date)
Counseling:
1) Use of neutral wrist
splints at night as
needed
2) Advice on optimal 3
ergonomic positions for
work activities to keep
wrists in neutral and
reduce median nerve
entrapments
Median nerve mobility
Pectoralis major & minor 3
stretching
Scalene stretching
78
UNSATISFACTOR
Low Back Pain with Mobility SATISFACTORY SUPERIOR
Deficits PERFORMANCE PERFORMANCE
Segmental Somatic Dysfunction (Date) (Date)
(Date)
Counseling:
Integrate movements into
end ranges into 3
activities, such as
walking, reaching,
bending, and twisting
Thoracolumbar self
mobilization
Thoracolumbar rotation
stretching; & extension 3
stretching
Hip flexor stretching
Lower abdominals
strengthening
UNSATISFACTOR
Low Back Pain with Movement SATISFACTORY SUPERIOR
Coordination Impairments PERFORMANCE PERFORMANCE
Lumbar Instability (Date) (Date)
(Date)
Counseling:
1) Postures and motions
that maintain the
involved spinal
structures in neutral,
symptom-alleviating
positions
2) Counseling strategies
that emphasize
4
a) understanding of the
anatomical/structural
strength inherent in
the human spine
b) neuroscience
concepts that explain
pain perception
c) the overall favorable
prognosis of low back
pain
79
d) the use of active pain
coping strategies that
decrease fear and
catastrophizing
e) the early resumption
of normal or
vocational activities,
even when still
experiencing pain
f) the importance of
improvement in
activity levels, not just
pain relief, including
low-stress aerobic
activities
Lower abdominals
strengthening
Lateral abdominals
strengthening
Low back / multifidi
strengthening
Hip extensors 4
strengthening
Hip abductors
strengthening
Hip internal rotation
stretching
Hamstrings-sciatic nerve
mobility
UNSATISFACTOR
Low Back Pain with Related SATISFACTORY SUPERIOR
(Referred) Lower Extremity Pain PERFORMANCE PERFORMANCE
Lumbar Disc Displacement (Date) (Date)
(Date)
Counseling:
Education on positions that
promote centralization
Progress to strategies
4
consistent with
treatments for patients
with Low Back Pain with
Movement Coordination
Impairments
80
Lateral shift correction
Thoracolumbar extension
repeated movements
4
Hip internal rotation
stretching
mobility
UNSATISFACTOR
Low Back Pain with Radiating SATISFACTORY SUPERIOR
Pain PERFORMANCE PERFORMANCE
Lumbar Radiculopathy (Date) (Date)
(Date)
Counseling:
Avoid positions and
movements that:
1) put the lumbar spine
into extension or 4
extension with end range
side-bending and
rotation
2) put the lower limb in
nerve tension positions
Slump/dural mobility
4
mobility
UNSATISFACTOR
Low Back Pain with Generalized SATISFACTORY SUPERIOR
Pain PERFORMANCE PERFORMANCE
Chronic Low Back Pain (Date) (Date)
(Date)
Counseling:
1) Education and
counseling to address
specific classification
exhibited by the
individual (ie, 4
depression, fear-
avoidance, pain
catastrophizing)
2) Low-intensity, prolonged
(aerobic) exercise
activities
81
Progressive aerobic
4
endurance and fitness
activities
UNSATISFACT SUPERIOR
SATISFACTORY
Number to achieve ORY PERFORMANC (CI
Non-arthritic Hip Joint Pain PERFORMANCE
competency PERFORMANCE E initials)
(Date)
(Date) (Date)
Counseling:
Education in regard to joint
protection strategies and
avoidance of symptom-
provoking activities, such
as:
1) Activities that place the
hip at end-ranges of
flexion, internal rotation,
3
and adduction
2) Modification of
movement impairments
that aggravate the
reported hip pain (eg
sitting, stairs, walking)
3) Modification of weight
loading forces that are
aggravating the reported
pain
Hip extensors
strengthening
Hip abductors
strengthening
Hip internal rotation 4
stretching
Hip external rotation /
piriformis stretching
mobility
Knee Stability and Movement UNSATISFACTOR
Knee Ligament Sprain competency PERFORMANCE initials)
(Date) (Date)
(Date)
82
Hip external rotation /
piriformis stretching
mobility
Knee Stability and Movement UNSATISFACTOR
Knee Ligament Sprain competency PERFORMANCE initials)
(Date) (Date)
(Date)
Counseling:
1) Assist with determining
the need for surgical
repair - based upon
injury, level of strength
and sensorimotor
control available, and 3
athletic or occupational
needs
2) Progress strength and
neuromuscular training
as able and needed for
performance of desired
activity
Hip abductors
strengthening
Hip external rotators
strengthening
4
Quadriceps strengthening
GastrocSoleus - fibularis
longus strengthening
Progressive loading &
Sensorimotor training
Knee Pain and Mobility UNSATISFACTOR
Impairments Number to achieve Y (CI
Knee Meniscal and competency PERFORMANCE initials)
(Date) (Date)
Articular Cartilage Lesions (Date)
Counseling:
Assist with determining
the optimal exercise
dose, weight-bearing 3
load, and return to
desired occupational,
recreational, or athletic
activity
Hip extensors /
hamstrings 4
strengthening
83
- using caution not to
load injured cartilage
UNSATISFACTOR
Patellofemoral Pain Syndrome PERFORMANCE PERFORMANCE
(Date) (Date)
(Date)
Counseling:
Assist with determining
the optimal exercise
dose, weight-bearing 3
load, and return to
desired occupational,
recreational, or athletic
activity
Hip abductors
strengthening
Hip external rotators
strengthening
GastrocSoleus / fibularis
3
GastrocSoleus / tibialis
posterior strengthening
Hip flexor / rectus femoris
stretching
Calf/gastrocnemius
stretching
Achilles Pain, Stiffness, and UNSATISFACTORY SATISFACTORY SUPERIOR
Number to achieve (CI
Muscle Power Deficits PERFORMANCE PERFORMANCE PERFORMANCE
competency initials)
Achilles Tendinitis (Date) (Date) (Date)
Counseling:
1) Assist with determining
the optimal walking or
running exercise training
load to adjust weight-
3
bearing load to Achilles
tendon tolerance
2) Consider footwear
modifications, such as
increase cushioning, and
/ or use of heel lifts or
84
orthotics to reduce
symptoms
Calf/gastrocnemius
stretching 4
Gastroscopes - eccentric &
concentric strengthening
Ankle Stability and Movement UNSATISFACTORY SATISFACTORY SUPERIOR
Number to achieve (CI
Coordination Impairments PERFORMANCE PERFORMANCE PERFORMANCE
competency initials)
Ankle Ligament Sprain (Date) (Date) (Date)
Counseling:
1) Assist with progressing
the return to function -
progressing from the
Acute / Protected Motion
through the Progressive
Loading / Sensorimotor
Training phases of 3
returning to daily
activities or sports
2) Encourage performance
of balance and
proprioceptive exercises
and drill to lessen the
likelihood of recurring
ankle injuries
Calf/gastrocnemius
stretching
GastrocSoleus / fibularis
longus strengthening 4
GastrocSoleus / tibialis
posterior strengthening
Progressive Loading &
Sensorimotor Training
UNSATISFACTORY SATISFACTORY SUPERIOR

