Guideline Standards Practice Complete PDF
Guideline Standards Practice Complete PDF
Guideline Standards Practice Complete PDF
standards of physical
therapy practice
WCPT guideline for standards of physical therapy practice
Contents
Section 1: Introduction ......................................................................................................................... 3
1.1 Purpose.................................................................................................................................... 3
1.2 Target audience ....................................................................................................................... 3
1.3 Application ............................................................................................................................... 4
Section 2: Guideline.............................................................................................................................. 4
2.1 Administration and practice management ............................................................................... 4
2.1.1 Administration ....................................................................................................................... 4
2.1.2 Collaboration ......................................................................................................................... 5
2.1.3 Communication ..................................................................................................................... 5
2.1.4 Fiscal management ............................................................................................................... 6
2.1.5 Mission, purposes and goals ................................................................................................ 6
2.1.6 Organisational plan ............................................................................................................... 6
2.1.7 Physical setting ..................................................................................................................... 7
2.1.8 Equipment ............................................................................................................................. 7
2.1.9 Policies and procedures ........................................................................................................ 7
2.1.10 Referral ................................................................................................................................. 8
2.1.11 Staff ....................................................................................................................................... 8
2.1.12 Staff development ................................................................................................................. 8
2.2 Communication ........................................................................................................................ 9
2.3 Community responsibility ......................................................................................................... 9
2.4 Cultural competence .............................................................................................................. 10
2.5 Documentation ....................................................................................................................... 10
2.6 Education ............................................................................................................................... 10
2.7 Ethical behaviour ................................................................................................................... 11
2.8 Informed consent ................................................................................................................... 11
2.9 Legal ...................................................................................................................................... 12
2.10 Patient/client management .................................................................................................... 12
2.10.1 Initial examination/assessment, evaluation, diagnosis, and prognosis/plan of care .......... 12
2.10.2 Interventions/treatments ..................................................................................................... 12
2.10.3 Interventions/treatments provided by physical therapist support personnel ....................... 13
2.10.4 Re-examination ................................................................................................................... 13
2.10.5 Discharge/discontinuation of intervention/treatment ........................................................... 14
2.10.6 Patient/client collaboration .................................................................................................. 14
2.10.7 Referral ............................................................................................................................... 14
2.11 Personal/professional development ...................................................................................... 14
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2.12 Quality assurance .................................................................................................................. 15
2.13 Research................................................................................................................................ 15
2.14 Physical therapist support personnel (where applicable) ...................................................... 16
Glossary ........................................................................................................................................... 16
Resource documents ...................................................................................................................... 17
References ....................................................................................................................................... 17
WCPT guidelines are produced to assist member organisations and others to raise the quality of physical
therapy. They may provide guidance on standards criteria or courses of action in areas relevant to physical
therapy education research practice or policy. They are not mandatory but designed to assist the implementation
of WCPT’s policies.
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WCPT guideline for standards of physical therapy practice
Section 1: Introduction
1.1 Purpose
This guideline for standards of physical therapy practice provides details on the statement of
performance and conditions to which WCPT expects physical therapists to aspire, in order to provide
high quality physical therapy professional services to society. These standards provide the foundation
for the assessment of physical therapy practice. They represent the physical therapy profession’s
commitment to society to promote optimal health and function in individuals and populations by
pursuing excellence in practice. These standards provide the basis for physical therapy practice in all
settings, including but not limited to: clinics, hospitals, schools and commercial premises.
Detail is provided on standards covering: administration and practice management, communication,
community responsibility, cultural competence, documentation, education, ethical behaviour, informed
consent, legal, patient/client management, personal/professional development, quality assurance,
research and support personnel.
The guideline has been informed by and is for use in conjunction with WCPT policy statements, such
as the standards of physical therapist practice and description of physical therapy.1-2 Other policies
and guidelines intended to assist in the delivery of the standards of practice policy include:
Policy statement: Education.3
WCPT guideline for the standard evaluation process for accreditation/recognition of physical
therapist professional entry level education programmes.6
1.2 Target audience
The standards have been developed with input from and specific reference to the member
organisations (MOs) of WCPT. They are intended for use by:
WCPT member organisations
potential WCPT member organisations
physical therapy educators
health and education authorities
monitoring and regulatory bodies
government policy makers
by physical therapists in countries where a WCPT member organisation does not currently
exist
others, including patients/clients who have an interest high standards of physical therapist
practice
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1.3 Application
The standards provided in this guideline are considered to be achievable standards of practice. They
are presented as ideal standards to which all physical therapists should aspire as part of their
professional responsibility. At the same time, it is recognised that some interpretation will be required
based on the setting, resources and support systems available. It is acknowledged that individual
MOs of WCPT may have their own more detailed standards of practice, and these are not intended to
replace them.
