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A subgroup of World Confederation for Physical Therapy

December 2006


Dear Member Organisation, Registered Interest Group Delegates and Special Friends

I trust all is well for you in the lead up to the festive season, and I do hope you get to have a few days break (if not longer) to spend with family and friends.

Welcome to Inge Ris Hansen, new delegate for Denmark and Laura Finucane, delegate for the United Kingdom. I would like to say a big 'thank you' to Per Kjaer and Linda Crocker for their great work as delegates over the past few years.

Update from the Standards Committee From Dr Alison Rushton

A big hello from the Standards Committee (SC) who have just returned from a very successful first face to face meeting in Charlotte, North Carolina, USA.

In a series of very productive meetings we have the following news to report:

  • Effective and efficient working of the Standards Committee and its interface with the Executive Committee was explored.

  • A review of the existing RIGs and their current activity was discussed through the mentorship of each RIG by a member of the SC.

  • A large component of the meetings was the 6-year review of the Standards Document part A (2000). The feedback from the MOs to the questionnaire was invaluable to assist this complicated process of review for a document that has different values and uses for MOs. A decision was made to update the document for voting on the acceptance of the updated version in Rotterdam in 2008. The following points reflect the key components of our discussions:

    • Hours of instruction and supervision are an important issue for some MOs politically. A further breakdown of hours would also be valuable for some MOs.

    • Research is an important activity that should continue to be encouraged by IFOMT.

    • Some MOs appreciate a more structured document, whereas others would like to see more flexibility.

    • The document needs to be updated to reflect development in manipulative physical therapy over the past 6-years e.g. new IFOMT definition of OMT.

    • Overall, most MOs felt that this was a well-written and comprehensive document and helpful from an organizational as well as political point of view.

    • Some MOs are moving towards more competency based educational mechanisms and are concerned that the present document is out of step with present educational philosophies regarding this approach.

    • The balance between theory and practice needs to be communicated.

    • Concepts of evidence informed practice / best practice need to be emphasised as the basis for practice.

    • Not all educational programmes in MOs are integrated into Universities.

    • Clinical reasoning needs to be strengthened in the document.

    • Higher order skills need to be emphasised. The level of descriptors for the learning outcomes / objectives need to be developed further to reflect an advanced level of practice.

    • Educational language needs to be used carefully to avoid jargon and confusion of terminology.

    • The format of the patient examination needs to be explicit.

    • There needs to be an explanation of the format of the document at the beginning, and clear signposting throughout.

    • Fiscal responsibility in decision making needs to be emphasised.

    • Sensitivity to environment needs to be emphasised, for example, the medicolegal professional context / benefit cost analysis etc.

    • Cultural sensitivity needs to be emphasised.

    • Communication skills need to be emphasised.

    • Principles of managing the returning patient need to be explicit, for example re evaluation and progression.

    • An outcome linked to an understanding of a range of outcome measures with their appropriate use in practice needs to be included.

    • Evidence based multimodal care needs to be emphasised.

  • A decision was made to move to a document that embraces and encourages the development of Competency Based Education. The SC will agree on a new structure and format of the Standards Document to circulate to the MOs for comment prior to the Vancouver 2007 meeting. This will enable planning for the complete document in Vancouver along with division of workload and plans for further comment by MOs prior to Rotterdam 2008.

  • The feedback from the questionnaire regarding reciprocal recognition (RR) between MOs was discussed at length. It was agreed that:

    • There appears to be general support for RR.

    • RR should be at the discretion of individual MOs at present.

    • RR can be encouraged by IFOMT, but not required by IFOMT.

    • RR is inherently associated with the Standards Document

  • Much discussion centred on the implementation of the International Monitoring process with the following agreed points:

    • Essentially, the international monitoring process examines the MO's own monitoring process, and delineates the development of such a monitoring process if not presently in place.

    • An external assessor may not necessarily be required to do a site visit, other means of communication and assessment could be used including but not restricted to teleconferences and telephone interviews. It may be necessary for an external assessor to visually observe practical examinations, or review of videotaped assessments, or interviewing students (in person or through telephone interview).

    • The MO need not do a major re-assessment every year, but yearly review of self-monitoring processes should occur through re-visiting of its working documents.

    • The International Monitoring document is a first draft and is a working document, As such it will be constantly evolving, and the first few years will probably necessitate revision after experience monitoring the first MOs.

    • A statement regarding the constitution of the Standards Committee and its commitment to fairness will be produced for information.

    • A Standards Committee member must not be involved with monitoring his/her own MO. All Standards Committee members can contribute to the discussion of process issues.

