PCE Candidate FAQs

What is the purpose of the exam?
 What does the exam do?
 What does the exam do for physiotherapy regulators?
 Why are there two components?

Who takes the exam?

Applying for the exam
Why did you return my application form?
Why wasn’t I assigned to my first choice of exam site for the Clinical Component?

Exam Results
Why did you place my exam results on hold?

Computer-based test format for the Written Component
When will the exams be offered?
Can I take the computer-based written exam on my computer at home or at work?
Do I need to be experienced or proficient with computers?
Can I request a change to my site assignment once I receive the confirmation email from Prometric?
Are individuals with Special Needs accommodated in the computer-based testing centres?
How long will it take to receive exam results?

Pre-Exam
What documents will I receive informing me of my site assignment and address for the exam?
What should I bring to the exam?
What are the exam times?
What if I arrive late for the Written Component of the PCE?
Does CAPR offer an exam resource to assist with exam preparation?
Where are the computer-based testing centres?

During the Exam
What happens if there is a loss of internet connectivity or computer has technical issues during the exam?
What happens if I have log in issues?
What kinds of questions will be used on the computer-based written exam?
Is the exam available in English and French?
Can I check a question in English if I do not understand the question in French?
During the exam, can I skip questions and return to them later?
Can I review or change my answers?
Can I increase and decrease the font?
What are the features on the computer-based testing interface?
Can I use scratch paper or make notes?
Are there bilingual proctors in all the testing centres?

About the Exam
What if I have other questions about CAPR’s computer-based written exam?
How do you set passing scores for the written component?
How do you set passing scores for the clinical component?
How do you calculate station scores?
How do you calculate the total score for all stations?
How do you determine the passing score for the total score criterion?
How do you determine the passing scores for each station?
How do you confirm passing scores?
What information does the Board of Examiners consider when they confirm the passing scores?
How do you consider critical incidents in scoring?
Why does the number of stations passed matter when I have achieved the passing score on the total score criterion?
I have heard that sometimes you remove a station from scoring. Why does that happen? How do you make that decision?
Why do you use standard scores?
How do you determine the standard score?
I failed the exam. What do I do now?
How do I apply to take the exam again?
I failed the Written Component. Why can’t I try again on the next date for the Written Component?
Why do I have to pay the fees to take the exam again?

Rescoring
I think my score is wrong. How do I request rescoring of my exam?
What happens in rescoring?
How long does rescoring take?

Administrative Reconsideration
What is administrative reconsideration?
What do I have to send for an administrative reconsideration?
When should I send my administrative reconsideration?
What if I was sick?
How long does administrative reconsideration take?

File Review
What is a file review?
How do I request a file review?
How long does a file review take?
What information will I get in my file review?
I passed the exam, but I want to know about my weaknesses. Can I get a file review?
Can I review my exam to see how I did on each station?

What are the psychometric features of the exam?
What is validity?
What evidence is there that the results of the PCE are valid?
Content Aspect of Validity
Construct Aspect of Validity
Structural Aspect of Validity
Generalizability Aspect of Validity
External Aspect of Validity
Consequential Aspect of Validity
What is the reliability of the Physiotherapy Competency Examination?
What quality control checks have you put in place to ensure that Clinical Component examiners are consistent?

How well do candidates usually do on the exam?
How and why do graduates of different Canadian physiotherapy programs perform differently on the exam?
Why is the pass rate lower for internationally-educated physiotherapists?
Why do the pass rates on the Clinical Component vary from one exam to another?
Why don’t you adjust the pass rate so the same percentage of candidates passes each time?
I heard that you use a “bell curve” to mark the exam. Is this true?

How do you set exam fees?
What is the money used for?
Why do I have to pay extra for additional feedback?
Why do exam fees go up?

Who does what for the exam program?
Written Test Development Group and Written Item Generation Teams
Clinical Test Development Group and Clinical Item Generation Teams
Exam Steering Group
Board of Examiners
Evaluation Services Committee
Do you decide whether a candidate can be registered or licensed to practice physiotherapy?