Heel Pain Number to achieve (CI
PERFORMANCE PERFORMANCE PERFORMANCE
Plantar Fasciitis competency initials)
(Date) (Date) (Date)

Counseling: 3
Modify activity to be within
85
pain tolerance - with
gradual increase in
weight-bearing loads
Footwear or orthotic
suggestions:
1) Arch support for
individuals with
excessive pronation
2) Heel cushioning for
individuals with
excessive supination
3) Encourage reduction of
body fat in overweight
individuals
Calf/gastrocnemius
stretching
GastrocSoleus / fibularis 3
Progressive loading &
Sensorimotor training
KEY:
Unsatisfactory: Education and counseling has a moderate likelihood of promoting greater
disability; or exercise education and training is deficient, which could lead to less than optimal
patient outcomes.
Satisfactory: Utilizes patient education / counseling strategies and exercise training strategies
that are consistent with what is 1) described in clinical practice guidelines for common
musculoskeletal conditions, and 2) instructed during the classroom/lab portion of the residency
curriculum.
Superior: Clinical reasoning, patient education / counseling strategies, and exercise training
strategies are utilized consistently with a high level of skill or with a patient for which a high level
of skill was required to achieve the desired outcome.
86
Appendix-I
Appendix-I
Assessment
List of Formative Assessment Tools
(According to executive policy on continuous assessment, minimum of 4 tools are needed, should
cover the three domains, resident should show competency in each assessment tool in order to be
promoted to the subsequent training level; for further details please refer to the policy on
www.scfhs.org)
Domain Tools
Knowledge • Written exams for each didactic class
• Structured academic activities (assignments, presentations,
discussions, case study report)
• Structured Oral Exams
Skills • Weekly Feedback Form. (Appendix J)
• Musculoskeletal Physical Therapy Procedures Performance

