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We’ve launched our Expert Advisory Panel - read more about the Innovation Agenda here.

Clinical Component Update: Week of August 2

On Schedule for the September 8 Exam Launch: Window 1 Candidates to Receive an Important Email Next Week

Window 1 candidates will receive an email on August 10 that will include their exam login credentials and a link to the Qpercom Observe orientation video. This group of candidates will be able to log in to the Qpercom platform with the same credentials they will use on exam day and see exactly how the system will work. Candidates in later exam windows will receive their login credentials for Qpercom approximately one month before the start of their window.


Orientation Webinar

Window 1 candidates will also receive an invitation to an orientation webinar scheduled during the week of August 16. This live webinar will give candidates an opportunity to ask questions about their upcoming exam. We are limited in the number of candidates we can accommodate in our webinars and are unable to offer to webinar to everyone at one time. Additional webinars will be scheduled in the fall for candidates in later windows.

Those who are unable to attend the live webinar will be able to find the recorded session on our website by the following week.

We will send invitations to separate webinars for candidates in each exam window, but the recorded sessions will be available on demand on our website for anyone interested in watching.


The Science Behind the Clinical Exam

We have been receiving emails from many individuals prompted by the urging of a third party. We are sorry that we do not have the resources to respond to each person individually. The templated emails we have received say,

“As a registered PT, I demand the Colleges and CAPR to discontinue the forcing of all new PT grads to complete an exam that has been shown to lack reliability and validity.

 It is unjust and simply wrong. There is zero scientific evidence that the exam actually “protects” the public as it is claimed.”

While we appreciate the opportunity for open dialogue about the exam, we are sorry for the additional stress the campaign against the exam is placing on candidates at this time. While CAPR is beginning the process of exploring the evolution of the PCE, we stand behind the science that supports the current examination process.

The PCE, including the clinical component, was developed on the basis of the best available psychometric evidence and yields results that support equity, diversity and fairness in Canadian physiotherapy registration practices. We have an outstanding PhD psychometrician on staff and consult with at least one external psychometric expert after each exam administration. We also consult with a three-member psychometric advisory panel as required and did so in development of the online version of the exam.

There are international examining standards [1] which CAPR adheres to carefully. In order to ensure that we continue to meet these standards, we regularly commission independent external reviews. Our most recent review (conducted in 2016) found the clinical component to be reliable and sound while identifying opportunities for future improvement.

Anyone interested in learning more about acceptable levels of reliability (Cronbach’s alpha) for clinical exams versus multiple choice exams can click here for a systematic review of reliability scores of OSCE exams. Based on a meta-analysis of 188 reliability coefficients from 39 different OSCE exams, the authors recommend a target reliability coefficient of 0.66 across stations, and 0.78 within stations. CAPR’s average reliability coefficients meet these requirements. On the most recent OSCEs in 2019, the average station-level reliability coefficient was 0.81 and the average exam-level reliability coefficient was 0.72. Other national examining bodies in Canada who run clinical assessments for licensure have very similar results.

Do CAPR exams contribute to ensuring that Canada’s physiotherapists provide safe and effective care to patients?  In an independent study of regulatory data by Takahashi and Nayer [2], good CAPR clinical exam outcomes were statistically significant as a protective factor against later regulatory encounters with the College. Findings from this study were replicated in two other Ontario jurisdictions. In other words, those who did well on the exam were less likely to be the subject of public complaints or identified as deficient in quality assurance activities. This is how the PCE contributes to protecting the public across Canada.

Anyone who would like to learn more detail about the scientific evidence behind the exam, or to explore CAPR’s response to specific claims made in the article that accompanied the solicitation for the anti-clinical exam email campaign should let us know. All our staff are presently engaged in ensuring a smooth launch of the upcoming exam, but we would be happy to provide a detailed response this autumn should demand warrant it.


Thank you

We want to acknowledge the tremendous assistance we have received in preparing for the upcoming exam from the members of the Canadian Council of Physiotherapy University Programs (CCPUP), which includes representation from Canada’s 15 physiotherapy university education and research programs and physiotherapy colleagues from the accreditation, regulatory and association sectors. In particular, Executive Director Keith Johnson, Chair Sharon Switzer-Mcintyre (from the University of Toronto) and Sue Murphy (from the University of British Columbia) have been meeting with us regularly to share their expertise and offer advice about how best to meet candidates’ needs throughout the development process.


Training materials for Examiners and Standardized Clients

Some of you might notice that we have not ticked this item off our July timeline. Not to worry! Development of the training materials is underway. We usually conduct the training just a few weeks before the exam and this year will be no different. We will be ready.


Review our Progress on the Project Timeline:


[1] American Educational Research Association. (2014). Standards for educational and psychological testing. American Educational Research Association American Psychological Association National Council on Measurement in Education.

National Commission for Certifying Agencies (US). (2003). Standards for the accreditation of certification programs. National Commission for Certifying Agencies.

[2] Nayer, M., Glover Takahashi, S. (March 2017). What Physiotherapist Data Says about Risks to Competence. College of Physiotherapists of Ontario, Toronto, ON.

[3] Brannick MT, Erol-Korkmaz HT, Prewett M. A systematic review of the reliability of objective structured clinical examination scores. Med Educ. 2011 Dec;45(12):1181-9. doi: 10.1111/j.1365-2923.2011.04075.x. Epub 2011 Oct 11. PMID: 21988659.