How do you develop the Physiotherapy Competency Examination?
Who decides what goes on the exam?
What is the exam blueprint?
Who writes the questions?
Who approves the questions?

How do you maintain the quality of the exam?
What is the Exam Monitoring and Evaluation Program?
What research do you do related to the exam?
What quality assurance processes do you use for the exam?
Who oversees the Exam Monitoring and Evaluation Program?

How do you translate exam materials?
Who participates in the translation process?
What are the steps in translating and checking exam questions?
Do you compare exam scores for French and English candidates?
How do you review the Written Component?
How do you review the Clinical Component?
What translation reference material do you use

 

What is the purpose of the exam?

The Physiotherapy Competency Examination (PCE) helps provincial and territorial physiotherapy regulators find out if you are ready for independent practice.

 What does the exam do?
 The Physiotherapy Competency Examination tests whether qualified exam candidates have demonstrated a minimum standard of practice. The PCE ensures that members of the public will be safe when they interact with physiotherapists. It fairly and accurately evaluates the competencies you need to have to practise physiotherapy. Most physiotherapy regulators in Canada include passing the PCE as part of their entry-to-practice process.

The PCE tests the essential competencies of physiotherapy practice – the essential knowledge, skills and abilities. It tests history-taking, physical examination, data interpretation, clinical problem solving, treatment techniques, ethics, safety, interviewing and communication. The exam covers the core clinical practice areas: neuromusculoskeletal, neurological, cardiopulmonary-vascular and multisystem. The PCE is a reliable and valid assessment tool that fairly evaluates candidates on many competencies.

Passing the PCE means that you have demonstrated the minimum standard of knowledge, skills and abilities. Failing the PCE indicates that you have not yet demonstrated the minimum standard of knowledge, skills and abilities.

What does the exam do for physiotherapy regulators?
The provincial and territorial regulators must protect the public. They can do this best by using a consistent and legally defensible standard for all candidates who want to register to practise physiotherapy, no matter where they have completed their physiotherapy program.

Why are there two components?
The Written and Clinical Components provide us with different information about your knowledge, skills and abilities.

The Written Component tests a broad base of physiotherapy knowledge in the practice areas of neuromusculoskeletal, neurological, cardiopulmonary-vascular and multisystem. The Written Component tests your ability to use and integrate clinical knowledge and to solve clinical problems using clinical scenarios. You must achieve a minimum overall score to pass the Written Component.

The Clinical Component tests safe, effective use of the principles and processes of physiotherapy practice. The knowledge, skills and abilities assessed by the Clinical Component include communication skills and professional behaviour.

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Who takes the exam?

Canadian-educated and internationally educated graduates of physiotherapy programs take the Physiotherapy Competency Examination (PCE), regardless of their experience. Most regulators in Canada include passing the PCE as part of their entry-to-practice process.

If you are an internationally educated graduate of a physiotherapy program, CAPR must evaluate your credentials before you can take the PCE. The Educational Credentials and Qualifications Assessment will determine whether your education and qualifications are substantially equivalent to those of a Canadian-educated physiotherapist.

Applying for the exam
When you apply for an exam, you need to fill in the application form completely, and you need to include all the required documents with your application.

Why did you return my application form?
If you do not fill in the application form completely, or if you do not include all the required documents, we will return your application. We send a memo with the returned application so that you can correct the problem. Some of the common problems with applications are:

  • your name on the application does not match the name on your Declaration of Identity
  • you have not completed one or more sections of the application
  • you forgot to include your payment
  • you forgot to include the Declaration of Identification
  • you forgot to include a second identical photograph with your Declaration of Identification.

Why wasn’t I assigned to my first choice of exam site for the Clinical Component?
Site assignment is done on a first come, first served basis. If your first-choice site is full, we automatically assign you to your second-choice site, and so on.

Exam results

Why did you place my exam results on hold?
Before we release your exam results, we check your file to make sure everything is up to date. We need to be sure that we have all the required documents, and all payments.