Assessment
Assessment Tool (Appendix G)
• Clinical Performance Evaluation Tool (Appendix K)
• Patient Demographic Data From (Appendix L)
• Body Region Log Book (Appendix M)
• Research Activity
Attitude • Weekly Feedback Form. (Appendix J)
• Orthopeadic Physical Therapy Counseling and Exercise
Education Assessment Tool (Appendix H)
• Clinical Faculty Evaluation Form (Appendix N)
• Classroom / Lab. Presentation Evaluation Form (Appendix O)
87
Appendix J: DAILY/WEEKLY FEEDBACK FORM
INTERN: DATE:
INTERN:
PATIENT: DATE:
INTERN:
Appendix J: DAILY/WEEKLY FEEDBACK FORM DATE:
Appendix
INTERN: J: DAILY/WEEKLY FEEDBACK FORM
PATIENT:
Appendix-J: DAILY / WEEKLY
PATIENT:
INTERN:
SKILL LEVEL
FEEDBACKDATE:
SKILL LEVEL
FORM
DATE:
COMMENTS
COMMENTS
PATIENT:
INTERN: SKILL LEVEL DATE: COMMENTS
EXAMINATION
PATIENT: TASKS
INTERN:
EXAMINATION TASKS SKILL LEVEL DATE: COMMENTS
PATIENT:
INTERN: SKILL LEVEL DATE: COMMENTS
EXAMINATION
Identify
PATIENT: TASKS
Problems/Concerns ___________
PATIENT:
EXAMINATION
Identify TASKS
Problems/Concerns SKILL LEVEL
___________ COMMENTS
Obtain Symptom
EXAMINATION
Identify History
TASKS
Problems/Concerns SKILL ___________
LEVEL
___________ COMMENTS
Obtain Symptom SKILL LEVEL COMMENTS
EXAMINATION
Administer
IdentifySymptom
Obtain Tests History
TASKS
and Measures
Problems/Concerns
History
___________
___________
___________
EXAMINATION
Identify
Administer TASKS
Problems/Concerns
Tests and Measures ___________
___________
EXAMINATION
Level
Obtain ofSymptom
Administer
Identify TASKS
painTests History
and Measures
Problems/Concerns ____________
___________
___________
Obtain
Level Symptom History
of Problems/Concerns
painTests and ___________
____________
Identify
Posture/structural
Administer assessment
Measures ___________
____________
___________
Level
ObtainofSymptom
Identify
AdministerpainTests History
Problems/Concerns
and Measures ____________
___________
___________
___________
Posture/structural
Obtain Symptom
Gait/balance
Level ofSymptom assessment
History
assessment
painTests ____________
___________
____________
____________
Posture/structural
Administer
Obtain assessment
and Measures
History
Level of pain assessment ____________
___________
___________
____________
Gait/balance
Administer
Integumentary Tests
Posture/structural and
tissue Measures
quality
assessment ____________
___________
____________
Gait/balance assessment
Level of painTests
Administer
Posture/structural and Measures
____________
___________
____________
Integumentary
Level of pain
Circulatory tissue quality ____________
of painassessment
Gait/balance
Integumentary assessment
Posture/structural
Level
Gait/balance tissue
assessmentquality
____________
____________
____________
Circulatory
Sensory assessment
Posture/structural
integrity
tissue quality ____________
____________
____________
____________
Circulatory assessment
Gait/balance
Posture/structural assessment
tissue quality ____________
____________
____________
____________
Sensory integrity
Gait/balance
Reflex integrity
Circulatory assessment
____________
Sensory integrity
Integumentary
Gait/balance
Circulatory tissue
assessment
assessment quality ____________
____________
____________
Reflex range
Active
Sensory integrity
Integumentary of tissue
motion
integrity quality ____________
____________
____________
____________
Reflex integrity
Circulatory
Integumentary
Sensory assessment
tissue quality
integrity ____________
____________
____________
Active
Motor
Reflex range
Circulatory of motion
assessment
function/coordination
____________
____________
____________
Active
Sensory range
Circulatory of motion
integrity
assessment
Reflex function/coordination
____________
____________
____________
Motor
Sensory
Joint
Active integrity
integrity
range of motion ____________
____________
____________
____________
Motor
Reflex
Sensory
Active function/coordination
integrity
integrity
____________
____________
____________
Joint
Reflex
Muscle
Motor integrity
integrity
performance
function/coordination ____________
____________
____________
Joint
Reflexintegrity
Active
Motor range of motion
integrity
function/coordination ____________
____________
____________
Muscle
Active
Joint performance
____________
Motorintegrity
Muscle
Active
Joint performance
function/coordination
range
integrity of motion ____________
____________
____________
____________
EVALUATION
Muscle TASKS
Motor function/coordination
performance ____________
____________
Joint integrity
Motor
Muscle function/coordination
performance
EVALUATION ____________
____________
____________
Joint integrityTASKS
EVALUATION ____________
Interpret
Muscle
Joint DataTASKS
from History
performance
integrity ___________
____________
EVALUATION
Muscle
Interpret Data TASKS
performance
from History ____________
___________
Developperformance
Muscle
EVALUATION
Interpret Working
DataTASKS
fromHypothesis
History ___________
____________
___________
Develop
EVALUATION
Plan
Interpret Working
Tests TASKS
andfrom
Data Hypothesis
Measures (i.e., P.E.)
History ___________
___________
___________
Develop
EVALUATION
Interpret Working
Data TASKS
fromHypothesis
History ___________
___________
Plan Tests
EVALUATION
Respond
Develop toand Measures
TASKS
Emerging
Working Data(i.e.,
Hypothesis fromP.E.)
P.E. ___________
___________
Plan Tests
Interpret
Develop andfrom
Data
Working Measures (i.e.,
History
Hypothesis P.E.) ___________
___________
___________
Respond
Interpret
Interpret
Plan Tests to Emerging
Data
Data
and from
from Data
History
Physical
Measures from
Exam
(i.e., P.E.
P.E.) ___________
___________
Respond
Develop
Interpret
Plan Tests to Emerging
Working
Data
and from Data(i.e.,
Hypothesis
History
Measures from P.E.
P.E.) ___________