The standards set out in this guideline apply to all physical therapists, whether newly qualified or
highly specialised, in direct or indirect contact with patients/clients, carers, and other professional
colleagues. Physical therapy practice is more than direct patient/client contact; it includes how
services are structured, managed and delivered. These standards reflect this. As highlighted in
section 2.1.2, collaboration is essential to delivering high quality physical therapy services. Some of
these standards cannot be achieved without collaboration with appropriate colleagues from other
professions and health service managers.
This guideline and any resulting standards of practice documents are tools that may be used by
physical therapists, patients/clients, members of the public, managers, and others who have an
interest in providing or receiving high quality physical therapy services.
Section 2: Guideline
2.1 Administration and practice management
2.1.1 Administration
2.1.1.1 A physical therapist is responsible for the direction of the physical therapy service.
2.1.1.2 The physical therapist who is responsible for the direction of the physical therapy
service shall:
ensure compliance with statutory (eg local, state, regional, federal, provincial,
institutional and national) requirements
provide for training of physical therapy support personnel that ensures continued
competence for their job description
provide for continuous in-service training on safety issues and for periodic safety
inspection of equipment by qualified individuals
undertake an evaluation of clinical practice, ensuring that:
□ confidentiality is maintained throughout evaluation and audit activities
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□ where it is undertaken, physical therapists participate in multi-professional
audit
2.1.2 Collaboration
2.1.2.1 The physical therapy service collaborates with all professionals as appropriate.
2.1.2.2 The physical therapist shall be aware of the qualifications and roles of other
professionals involved in comprehensive patient/client care/management and
practices in collaboration with them to provide quality patient/client services.
2.1.2.3 The collaboration when appropriate:
uses a team approach to the management of patients/clients
provides instruction to patients/clients and families
ensures professional development and continuing education
2.1.2.4 When physical therapists are members of a multi-professional team providing
services for the patient/client, they will ensure that:
relevant information is sought and communicated promptly and clearly within the
team
a system is in place for written communication with other members of the team
operational policies exist for cross referral to other professionals in the team,
discharge, and transfer of patients/clients
evidence exists of participation in case conferences, rounds, individual
patient/client programme meetings, discharge planning, and collaborative
patient/client records
the physical therapy goals comply with the team goals
2.1.3 Communication
2.1.3.1 Communication links exist between staff, the director/manager of the service, and the
organisation to optimise the quality of the patient/client services provided.
2.1.3.2 The physical therapy director/manager ensures the appropriate communication and
availability of service specific and organisational policies, procedures and documents
including:
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a job/position description for each staff member and a formal appraisal system
annual report
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2.1.7 Physical setting
2.1.7.1 The physical setting is designed to provide a safe and accessible environment that
facilitates fulfilment of the mission, purposes and goals of the physical therapy
service. The equipment is safe and sufficient to achieve the purposes and goals of
physical therapy.
2.1.7.2 The physical setting is planned, constructed and equipped to provide adequate space
and the proper environment to meet the professional, educational, and administrative
needs of the service with safety and efficiency.
2.1.7.3 The physical setting shall:
meet all applicable legal requirements for health and safety
have fire exits that are clearly marked and kept free of obstruction
meet space needs appropriate for the number and type of patients/clients served
provide reception and waiting facilities with consideration to people with
disabilities
provide treatment areas that offer privacy, security and comfort
2.1.8 Equipment
2.1.8.1 The equipment meets all applicable legal requirements for health and safety and
accessibility.