If you are a graduate of a Canadian physiotherapy program, you must make sure that CAPR has received your final, official transcript directly from your university program before clinical exam results can be released.

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Computer-based test format for the written component

When will the exams be offered?
Refer to the Exam Registration Guide for available dates, both Written and Clinical.

Can I take the computer-based written exam on my computer at home or at work?
No. CAPR’s computer-based written exams are only offered in Prometric’s secure and proctored testing centres. This provides every candidate with a professional and consistent testing environment.

Do I need to be experienced or proficient with computers?

No. The computer-based written exam is very user-friendly. Prior to the exam day, you can experience the testing environment by scheduling a practice exam through the Prometric site at www.prometric.com. For CA$45, the practice exam allows candidates to walk through, on a practice basis, all check-in and testing procedures that occur at the test centre on exam day, as well as experience the testing platform – the practice exam uses the recently updated Written Component practice questions.

You can also access a “What To Expect On Test Day” video on the Prometric site at https://www.prometric.com/en-us/Pages/home.aspx

Can I request a change to my site assignment once I receive the confirmation email from Prometric?
Yes. See the Exam Registration Guide for information on timelines and fees.

Are individuals with Special Needs accommodated in the computer-based testing centres?
Yes. Candidates who have special needs will be accommodated at the computer-testing centres. Candidates should submit a Special Needs Accommodations Request Form, along with supporting documentation, to CAPR no later than the timelines outlined at https://www.alliancept.org/taking-the-exam/information-and-accommodations/special-needs/ .

How long will it take to receive exam results?
Official exam results (Pass/Fail) will be available on CAPR website within approximately six weeks from the exam. Exam results will not be provided upon completion the testing centre.

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Pre-exam

What documents will I receive prior to the exam?
Once you register for the Written Component, you will receive confirmation of registration via email from CAPR. This email will include your Personal Identification Number (PIN) and a link to where you can schedule your exam (choose your test centre) through Prometric.

Once you have scheduled your exam through Prometric, you will receive a confirmation email with your exam date and time, information on what to bring and when to arrive at the test centre, and driving directions to your chosen test centre.

What should I bring to the exam?
You must bring a valid (not expired), government-issued photo identification with your signature. This identification must match the name that you used to register with CAPR and resemble your current physical appearance.

The following pieces of identification are accepted:

  • Canadian or foreign passport.
  • Canadian driver’s license.
  • Canadian Permanent Resident card.

What are the exam times?
The computer-based written exam is administered in one session, either from 8 a.m. to 12:30 p.m. or 12:30 to 5 p.m. (local time). The Prometric website will outline the session for each exam.

Plan to arrive at the examination site 30 minutes in advance of your scheduled appointment time. This is a timed exam, and any breaks you take during the test session are at your discretion; you will not receive any extra testing time to make up for those breaks.

What if I arrive late for the Written Component of the PCE?
Any candidate arriving more than 30 minutes after the scheduled start time will not be permitted to take the exam and will forfeit their exam fee.

Does CAPR offer an exam resource to assist with exam preparation?
Yes. CAPR, through Prometric, offers candidates the opportunity to take a “Test Drive”. The “Test Drive allows candidates to walk through, on a practice basis, all check-in and testing procedures that occur at the test centre on exam day.

Where are the computer-based testing centres? Are they the same as the paper-based testing sites?
The list of testing centres offered is available in the Exam Registration Guide.

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During the exam

What happens if there is a loss of internet connectivity or computer has technical issues during the exam?
If you experience loss of internet connectivity or have technical issues with the computer, please do not panic. Raise your hand as soon as this happens, and the proctor at the exam site will address this issue. All answers submitted up to that point would NOT be lost. Also, NO exam time would be lost. In the event you feel you did lose time, CAPR will investigate your claim.  Further actions will be taken on a case-by-case basis.

What happens if I have log in issues?
If you experience log in issues on exam day, please do not panic. Raise your hand as soon as this happens and the proctor at the exam site will address this issue.