___________
InterpretWorking
Develop
Correlate
Respond Data from
History
to &
Emerging Physical
Hypothesis
P.E. Exam
Findings
Data from P.E. ___________
___________
___________
___________
Interpret
Plan Tests
Develop
Respond Data
and
Working
to from Physical
Measures
Hypothesis
Emerging Data Exam
(i.e.,
fromP.E.)
P.E. ___________
___________
___________
Correlate
Plan Tests
Identify
Interpret History
and
Cause
Data of
from& P.E.
Measures
ProblemFindings
(i.e.,
Physical P.E.)
Exam ___________
___________
___________
___________
Correlate
Respond
Plan Tests
Interpret History
toand
Data & P.E.
Emerging
Measures
from Findings
Data from
(i.e.,
Physical P.E.
P.E.)
Exam ___________
___________
___________
___________
Identify
Respond
Respond
Correlate Cause
to
to of Problem
Emerging
Emerging
History & Data
Data
P.E. from
from
Findings P.E.
Rx ___________
___________
___________
___________
Identify
InterpretCause
Respond
Correlate Data
to of Problem
from
Emerging
History Physical
Data
& P.E. Exam
from
Findings P.E. ___________
___________
___________
___________
Respond
Interpret
Identify to
CauseEmerging
Data from
of Data
Physical
Problem from
ExamRx ___________
___________
___________
Respond
Correlate to
InterpretCause
Identify Emerging
History
Data from
of & Data
P.E. from
Findings
Physical Exam
Problem Rx ___________
___________
___________
___________
DIAGNOSIS
Correlate
Respond to TASKS
History &
Emerging P.E. Findings
Data from Rx ___________
___________
Identify Cause
Correlate
Respond
DIAGNOSIS to of Problem
History & P.E.
Emerging
TASKS Findings
Data from Rx ___________
___________
Identify Cause
DIAGNOSIS of Problem
TASKS ___________
Establish
RespondCause
Identify Diagnosis
to Emerging Data from Rx
of Problem ___________
___________
___________
DIAGNOSIS
Respond to
Establish TASKS
Emerging Data from Rx
Diagnosis ___________
___________
Determine
Respond
DIAGNOSIS
Establish toIntervention
Emerging Data
TASKS
Diagnosis Approach
from Rx ___________
___________
___________
Determine
DIAGNOSIS
Establish
PROGNOSIS Intervention
TASKS Approach ___________
DetermineDiagnosis
DIAGNOSIS
Establish
TASKS
Intervention
TASKS
Diagnosis Approach ___________
___________
___________
PROGNOSIS
DIAGNOSIS
Determine
Establish TASKS
TASKS
Establish Plan
PROGNOSIS
Determine
Intervention
of Care Approach
TASKS
Diagnosis
Intervention Approach
___________
___________
___________
___________
Establish
Choose
PROGNOSIS Plan of
Diagnosis
Assessment
TASKS CareMeasures ___________
___________
___________
Determine
Establish
PROGNOSIS Plan of
DiagnosisCare
Intervention Approach
TASKS Measures ___________
___________
___________
Choose
Determine
Establish Assessment
Intervention
Plan of Care Approach ___________
___________
___________
Choose
PROGNOSIS
___________
Determine
Establish Assessment
TASKS
Intervention
Plan ofTASKS
CareMeasures
Approach ___________
___________
___________
INTERVENTION
PROGNOSIS
Choose TASKS
Assessment Measures ___________
Establish
_______ INTERVENTION
PROGNOSIS
Choose Plan ofTASKS
TASKS
Assessment CareMeasures ___________
___________
Establish
INTERVENTION
Provide Plan
Patient of Care
TASKS ___________
Choose Assessment
_______ Implement
Establish Plan ofEducation
Care
Therapeutic Measures
Exercise Instruction ___________
___________
INTERVENTION
Choose Assessment
Provide
Implement Patient TASKS Measures
Education
Therapeutic Exercise Instruction ___________
___________
___________
Choose Assessment
INTERVENTION
Provide Functional
Patient TASKS Measures
Training
Education ___________
___________
___________
INTERVENTION
Implement
Provide Patient
ManualTASKS
Functional Training
Education
Therapy Procedures ___________
___________
INTERVENTION
Provide Patient TASKS
Education ___________
INTERVENTION TASKS
_______ Provide Patient Education Procedures
Implement Manual Therapy ___________
___________
Provide Patient
OUTCOMES Education
REVIEW ___________
_______ Provide Patient Education ___________
OUTCOMES REVIEW
_______ Review Patient Satisfaction Outcomes ___________
Review Patient
Activity Satisfaction Outcomes
Limitations Outcomes ___________
Review Activity
Outcomes Limitations
Related toOutcomes
Prevention ___________
Scores
Review Outcomes Related to Prevention ___________
0 = Not Acceptable
1 = Minimal Level of Competence Scores
2 = Superior Level of Competence Scores
0 = Not Acceptable
3 = Exceptional Level of Competence 0 = Minimal
1 Not Acceptable
Level of Competence
1 = Superior
2 Minimal Level
Levelof
ofCompetence
Competence
2 = Exceptional
3 Superior Level of Competence
Level of Competence
88
3 = Exceptional Level of Competence
Appendix-K:
Appendix CLINICAL
K: CLINICAL PERFORMANCE
PERFORMANCE EVALUATION
EVALUATION TOOL TOOL
Name of Intern: ______________________
Evaluation Period: ( ) Date: ____________________
First Corresponding
Name of Observations/Comments/Feedback Practice
Patient Competency(ies)
EXAMINATION
Unsatisfactory Satisfactory Superior
Directions: Place the date (month/day) in the box that reflects behavior observed on Performance Performanc Performanc
that date. e e
1. Examination
a. Obtain a history/perform an interview
(1) Identify the patient’s current level of activity and ability to participate in
desired tasks
89
(2) Identify the area(s) of the patient’s symptoms
(3) Identify the type/nature of the patient’s symptoms
(4) Identify the time behavior of the symptoms.
(5) Identify the level of irritability or severity of the symptoms
(6) Identify the symptom’s aggravating factors
(7) Identify the symptom’s easing factors
(8) Identify other therapeutic interventions employed by the patient - and their
usefulness
b. Examination/Re-examination. Administration of selected specific tests and measures, when