2.1.8.2 The equipment is inspected and maintained routinely.
□ clinical education
□ clinical research
□ collaboration
□ competency assessment
□ continuing education/professional development
□ criteria for access to care
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□ criteria for termination of care
□ disaster plan
□ documentation
□ emergency plans (to include patient/client and facility)
□ equipment maintenance, including urgent repair and replacement
□ fiscal management
□ improvement of quality of care and performance of services
□ infection control
□ job/position descriptions
□ patient/client and environmental safety and health issues
□ patient/client management, including guidelines
□ personnel
□ rights of patients/clients
□ staff orientation
□ transfer of patients
2.1.10 Referral
2.1.10.1 A referral system is in place to ensure that patients/clients can access a physical
therapist either by direct access or from an appropriate referral source.
2.1.11 Staff
2.1.11.1 The physical therapy personnel affiliated with the physical therapy service have
demonstrated competence and are sufficient in number to achieve the mission,
purposes and goals of the service.
2.1.11.2 The physical therapy service has staff that:
meet all legal requirements regarding licensure, registration and certification of
appropriate personnel
ensure that the level of expertise within the service is appropriate to the needs
of the patients/clients served
2.1.11.3 Staff members are aware of their responsibilities as employees under any
appropriate Health and Safety Acts and attend training sessions as necessary.
2.1.11.4 Staff members participate in the quality assurance programme, and information from
quality assurance activities is accessible to all staff.
2.1.12 Staff development
2.1.12.1 The physical therapy service has a written plan that provides for appropriate and
ongoing staff development.
2.1.12.2 The staff development plan:
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includes strategies for lifelong learning and professional and career
development
includes mechanisms to foster mentorship activities
2.2 Communication
2.2.1 The physical therapist knows that communication is an integral element of every
patient/client and professional encounter and facilitates the provision of effective and
appropriate physical therapy services.
2.2.2 The physical therapist communicates and coordinates all aspects of patient/client
management including the results of the initial examination/assessment and
evaluation, diagnosis, prognosis/plan of care, intervention/treatment, response to
interventions/treatment, changes in patient/client status relative to the
interventions/treatments, re-examination and discharge/discontinuation of
intervention/treatment and other patient/client management activities.
2.2.3 The physical therapist provides the patient/client or parents, guardians, carers or
others designed to act on the behalf of the patient/client who is not competent with
relevant clear, concise written and verbal information ensuring that:
the role of the physical therapist is explained during the initial contact
the discretion of the physical therapist is used in the discussion of the diagnosis
with the patient/client
treatment plans, goals and expected outcomes are agreed upon between the
patient/client and the physical therapist and any changes in previously agreed
intervention/treatment plans are discussed and agreed upon with the
patient/client
2.2.4 The physical therapist, when communicating with appropriate carers, respects the
wishes of both the patients/clients and carers.
2.2.5 The physical therapist communicates with other physical therapists to ensure
continuity of effective patient/client services and facilitates the use of available clinical
expertise.
2.2.6 The physical therapist, when communicating with members of a multi-professional
team providing services for the patient/client, ensures that information is both sought
and communicated promptly and clearly within the team, and a system exists for
written communication with other members of the team.
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2.4 Cultural competence
2.4.1 The physical therapist acquires skills to better understand people from differing
cultures in order to achieve the best possible health outcomes.
2.4.2 Physical therapists show respect and sensitivity to people and communities, taking
into account their spiritual, emotional, social and physical needs.
2.4.3 Physical therapy is planned and delivered in a way that respects cultural values,
requirements and variations.
2.4.4 Physical therapists should identify their own cultural realities, knowledge and
limitations.
2.4.5 The cultural values of the physical therapist are acknowledged and respected.
2.5 Documentation
2.5.1 The physical therapist clearly documents all aspects of the patient/client management
including the results of the initial examination/assessment and evaluation, diagnosis,
prognosis/plan of care, intervention/treatment, response to interventions/treatment,
changes in patient/client status relative to the interventions/treatment, re-examination
and discharge/discontinuation of intervention, and other patient/client management
activities.7-8
2.5.2 Physical therapists ensure that the content of documentation:
is accurate, complete, legible and finalised in a timely manner
is dated and appropriately authenticated by the physical therapist
records equipment loaned and/or issued to the patient/client
includes, when a patient/client is discharged prior to achievement of goals and
outcomes, the status of the patient/client and the rationale for discontinuation
includes reference to appropriate outcome measures, where possible
2.5.3 Physical therapists make sure that documentation is used properly by ensuring it is:
stored securely at all times in accordance with legal requirements for privacy and
confidentiality of personal health information
only released, when appropriate, with the patient’s/client’s permission
2.6 Education
2.6.1 The physical therapist contributes to the education of health professionals.
2.6.2 The physical therapist participates in the education of students by supervision.
2.6.3 The physical therapist educates and provides consultation to other health
professionals regarding the purposes and benefits of physical therapy.