What kinds of questions will be used on the computer-based written exam?
The exam questions are multiple-choice, with four answer choices and one best answer. Some questions are part of vignettes (associated with short scenarios) and some are stand-alone multiple-choice questions.

Is the exam available in English and French?
Yes. CAPR’s computer-based written exam is available in English and French.

Can I check a question in English if I do not understand the question in French?
Yes. You will have the ability to view the alternate language version of your exam at any time during the exam, at any site.

During the exam, can I skip questions and return to them later?
Yes. Questions can be flagged and returned to at a later point in the exam.

Note: Be sure to answer all questions, as only answered questions are scored.

Can I review or change my answers?
Yes. An answer can be changed at any time during the exam.

Can I increase and decrease the font?
Yes. You can increase and decrease the font of the test questions.

What are the features on the computer-based testing interface?
Some of the key features in the computer-based written exam include the ability to:

  • move to the next question or go back to the previous question
  • flag a question to come back to later
  • highlight text within a question
  • strike out incorrect responses
  • change the appearance/theme of the exam for ideal visibility.

There is also an exam progress bar indicating percentage of completion.

Can I use scratch paper or make notes?
Yes. Note boards and markers or scratch paper & pencils will be provided to you at the test centre. You are required to leave these with the proctor at the end of the exam.

Are there bilingual proctors in all the testing centres?
No. Proctors are not bilingual in all testing centres. Proctors in French-speaking regions (Quebec, New Brunswick, and certain parts of Ontario) may be bilingual.

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About the exam

What if I have other questions about CAPR’s computer-based written exam?
These questions can be directed to Erin Gollaher, Client Services Coordinator via email at csc_exams@alliancept.org or by phone at 416-234-8800 ext. 235 during the outlined phone hours, provided for your reference below:

  • Monday: 9:00am EST to 11:00am EST
  • Wednesday: 2:00pm EST to 4:00pm EST
  • Friday: 1:00pm EST to 3:00pm EST

How do you set passing scores for the written component?
The scoring system used in the Physiotherapy Competency Examination (PCE) is different from a percentage scoring system.

The passing score for the Written Component is a specific point set on a standard score scale. The Board of Examiners sets the passing score for the Written Component. The Written Test Development Group reviews the passing score from time to time and recommends changes when necessary.

See below for more information about Standard Scores.

How do you set passing scores for the clinical component?
You must meet three criteria to pass the Clinical Component:

  • you must achieve a the overall passing score (the Total score criterion)
  • you must pass a set number of stations (the Number of stations criterion)
  • you must demonstrate safe and professional actions and behaviours at the entry-to-practice level (the Critical Incidents criterion).

Total score criterion

The total score criterion determines if you have demonstrated the required standard of knowledge, skills and abilities. The total score does not provide information about specific areas of practice or functions in which you may have gaps. To meet the total score criterion, you must achieve or exceed the passing score set for the exam.

The total score criterion is a “compensatory” score because you can compensate for poor scores in some stations with good scores in others.

Number of stations criterion

The number of stations criterion identifies frequent or systematic gaps in your knowledge, skills and abilities. It eliminates the possibility that you could pass the Clinical Component with significant gaps in some areas of practice. To meet the number of stations criterion, you must achieve a passing score on a set number of stations.

The number of stations criterion is a non-compensatory score, because you cannot make up for failed stations.

Critical incidents criterion

The critical incidents criterion determines whether you have demonstrated safe, professional practice. This criterion provides a way for examiners to identify potentially unsafe or unprofessional actions or behaviours. The Board of Examiners reviews these actions and behaviours and makes a final decision about each one. To meet the critical incidents criterion, you must have no more than 2 minor Critical Incidents, and no major Critical Incidents.

  • minor safety or professionalism incident is an action, behaviour, or omission that could harm the client, physically or emotionally
  • major safety or professionalism incident is an action, behaviour, or an omission that could cause serious harm or death
  • the Safe Professional Practice Criterion Study[1] confirmed that the Critical Incidents criterion adds value to the Clinical Component.
[1] Canadian Alliance of Physiotherapy Regulators (2002). Report on the use of the safe professional practice criterion in the Clinical Component of the Physiotherapy Competency Examination. Toronto: Author.