appropriate.
(1) Assess current level of function using a self-report questionnaire
(2) Assess pain levels
(3) Assess postural alignment during static and dynamic activities
(4) Assess gait, locomotion, and/or balance
(5) Assess integumentary and joint tissue quality (e.g., signs of inflammation,
effusion)
(6) Assess circulation (e.g., VBI, PVD)
(7) Assess sensation, proprioception, and reflexes
(8) Assess active range of motion and movement/pain relations
(9) Assess joint passive mobility (range of motion, movement/pain relations)
(10) Assess extremity joint accessory/joint play motions
(11) Assess spinal segmental mobility (mobility and movement/pain relations)
(12) Assess joint integrity (e.g., ligamentous stress tests)
(13) Assess muscle flexibility/muscle length
(14) Assess nerve mobility (range of motion, movement/pain relations)
(15) Assess soft tissue mobility (e.g., fascia, myofascia, nerve entrapment sites)
(16) Assess response of connective tissues (e.g., ligament, bone) to palpatory

provocation.
90
(17) Assess response of muscle tissues (e.g., trigger points) to palpatory
provocation.
(18) Assess muscle power – strength, endurance
(19) Assess muscle power – force/pain relations (e.g., contractile tissue response
to tests)
(20) Assess movement coordination
(21) Assess motor learning
EVALUATION
Directions: Place the date (month/day) in the box that reflects behavior observed on
Performance Performanc Performanc
that date. e e
2. Evaluation
a. Interpret data from history
(1) Identifying relevant, consistent, and accurate data
(2) Prioritize reported functional limitations and activity restrictions
b. Develop working diagnosis (hypothesis)

(1) Develop working diagnosis (hypothesis) for possible contraindications for
physical therapy intervention
(2) Develop working diagnosis (hypothesis) for the stage of condition
(3) Develop working diagnosis (hypothesis) for the anatomical structures

involved with the complaint(s)
(4) Develop working diagnosis (hypothesis) for the probable cause(s) of the
complaint(s)
c. Plan the physical examination/select tests and measures
(1) Select tests and measures that are consistent with the history for verifying or
refuting the working diagnosis
(2) Select tests and measures that are appropriately sequenced for verifying or
refuting the working diagnosis
d. Interpret data from the physical examination
(1) Interpret data from the physical examination – related to the stage of the
condition(s)
91
(2) Interpret data from the physical examination – related to the irritability of the
condition(s)
e. Respond to emerging data from examinations and interventions
(1) Respond to emerging data from examinations and interventions by modifying

the intervention
DIAGNOSIS
3. Diagnosis
a. Based on the evaluation, organize data into recognized clusters, syndromes, or
categories
b. Based on the diagnosis, determine the most appropriate intervention approach
PROGNOSIS
4. Prognosis
a. Choose assessment measures

(1) Choose re-assessment measures to determine initial responses to
intervention
(2) Choose re-assessment measures to determine long-term responses to

intervention
b. Establish plan of care

(1) Establish plan of care, selecting specific interventions based on impairments
(2) Establish plan of care, prioritizing specific interventions based on

impairments
c. Prognosticate regarding function

(1) Predict the optimal level of function that the patient will achieve
INTERVENTION
Directions: Place the date (month/day) in the box that reflects behavior observed on Performance Performanc Performanc
that date. e e
5. Intervention
a. Provide patient education related to the plan of care