2.6.4 The physical therapist contributes to the education of the public.
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2.6.5 The physical therapist educates and provides consultation to consumers, the general
public, community organisations, clubs and associations regarding the purposes and
benefits of physical therapy, the roles of the physical therapist and the roles of other
support personnel.
Informed consent
2.8.1 The physical therapist shall inform the patient/client verbally, and where required, in
writing of the nature, expected duration and cost of intervention/treatment prior to the
performance of such activities.
2.8.2 The physical therapist shall document in the clinical notes when consent is received,
implied or expressed. Once consent has been received, the intervention/treatment
plan may be instituted.
2.8.3 Patients/clients, wherever possible, are given information as to the physical therapy
interventions/treatments proposed, so that the patient/client is:
aware of the findings of the examination/assessment
given an opportunity to ask questions and discuss with the physical therapist the
preferred interventions/treatments, including any significant side effects.
given the opportunity to decline particular modalities in the plan of
intervention/treatment
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2.8.6 The physical therapist obtains written consent of the patient/client for participation in
teaching of physical therapy and in physical therapy research.
2.8.7 The procedure for informed consent must comply with local legislation.
Legal
2.9.1 The physical therapist complies with all the laws and legal requirements of the
jurisdiction in which they practice and the body which regulates the practice of
physical therapy.11-12
2.9.2 The physical therapist possesses a license to practice that is granted for the
legislative jurisdiction in which the physical therapist practices.
2.9.3 The physical therapist shall not release patient information to a third party without
consent of the patient/client or legal authorisation.
2.9.4 The physical therapist with first-hand knowledge shall report violations by physical
therapy personnel of laws and legal requirements of the jurisdiction.
2.10.2 Interventions/treatments
2.10.2.1 The physical therapist determines the interventions/treatments and manages the
needs of the patient/client based on the examination, evaluation, diagnosis,
prognosis/plan, anticipated goals and expected outcomes of the planned
interventions/treatments for identified impairments, activity limitations and
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participation restrictions and/or for prevention, health promotion, fitness, and
wellness.
2.10.2.2 The physical therapist collaboratively involves the patient/client and others as
appropriate in the planning, implementation, and assessment of the
intervention/treatment.
2.10.2.3 The physical therapist, in consultation with appropriate disciplines, plans for
discharge of the patient/client taking into consideration achievement of anticipated
goals and expected outcomes and provides for appropriate follow-up or referral.
2.10.3.1 The physical therapist provides or directs and supervises the physical therapy
intervention/treatment consistent with the results of the examination, evaluation,
diagnosis, prognosis, and plan of care/intervention/treatment.13
2.10.4 Re-examination
2.10.4.1 The physical therapist re-examines the patient/client as necessary during an
episode to evaluate progress or change in patient/client status and modifies the plan
accordingly or discontinues physical therapy services.
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2.10.4.2 The physical therapist re-examination:
is documented, dated, and appropriately authenticated by the physical therapist
who performs it
includes modifications to the intervention/treatment or referral to other
practitioner/professional
2.10.6.1 Within the patient/client management process, the physical therapist and the
patient/client establish and maintain an ongoing collaborative process of decision-
making that exists throughout the provision of services.
2.10.7 Referral
2.10.7.1 Where the examination, diagnostic process, or any change in status reveals findings
outside the scope of knowledge, experience, and/or expertise of the physical
therapist, the patient/client shall so be informed and referred to the appropriate
practitioner/professional.
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2.11.3 The physical therapist continues to update and extend their knowledge and skills
through a variety of learning opportunities and keeps up to date with developments
in research and evidence based practice.14-15
2.11.4 The physical therapist is an active participant of an appropriate peer review
appraisal system in their practice environment.
2.11.5 The physical therapist complies with regulatory requirements in their country, where
they exist.