How do you calculate station scores?
For ten-minute stations, we calculate the station score from the number of checklist items done correctly (80% of the station score), the performance ratings (10% of the station score) and the communication ratings (10% of the station score).

For five-minute (couplet) stations, we calculate the station score from the number of checklist items done correctly (40% of the station score), the performance ratings (10% of the station score) and the written station score (50% of the station score).

How do you calculate the total score for all stations?
The total score is the average of the station scores. You must achieve or exceed the passing score set by the Board of Examiners to meet this criterion.

How do you determine the passing score for the total score criterion?
The passing score for the total score criterion is the average of all the stations passing scores plus one standard error of measurement (SEM).

The standard error of measurement (SEM) is a statistical term. It is an estimate of the amount of random error in the measurement process. Adding one SEM to the scores decreases the chance that you will pass the exam when you should not pass. This method is used by other exam programs, including the Medical Council of Canada.

How do you determine the passing scores for each station?
For each of the 16 stations, the examiners give you a global rating on a 6-point scale:

  • satisfactory — excellent
  • satisfactory — good
  • satisfactory — borderline
  • unsatisfactory — borderline
  • unsatisfactory — poor
  • unsatisfactory — unacceptable

The passing score for each station is the mean (average) score of all candidates who received a Satisfactory — Borderline or an Unsatisfactory — Borderline overall rating on that station.

CAPR’s definition of a borderline failing candidate for the clinical exam is:

  • A “borderline failing” candidate is an individual who does not demonstrate an entry-level competence in the Clinical Component of the Physiotherapy Competency Examination, and
  • who has failed the examination by less than one standard error of measurement (SEM) below the total standardized passing score.
  • Borderline fail refers only to those individuals who do not meet the total score criteria but who do meet the station criteria and the safety and professional conduct criteria.

How do you confirm passing scores?
The exam consultant prepares a technical report after each exam. The Board of Examiners (BOE) reviews the report and sets the passing scores for the three criteria for the exam according to the BOE Decision Rules. The Board of Examiners repeats this process for each exam. This means that the passing scores are the same for all candidates on one exam, but may be different for candidates on the next exam, depending on the performance of each exam.

What information does the Board of Examiners consider when they confirm the passing scores?
The Board of Examiners uses a variety of quantitative and qualitative information when they are confirming the passing scores. Some of the things they consider are:

  • Descriptive statistics for each station and for the overall exam (e.g., the number of candidates, the average score for the station, and the standard deviation of the average score).
  • Correlations between each station and the total exam score. These correlations show how much information each station contributes to the overall score.
  • Reliability and reproducibility coefficients. These coefficients show whether the exam results would be the same with repeated administrations.
  • A comparison of the difficulty estimates (Angoff estimates) for each station with the actual performance for that station. This tells us if the stations were harder or easier than usual.
  • A comparison of the average of the difficulty estimates (Angoff estimates) for the entire exam with previous exams. This tells us if the overall exam was harder or easier than usual.
  • Trends in the average station scores for repeated stations (i.e., mean scores for stations used on this exam compared to the same stations in previous exams). This tells us whether candidates performed similarly to past exams, and whether there is a problem with a station.
  • The performance of Canadian-educated physiotherapists completing the exam for the first time compared to past exams. This tells us if the exam is harder or easier than usual.
  • Trends in mean scores for all candidates. This tells us if the exam is harder or easier than usual.
  • A comparison of BOE decisions from past exams. This helps to keep the decisions consistent from one exam to the next.
  • A comparison of the effect of various passing scores on the passing rate (consequential validity).
  • A report on any administrative or statistical issues that affected scoring. This helps us to decide if we should eliminate any stations from scoring because of problems with the administration of the station or the results of the station.