(1) Educate patient on his/her diagnosis
(2) Educate patient on his/her treatment
(3) Educate patient onself-management strategies
92
b. Implement therapeutic exercise
(1) Implement therapeutic exercise to improve mobility
(2) Implement therapeutic exercise to improve muscle performance
c. Implement functional training
(1) Implement functional training for injury prevention
(2) Implement functional training using movement cuing
(3) Implement functional training usingendurance training
d. Implement manual therapy procedures
(1) Implement manual therapy procedures – soft tissue mobilization
(2) Implement manual therapy procedures – joint mobilization
(3) Implement manual therapy procedures – joint manipulation
(4) Implement manual therapy procedures – passive range of motion
(5) Implement manual therapy procedures – neuromuscular facilitation
(6) Implement manual therapy procedures – mobilization with movement
e. Apply physical agents
(1) Apply physical agents – to facilitate tissue healing
(2) Apply physical agents – to modulate pain
f. Apply taping or external devices
(1) Apply taping or external devices to prevent tissue injury
(2) Apply taping or external devices to facilitate tissue healing or edema

management
(3) Apply taping or external devices for neuromuscular re-education
Clinical Performance Evaluation Tool - Summary

•
Of the
• __ practice competencies that were observed during this clinical skills performance
evaluation
•
• period, you were Superior or Satisfactory on __ of the areas and Unsatisfactory
on __
• of the areas. Thus, you performed satisfactorily on __ % of the skills observed (__
•
divided
•
• by __ times 100).
•
••
Summary Comments:
•
•
•
•
•
Areas to work on in the upcoming week/months:
Areas
• to work on in the upcoming week/months:
•
Areas to work on in the upcoming week/months:
1. to work on in the upcoming week/months:
Areas
1.
•
1.
•2.
Areas
2.
2.
3.
Areas
2.
3.
Areas
1.
3.
2. 93
Appendix-L:
Appendix L: Patient Patient Demographic
Demographic Data Data
Total number Percent

Name of Resident: of conditions examined and of total body regions
Condition treated number
NERVOUS SYSTEM
Carpal Tunnel Syndrome
Cervical Radiculopathy
Cubital Tunnel Syndrome
Lumbar Radiculopathy
Thoracic Outlet Syndrome
MUSCULOSKELETAL SYSTEM
Chronic Pain Syndromes (eg, fibromyalgia)
Ankle / Foot Fracture
Ankle / Foot Ligamentous Injuries
Ankle / Foot Tendinopathies
Hallux Valgus
Other Disorders of the Lower Leg, Ankle and Foot
Plantar Fasciitis
Elbow / Forearm Fracture
Elbow Instability (eg, subluxation/dislocation,
ligamentous)
Elbow Tendinopathies
Other Disorders of the Elbow and Forearm
Wrist, Hand, Finger Fracture
Wrist, Hand, Finger Instability (eg,
subluxation/dislocation, ligamentous)
Wrist, Hand, Finger Tendinopathies
Other Disorders of the Wrist and/or Hand
Cervical Disc Pathologies (eg, DDD, protrusion,
herniation)
Cervical Instability
Cervical Sprain/Strain
Cervicogenic Headache
Other Disorders of Cervical Spine
Temporomandibular Dysfunction
Femoroacetabular Impingement
Hip Fracture
Hip Osteoarthritis
Hip Tendinopathies
Trochanteric Bursitis
Other Disorders of the Hip and Thigh
Knee Fracture
Knee Ligamentous Injuries
Knee Osteoarthritis
Knee Tendinopathies
Meniscal Pathology
94
Patellofemoral Dysfunction
Other Disorders of the Knee
Lumbar Disc Pathologies (eg, DDD, protrusion,
herniation)
Lumbar Instability
Lumbar Spondylosis / Spondylolisthesis
Lumbar Strain
Other Disorders of the Lumbar Spine
Piriformis Syndrome
Sacroiliac Dysfunction
Other Disorders of the Pelvic Girdle
Rotator Cuff Pathology
Shoulder Adhesive Capsulitis
Shoulder Labral Pathology
Shoulder Complex / Arm Fracture
Shoulder Instability (eg, subluxation/dislocation,
ligamentous)
Shoulder Osteoarthritis
Other Disorders of the Shoulder Complex
Rib Dysfunction
Thoracic Sprain/Strain
Other Disorders of the Thoracic Spine
Other
95
Appendix M: Body Regions Log
Appendix-M: Body Region Log
Name of Resident _____________________________
Date Patient Name Body Region(s) Examined and Body Region Code(s)
or MR# Treated
Body Region Code Body Region Code