Quality assurance
2.11.6 The physical therapy service has a written plan for continuous improvement of
quality of care and performance of services.16
2.11.7 The physical therapist shall demonstrate commitment to quality assurance by peer
review and self-assessment.
2.11.8 The improvement plan:
provides evidence of ongoing review and evaluation of the physical therapy
service
provides a mechanism for documenting improvement in quality of services and
performance
is consistent with requirements of external agencies, as applicable
includes specification of contracts with purchasers
2.12.4 Quality assurance activities focus on service user satisfaction by ensuring that:
a system is in place for monitoring service user satisfaction
service users are invited to make suggestions about services provided
a complaints procedure exists including a system for response
Research
2.11.9 The physical therapist applies research findings to practice and encourages,
participates in and promotes activities that establish the outcomes of patient/client
management provided by the physical therapist.14-15
2.11.10 The physical therapist shall advance the science of physical therapy by conducting
and/or supporting research activities or by assisting those engaged in research.
2.11.11 The physical therapist:
ensures that their knowledge of the research literature related to practice is
current
ensures that the rights of research subjects are protected, and the integrity of
research is maintained
participates in the research process as appropriate with the physical therapist’s
education, experience and expertise
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general public about the outcomes of physical therapist practice
2.11.12 The physical therapist recognises research as an integral part in the continuing
growth and development of the profession.
2.11.13 The physical therapist conducting a research project has sufficient knowledge of
research principles and methodology and adheres to international standards for
performing research on human subjects.
2.11.15 Support personnel must at all times be under the direction and supervision of the
physical therapist when implementing direct interventions/treatment. This should
reflect WCPT’s position statement on physical therapist support personnel.
2.11.16 The physical therapist should not delegate any activity that requires the unique skill,
knowledge and judgment of the physical therapist.
Glossary
Clients — are: a) individuals who are not necessarily sick or injured but who can benefit from a
physical therapist’s consultation, professional advice, or services, or b) businesses, schools systems,
and others to whom physical therapists offer services. See also patients.17
Informed consent — is a decision to participate in assessment, treatment or research, taken by a
competent individual who has received the necessary information; who has adequately understood
the information; and who, after considering the information, has arrived at a decision without having
been subjected to coercion, undue influence or inducement, or intimidation. Informed consent is
based on the principle that competent individuals are entitled to choose freely whether to participate in
assessment, treatment or research. Informed consent protects the individual's freedom of choice and
respects the individual's autonomy.18 In order to obtain the valid consent of patients for assessment,
treatment or participation in research, they must be informed of all potential and significant risks,
benefits and likely outcomes of treatment, taking into account their age, emotional state and cognitive
ability, to allow valid/informed consent to be given.19-20
Patients — are individuals who are the recipients of physical therapy and direct interventions.
Individuals who are recipients of physical therapy may also be referred to as clients.17
Referral procedures — the process by which patients/clients are referred between physiotherapists
and other health professionals and persons/agencies involved with the patient/client. These may differ
from country to country and are determined by national legislation, national authorities and the
professional organisation.21
Support personnel — a generic term to encompass a range of employment classifications such as
physical therapy assistant, aide, technician or helper; rehabilitation assistant and classroom therapy
assistant. Support personnel will function only in a properly conducted physical therapy service under
the direction and supervision of a physical therapist when implementing direct care programmes.13
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Resource documents
American Physical Therapy Association (2003) Standards of Practice for Physical Therapy APTA,
Alexandria, USA.
European Region of WCPT (2002) European Core Standards of Physiotherapy Practice. ER-WCPT,
Brussels, Belgium.
New Zealand Society of Physiotherapists (2006) Standards of Physiotherapy Practice. New Zealand
Society of Physiotherapists, Wellington, New Zealand.