How do you consider critical incidents in scoring?
The Board of Examiners reviews all safety and professionalism actions, behaviours, or omissions identified by examiners and makes a final decision about whether each identified issue is a Critical Incident. The decision considers many factors, including completeness of the examiner’s documentation; the standardized client’s planned portrayal, relevant literature, past decisions on similar critical incidents, and the professional judgment of the Board of Examiners.

Why does the number of stations passed matter when I have achieved the passing score on the total score criterion?
The number of stations criterion identifies frequent or systematic gaps in your knowledge, skills and abilities. It ensures that you demonstrate reasonably consistent knowledge, skills and abilities from station to station by making it impossible to pass the Clinical Component by doing well in some stations and badly in others. The number of stations criterion is therefore a “non-compensatory” score.

Candidates who fail on this criterion often say that they failed the exam “by one station.” In fact, these candidates failed several stations, showing that they have gaps in their knowledge, skills and abilities.

I have heard that sometimes you remove a station from scoring. Why does that happen? How do you make that decision?
After each exam, the Board of Examiners reviews the technical report on the exam. This report gives information on the performance of the stations on the exam and the performance of the exam in general. If there are problems with the statistical performance of a station, or if there were operational or security problems with a station, the BOE may decide to remove the station from scoring.

Why do you use standard scores?
We convert exam scores to a standard score before we report your exam results so that we can compare the scores with other sittings of the exam.

How do you determine the standard score?
We calculate a Z score for each candidate. We then linearly transform the Z score to a scale with a mean of 500 and a standard deviation of 100.

To calculate your score, we convert your percent score to a standard three-digit score so that we can compare candidates’ scores from different sittings of the exam. Your standard score is not equal to the number of questions you answered correctly on the Written Component, or to the number of checklist items that you did correctly on the Clinical Component.

I failed the exam. What do I do now?
If you fail an exam you have several options.  You can:

  • apply to take the exam again
  • request rescoring of your exam
  • request administrative reconsideration
  • request a file review (Clinical Component only).

You should request everything you want at the same time. If you wait for some of your requests, you may miss the deadline date.

How do I apply to take the exam again?
We include information about repeating the exam in your results package, if you fail the exam. You will need to apply for the exam again. You can get the application form from the website.

I failed the Written Component. Why can’t I try again on the next date for the Written Component? 
We include information about applying for another exam in your results package. This package includes the date of the next exam that is available to you. Sometimes the next exam date on the calendar is no longer available, because the application deadline has passed.  We cannot accept applications for an exam after the application deadline for that exam.

Why do I have to pay the fees to take the exam again?
We set exam fees to cover the costs to administer each exam. If you fail an exam, you must send the full exam fee with your application to repeat the exam.

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Rescoring

I think my score is wrong. How do I request rescoring of my exam?
We check exam scores carefully before we release results. If you still think your score is wrong, we can rescore your exam.

You can request rescoring on the form that we include in your results package. Please read the form carefully and make sure you send it to us before the deadline date. We cannot do rescoring after the deadline date.

What happens in rescoring?
We rescore exams by hand, following the answer key for the exam.

For the computer based version of the Written Component, we download your exam responses and check them against the answer key of the exam, ensuring you got credit for all your correct answers. We then validate the score you received against the second check.

For the Clinical Component, we check to make sure that you received credit for all the checklist items that the examiner said you did correctly. We recalculate all your station scores, and we remark your written station answers.

If your exam outcome changes after rescoring (i.e., if your results change to a pass), we will refund your rescoring fee, and we will refund any fees you have paid to take the exam again.

How long does rescoring take?
We complete rescoring requests as they are received. We will send your rescoring result by 4 weeks after the rescoring deadline date for the Written and Clinical Components.

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Administrative Reconsideration

What is administrative reconsideration?
Sometimes something happens that makes it harder for you to do your best. For example, you might be sick before or during the exam, you could have a family emergency, or something could be wrong with the administration of the exam. If these kinds of problems affect your exam, you might want to ask for administrative reconsideration.