    • The spirit of the monitoring process should express international co-operation, and should be interpreted as a necessary and beneficial process for OMT international recognition, rather than an anxiety provoking exercise. The Standards Committee does not wish to be viewed as policing educational processes, but as a valuable resource for quality assurance and quality control of OMT education.

    • There should be no need for duplication of documentation, as stated previously. The International Monitoring process is intended to use the documentation of existing processes.

    • The report from the International Monitoring review will include commendations as well as recommendations. A draft report will initially be forwarded to the MO for their comment and / or provision of further clarification.

    • Any modification of the Standards Document will be reflected in the International Monitoring Process Document and processes.

  • The SC will meet again in Vancouver at WCPT Congress where we hope to meet representatives from MOs. The agenda for Vancouver will include: Update on RIGs / Update on MOs / Standards document review / International monitoring Australia / International monitoring UK / Planning for future processing MOs international monitoring

The Standards Committee had the opportunity to meet the American Academy of Orthopaedic Manipulative Physical Therapy (AAOMPT) Executive Committee formally and then informally throughout the conference. We also had the opportunity to meet representatives from the Canadian Academy of Manipulative Therapy (CAMT) and the Orthopaedic Division of the Canadian Physiotherapy Association. Members of the Standards Committee also attended a meeting between the AAOMPT, CAMT, and Orthopaedic Division Executive committees to explore the development of an IFOMT Education Committee Americas.

We would like to say a big thank you to AAOMPT for their hospitality throughout the conference and in the wide variety of social events that were timetabled. It made the meeting very enjoyable as well as stimulating!

Report from IFOMT-ECE meeting in London, 27th October 2006

13 out of 14 possible European MO delegates attended the meeting, which took place at Brunei Gallery in London. From Greece one delegate from the RIG group was present. Moreover we were happy to welcome among others Agneta Lando, past president of IFOMT, Michael Shacklock, lecturer, and Christopher McCarthy, president of MACP our host. The meeting was held in connection with MACPs' annual meeting on 28th October.

There was discussion, information and comments on different items, which I'll give some details about.

  • IFOMT have asked the MO delegates to inform their universities about the possibility of advertising on the IFOMT website. The cost for six months is US $25.00. This could also increase the traffic to the website, which is an advantage when negotiating with our advertisers in the future.

  • At the WCPT Congress on the 2nd 6th June 2007 in Vancouver, IFOMT will have a scientific program. IFOMT will also have an Open Business Meeting and informal meetings with all the present delegates. Duncan Reid, executive member, has a post congress course on the 7th- 8th June named "Comfort and Safety in Cervical Manipulation". You are welcome to attend see http://www.wcpt.org/congress/courses/index.php

  • Lothar Joerger, executive member, informed delegates about the new suggested logo and the voting process for it. The voting finishes on 30th November via email.

  • He also showed the new design for the coming Newsletter. The Newsletter will have different topics. Read more of it on our website www.ifomt.org

  • Alison Rushton, chair of the IFOMT Standards Committee, told us of the AAOMPT meeting in Charlotte, USA. This was the first face to face meeting of the SC and it turned out to be successful. In Charlotte delegates also met to discuss the formation of EC America, and this will be further discussed again in Vancouver 2007.

  • Alison Rushton also answered some questions concerning the instigation of the Self-Monitoring process.

  • There was a lively discussion between the delegates about the names of the associations and of IFOMT in the future. The suggestions varied from very long complicated names to very simple short ones. This is something to think about before the next GM!

  • Heather Nicol, Norway, told us that in Norway it is now nationally established that the Manual Therapists are the primary contact for the patients. They can refer patients to medical specialists, to radiology and to other PTs. They can also give up to eight weeks sick leave. Well done!

  • All the delegates told us about the education situation in their countries. You can read more in the reports in this Newsletter.

The very good news is that almost every European MO country now has an OMT education in one way or another connected to a University.

  • Erik Thoomes, chair of the IFOMT Congress 2008 in Rotterdam, made an elegant PP presentation of what we are going to experience when we meet in Rotterdam 8-13 June 2008.

In the evening, after this meeting, we were all invited by our generous host, MACP, to a spectacular reception onboard the London Eye. There we were 135 metres above London by night with a glass of good wine! Fantastic! There, up in the air, Chris McCarthy announced that UK will bid for the IFOMT Congress 2012!!

The following day the MACP Congress started. The theme was 'Neurodynamics and Neural Integrity Testing The State of the Science' and the key note speaker was Michael Shacklock. IFOMT had a stand at the exhibition were we met and the MOs and RIGs placed their pamphlets. The meeting was, from my

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