Cranio/Mandibular TMJ Arm/Elbow AE
Cervical Spine CS Wrist/Hand WH
Thoracic Spine/Ribs TS Pelvic Girdle/SI/Abd PG
Lumbar Spine LS Hip HP
Shld/Shoulder Girdle SH Thigh/Knee KN
Leg/Ankle/Foot AF
96
Appendix-N:
Appendix CLINICAL
N: CLINICAL FACULTY FORM
FACULTY EVALUATION EVALUATION FORM
Date:______________________ Name of Trainee:________________________
Name of Clinical Faculty: ___________________
The Clinical Faculty Member mentioned above: Consistently Occasionally Infrequently
1. Is able to build rapport with patients ______ ______ ______
2. Is able to identify the needs of the patients. ______ ______ ______
3. Is able to identify my needs as a resident. ______ ______ ______
4. Demonstrates superior clinical reasoning. ______ ______ ______
5. Demonstrates superior treatment skills. ______ ______ ______
6. Is able to provide the cues I need to improve ______ ______ ______

my clinical reasoning and treatment skills.
7. Is on time and fully present during our ______ ______ ______

designated clinical supervising periods.
8. Is considerate and professional when ______ ______ ______

providing feedback to me when the patient is
present.
9. Participates in data collection and publication ______ ______ ______

of clinical research.
10. Has a thorough understanding of the ______ ______ ______

curriculum and performance measures
utilized in this residency.
11. Has a pleasant demeanor and mood. ______ ______ ______
Up to this point, the aspects most valuable to me during our clinical supervision periods are:
I would have a better experience if the following changes could me made:
(Feel free to use space on additional pages when providing feedback)
97
Appendix O: CLASSROOM / LAB PRESENTATION EVALUATION FORM
Appendix-O: CLASSROOM / LAB PRESENTATION EVALUATION FORM
Date: _________________ Name of Instructor: ___________________________________
Topic: ________________________________________________________________________
1. The Instructor mentioned above: Consistently Occasionally Infrequently
2. Began presentation(s) promptly on time. ______ ______ ______
3. Was able to identify the learning needs of the ______ ______ ______
residents.
4. Clearly communicated the objectives on the ______ ______ ______

instruction.
5. Utilized content that was appropriate to the ______ ______ ______

level of instruction and interest to the resident.
6. Has a thorough understanding of the content ______ ______ ______

area of the topic(s) presented.
7. Utilized audiovisuals/explanations that were ______ ______ ______

helpful in describing the key concepts of the
presentation.
8. Is a skilled and effective teacher/educator. ______ ______ ______

______ ______ ______
9. Has a pleasant demeanor and mood.
______ ______ ______
10. Ended presentations at an appropriate time.
______ ______ ______

11. The content of this presentation was
appropriate for the 7-8 hour block of
instruction provided
The aspects of this presentation that were most valuable to me were:
98
Appendix P: PROGRAM EVALUATION FORM
Appendix-P:
Appendix PROGRAM
P: PROGRAM EVALUATION
EVALUATION FORM FORM
Date: Module: Name of Trainee:
Date: Module: Name of Trainee:
Up to this point in the Residency program, with Dissatisfied Satisfied Highly

Up to regard to the
this point following
in the points,
Residency I am with
program, Dissatisfied Satisfied SH
atigishfileyd
regard to the following points, I am Satisfied
1. with the extent and breadth of clinical practice ______ ______ ______
1. opportunities
with the extent and breadth of clinical practice ______ ______ ______
opportunities
2. with the quality and content of classroom/lab ______ ______ ______
2. instruction
with the quality and content of classroom/lab ______ ______ ______
instruction
3. with the 1:1 clinical supervision while treating ______ ______ ______
3. patients
with the 1:1 clinical supervision while treating ______ ______ ______
patients
4. with the performance evaluations (daily ______ ______ ______
4. feedback, procedure check-off
with the performance lists,
evaluations clinical
(daily ______ ______ ______
performance evaluation)
feedback, procedure check-off lists, clinical
performance evaluation)
5. with the administrative aspects of the program ______ ______ ______
5. (i.e.,
with scheduling, administrative
the administrative aspects supervision,
of the program ______ ______ ______
clerical support)
(i.e., scheduling, administrative supervision,
clerical support)
6. with the opportunities and resources for ______ ______ ______
6. mentoring students and resources for
with the opportunities ______ ______ ______
mentoring students
7. with the opportunities and resources for ______ ______ ______
7. improving cultural competence
with the opportunities and resources for ______ ______ ______
improving cultural competence
Please provide any feedback you have regarding the above issues.
Please provide any feedback you have regarding the above issues.
Up to this point, the most valuable aspects of this program for me are:
Up to this point, the most valuable aspects of this program for me are:

99
Appendix-Q
Appendix-Q
Glossary
Glossary
Description correlating educational objectives with
assessment contents. For example, test blueprint

Blueprint
defines the proportion of test questions allocated
to each learning domain and/or content.
Capability to function within a defined professional
role that implies entrustment of a resident by
Competency graduation of the program with the required
knowledge, skills, and attitude needed to practice
unsupervised.
A specific knowledge or skill or professional

Specialty Core Content (skills, knowledge,
attitude that is specific and integral to the given
and professional attitude)
specialty.
An assessment that is used to inform the trainer
and learner of what has been taught and learned,
respectively, for the purpose of improving
learning. Typically, the results of formative