You should read the information in your results package carefully, and make sure you send your request for administrative reconsideration before the deadline. We will not process and administrative reconsideration request after the deadline.

What do I have to send for an administrative reconsideration?
You must send the administrative reconsideration application form, your payment, and a letter outlining the reasons for your request. You should include supporting documents, where applicable. If you are not sure what to send, contact our office.

When should I send my administrative reconsideration?
You must send your request by the deadline date on the application form. If you do not have all your supporting documents, send the request and your payment before the deadline. In your letter tell us what documents you are waiting for and when you expect to send them.

What if I was sick?
There are special rules if you were sick on the day of the exam. If absent from the examination due to illness, you must provide an original CAPR Candidate Medical Certificate, verifying that you were examined at the time of the illness. The date of the certificate must be appropriate for or match the examination date (i.e., certificates dated more than two days after the November Clinical Exam or three days after the June Clinical Exam will not be accepted).

You cannot wait until you get your results.

How long does administrative reconsideration take?
It depends on how complicated your request is. If we have all the information, we can usually send our decision quickly. If we have to wait for documents, or if we need to contact people to investigate your request, it may take longer. We will tell you if we need more information, or if your request will take longer than usual.

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File Review

What is a file review?
A file review provides more detail of your performance on the Clinical Component. You cannot get a file review for the Written Component.

How do I request a file review?
To request a File Review, send the completed application form and your payment by the deadline date.

How long does a file review take?
File reviews will be completed on a first-come, first-served basis. File review requests MUST be received in the CAPR office by the deadline on the file review form, located in your results package. Requests received after the deadline date will not be processed.

Due to the increasing number of requests for this service, the timeline on when your file review will be completed cannot be guaranteed. That being said, CAPR endeavours to complete and mail all file reviews within 30 business days of the deadline located on the file review form.

What information will I get in my file review?
Here is a sample file review, this is also available on CAPR website. You can review the sample to see the kind of information that you will receive. Each file review will be different, depending on the examiners’ comments, and on the trends in your performance.

The file review will not give you information about the specific tasks in the stations, or about the specific things that you did wrong.

I passed the exam, but I want to know about my weaknesses. Can I get a file review?
File reviews are only available for candidates who need to take the exam again. The PCE is not designed to provide diagnostic feedback for areas of weakness.

Can I review my exam to see how I did on each station?
No, you cannot review your Clinical Component test sheets. These materials are confidential and we do not allow candidates to review them after the exam.

In the Clinical Component, each test sheet has a barcode label with your candidate ID number. We check this information carefully during scoring to make sure that the results we are reporting are your results.

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What Are the Psychometric Features of the Exam?

We use the best available evidence in measurement and evaluation research literature to guide each step in the development and maintenance of the Physiotherapy Competency Examination (PCE).

What is validity?
The validity of exam results is the extent to which the scores measure what we want to test. In the assessments used for licensure decisions for health care professionals, we measure the competence of individual practitioners entering practice. In other words, do candidates who successfully complete the PCE have the competence to perform at the desired level of proficiency? Also, do candidates who are not successful fall short of the necessary level of proficiency?

What evidence is there that the results of the PCE are valid?
Validity is built into an exam program. In licensure testing, this is done by thoroughly reviewing the competencies a candidate needs to have to practise safely and competently (the Analysis of Practice). These competencies determine the content domain – the areas of study – from which the exam will be built. Decisions that are made based on the exam scores can be considered valid when an exam has been built by sampling from the specified content domain according to a pre-determined formula (also known as the exam blueprint).