References
1. World Confederation for Physical Therapy. Policy statement: Standards of physical therapist practice.
London, UK: WCPT; 2011. www.wcpt.org/policy/ps-standards (Access date 22nd September 2011)
2. World Confederation for Physical Therapy. Policy statement: Description of physical therapy. London, UK:
WCPT; 2011. www.wcpt.org/policy/ps-descriptionPT (Access date 22nd September 2011)
3. World Confederation for Physical Therapy. Policy statement: Education. London, UK: WCPT; 2011.
www.wcpt.org/policy/ps-education (Access date 23rd September 2011)
4. World Confederation for Physical Therapy. WCPT guideline for physical therapist professional entry level
education. London, UK: WCPT; 2011. www.wcpt.org/guidelines/entry-level-education (Access date 22nd
September 2011)
5. World Confederation for Physical Therapy. WCPT guideline for the clinical education component of the
physical therapist professional entry-level programme. London, UK: WCPT; 2011.
www.wcpt.org/guidelines/clinical-education (Access date 22nd September 2011)
6. World Confederation for Physical Therapy. WCPT guideline for a standard evaluation process for
accreditation/recognition of physical therapist professional entry level education programmes. London, UK:
WCPT; 2011. www.wcpt.org/guidelines/accreditation (Access date 22nd September 2011)
7. World Confederation for Physical Therapy. Policy statement: Records management: record keeping,
storage, retrieval and disposal. London, UK: WCPT; 2011. www.wcpt.org/policy/ps-records-management
(Access date 22nd September 2011)
8. World Confederation for Physical Therapy. WCPT guideline for records management: record keeping,
storage, retrieval and disposal. London, UK: WCPT; 2011. www.wcpt.org/guidelines/records-management
(Access date 22nd September 2011)
9. World Confederation for Physical Therapy. Ethical Principles. London, UK: WCPT; 2011.
www.wcpt.org/ethical-principles (Access date 22nd September 2011)
10. World Confederation for Physical Therapy. Policy statement: Ethical responsibilities of physical therapists
and WCPT members. London, UK: WCPT; 2011. www.wcpt.org/policy/ps-ethical-responsibilities (Access
date 22nd September 2011)
11. World Confederation for Physical Therapy. Policy statement: Regulation of the physical therapy profession.
London, UK: WCPT; 2011. www.wcpt.org/policy/ps-regulation (Access date 22nd September 2011)
12. World Confederation for Physical Therapy. WCPT guideline for the development of a system of
legislation/regulation/recognition. London, UK: WCPT; 2011. www.wcpt.org/guidelines/regulation-legislation
(Access date 22nd September 2011)
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13. World Confederation for Physical Therapy. Policy statement: Support personnel for physical therapy
practice. London, UK: WCPT; 2011. www.wcpt.org/policy/ps-support-personnel (Access date 22nd
September 2011)
14. World Confederation for Physical Therapy. Policy statement: Evidence based practice. London, UK: WCPT;
2011. www.wcpt.org/policy/ps-EBP (Access date 23rd September 2011)
15. World Confederation for Physical Therapy. Policy statement: Research. London, UK: WCPT; 2011.
www.wcpt.org/policy/ps-research (Access date 22nd September 2011)
16. World Confederation for Physical Therapy. Policy statement: Quality services. London, UK: WCPT; 2011.
www.wcpt.org/policy/ps-quality (Access date 22nd September 2011)
17. American Physical Therapy Association. Normative Model of Physical Therapist Professional Education.
Washington DC, USA: APTA; 2004.
www.apta.org/AM/TemplateRedirect.cfm?template=/CM/ContentDisplay.cfm&ContentID=41493
(Access date 22nd March 2010)
18. Council of International Organizations of Medical Science. Ethical Guidelines for Biomedical Research
Involving Human Subjects. London, UK: CIOMS; 2008.
http://www.cioms.ch/frame_guidelines_nov_2002.htm (Access date 23rd March 2010)
19. European Region of World Confederation for Physical Therapy. European Core Standards of Physiotherapy
Practice. Brussels, Belgium: ER-WCPT; 2008. http://www.physio-
europe.org/download.php?document=71&downloadarea=6 (Access date 22nd March 2010)
20. Chartered Society of Physiotherapy. Core standards of physiotherapy practice. London, UK: CSP; 2008.
http://www.csp.org.uk (Access date 22nd March 2010)
21. European Region World Confederation for Physical Therapy. European Region World Confederation for
Physical Therapy Glossary of Terms. Brussels, Belgium: ER-WCPT; 2010.
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Publication, review and related policy information
Date published: Originally adopted as a WCPT Position Statement at the 16th WCPT
General Meeting June 2007.
Revised and published as a WCPT guideline at the 17th WCPT General
Meeting June 2011.
WCPT guideline:
Guideline for records management: record keeping, storage, retrieval
and disposal
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