Formative assessment
assessment are communicated through feedback
to the learner. Formative assessments are not
intended primarily to make judgments or
decisions (though it can be as a secondary gain).
Exceeding the minimum level of competency to
the proficient level of performance indicating rich

Mastery
experience with possession of great knowledge,
skills, and attitude.
100
nt tools
hat are
approved
by the
cientific
council/co
mmittee
A collection of evidence of progression towards
of the
program. competency. It may include both constructed
Formative
assessme components (defined by mandatory continuous
nt tools Portfolio
hould be assessment tools in curriculum) and
outlined
based on unconstructed components (selected by the
he
learner).
earning
domain An assessment that describes the composite
knowledg
e, skills, performance of the development of a learner at a
and
attitude). Summative assessment particular point in time and is used to inform
Under
each tool judgment and make decisions about the level of
describe
elevant learning and certification.
nformati
A knowledge, skills, or professional behavior that
on: aim,
expectatio is not specific to the given specialty but universal
n, and Universal Topic
requency. for the general practice of a given healthcare
.etc.
Make sure profession.
hat the
marking
of each
ool is
clear and
s based
on the
ecomme
ndations
outlined
n the
executive
policy (no
ndividual
weight for
each tool,
esident
hould
atisfacto
ily pass
each tool;
comprehe
nsive
assessme
nt can be
applied
or
borderline
ailure:
efer to
policy).
t is
ecomme
nded to
101

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Saudi Board

Curriculum Development Committee

• Dr. Edan Alzahrani

Reviewed and Approved by Specialty’s Scientific

• Dr. Edan Alzahrani

Curriculum Review Committee Members

• Dr. Sakra Balhareth, Pharm.D., BCPS, BCACP

Approved by Head of Curriculum Review Committee

• Dr.Ali Dr.Ali Alassiri, MBBS, Msc.MedEd. FRCSC, FACS

practice, research and academic study. Therefore, specialization in a selected area is

of knowledge development and academia. Such specialization can be achieved through

skills are required to be practiced at a higher level in today’s musculoskeletal

rehabilitation settings. Postgraduate clinical training programs accelerate a clinician’s skill

development. The number of these programs is continuing to grow worldwide. However, in

profession. Lacking a Physical Therapy advanced and specialized clinical training

programs might deprive the local healthcare-seeking community from receiving an

a challenge when trying to secure experienced clinical instructors to provide high-level

programs might deprive the local healthcare-seeking community from receiving an

a challenge when trying to secure experienced clinical instructors to provide high-level

PT program is comprised of two parts:

remaining year of the program. It focuses on musculoskeletal impairments of the spine

and extremities. Eligibility to advance to Senior level is based on successful completion of

To become a preeminent clinical physical therapy program recognized for

groundbreaking leadership in musculoskeletal clinical practice, education and mentorship.

To expand the availability of guidelines-based clinical practice of musculoskeletal

1. To integrate skill improvement in the areas of clinical reasoning with improvements in

the application of manual therapy, therapeutic exercises, neuromuscular reeducation,

and patient education.

musculoskeletal disorders generally and spinal impairments specifically.

take over the training functions in the physical therapy departments.

rehabilitation outside the KSA.

stakeholders involved in postgraduate training. As an “adult-learner” residents have to

objectives, self-directed learning, openness to reflective feedback and formative

significant impact on the program implementation. Residents should be enabled to share

standards in postgraduate physical therapy clinical education.

5.2. Policies and Procedures

different training center. training center. center.

Rotation name Duration Rotation name Duration Duration

Year 1 • Musculoskeletal Physical 3 months Resident enrolls to only 2

Year 2 • Musculoskeletal Physical 3 months

Year 3 • Musculoskeletal Physical 3 months

scientific council/committee, and the resident is required to do some of them.

7.3 Introduction to Learning Outcomes and Competency-Based Education

expected demands of the healthcare system in relation to their particular specialty.

Competency-based education (CBE) is an approach of “adult-learning” that is based on

from complex professional competencies.

Professional competencies related to healthcare are usually complex and entertain a

Furthermore, CBE emphasizes the critical role of informed judgment of learner’s

for postgraduate education in healthcare (example: CanMEDs by the Royal College of

Physician and Surgeon of Canada (RCPSC), the CBME-Competency model by the

Accreditation Council for Graduate Medical Education (ACGME), tomorrow’s doctor in UK

• Competency: Competency is a cognitive construct assessing the potential to perform

efficiently in a given situation based on the standard of the profession. Professional

roles (e.g. expert, advocate, communicator, leader, scholar, collaborator, and

professional) are used to define competency-role in order to make it mendable for

learning and assessment.

throughout senior levels, will be assisted to transform from being (novice/supervised)

into (master/unsupervised) practitioners. This should not undermine the role of

supervisory/regulatory bodies toward malpractice of independent practitioners.

Milestones is expected to enhance learning process by pacing the training/assessment

to match the developmental level of residents (junior vs. senior).

• Learning-Domains: Whenever possible, efforts should be directed to annotate the

learning outcomes with the corresponding domain (K=Knowledge, S=Skills, and