Establishing the validity of exam inferences (the decisions that are made based on exam results) is a process that takes place by accumulating evidence over time. Evidence that supports the validity of the decisions made based on PCE results includes the following:

Content Aspect of Validity

  • The Cost and Structure Study (1998)
  • Analysis of Practice 2008
  • The Blueprint for the PCE (2009) (included in the Analysis of Practice 2008)
  • An extensive local and national consultation process to develop and review exam items and stations
  • Processes for translating and verifying translation for all exam items and stations
  • Standardized quality control of exam administration
  • Standardized training of exam site coordinators, standardized clients and physiotherapist examiners
  • Examiner feedback on station content

Construct Aspect of Validity

  • Essential Competency Profile for Physiotherapists in Canada (2009)
  • The Report on the Use of the Safe Professional Practice Criterion in the Clinical Component of the Physiotherapy Competency Examination (2002)
  • The Candidate Demographic Study (unpublished)

Structural Aspect of Validity

  • Support by external testing and measurement services for the development and administration of the Written Component and the Clinical Component, respectively
  • Standardized quality control of exam scoring and results processing
  • Verification of the quality of the multiple-choice questions through statistical analysis
  • The development and consistent use of decision rules for the Board of Examiners
  • Verification of borderline results
  • Standardized exam sheets
  • Documentation of all procedures
  • Standardized communication of exam information to candidates
  • Selection of testing sites according to predetermined criteria

Generalizability Aspect of Validity

  • See “What is the reliability of the Physiotherapy Competency Examination?” below.

External Aspect of Validity

  • Inter-rater Reliability Study, 2008

Consequential Aspect of Validity

  • The development and consistent use of decision rules for the Board of examiner

What is the reliability of the Physiotherapy Competency Examination?
Reliability is the extent to which the scores would be reproducible on repeated administrations of the exam. Since we cannot administer the same exam to the same individuals, we use statistical methods to estimate the reliability based on the results of a single exam given to a single group.

The bodies that develop standards for educational and psychological tests (the American Educational Research Association, the American Psychological Association and the National Council on Measurement in Education) do not set numerical thresholds for reliability, even for use in specific types of decision making. The reason for this is that a “one size fits all” approach to reliability is not consistent with the context specific nature of psychometrics. Different standards must be used for different kinds of exam results.

When an exam is testing clinical competence in order to determine whether a candidate should be licensed, it is important that a test consistently classifies candidates as passing or failing relative to a standard. The most important reliability for licensing exams is the consistency of classification: would the same candidates be classified as passing and failing the exam on a repeated administration?

For the Written Component, we use the Cronbach alpha coefficient to assess the reliability of test results. The Written Component consistently achieves acceptable Cronbach alpha values.

In 2015, CAPR changed the method for assessing reliability of classification for the Clinical Component from Subkoviak to Livingston and Lewis (1995) method. With this approach, we can define a coefficient of consistency of classification. The Clinical Component of the Physiotherapy Competency Examination (PCE) consistently achieves acceptable values for criterion-referenced consistency of classification at the passing score for both the total score criterion and the number of stations criterion.

Finally, it is more important that an exam is considered reliable when compared to other exam programs than to an arbitrary external standard. In this respect, for the Clinical Component, Norcini7 found that the “reproducibility of the [total binary score] is not equivalent to most written exams, but it is comparable to other Objective Structured Clinical Examination/oral examination formats.”

What quality control checks have you put in place to ensure that Clinical Component examiners are consistent?
Consistent scoring is very important. We have several processes to ensure that our examiners are consistent.

Each exam site uses local physiotherapists as examiners and markers. This ensures that the examiners and markers are familiar with local terminology and conventions.

All examiners (and all written station markers) must attend a pre-exam training session before they can work on an exam. Examiners must attend training again at least every three years, and many examiners attend more often. Examiners and markers all attend an exam day orientation session. Training and orientation cover the process of marking and the rules for consistent marking.

The Chief Examiners meet before the exam to discuss the exam stations. This meeting helps to ensure consistency across the country.

On the day of the exam, examiners receive detailed scoring guides that cover the stations they are marking. The Chief Examiner helps the examiners to understand the marking guide. If there are questions about a station, the Chief Examiner contacts the Physiotherapist Advisor of the exam program. This ensures that questions and answers are communicated to all sites across the country.

The Written Station Coordinators have an orientation the day before the Written Station Marking. The Markers have an orientation on the day of the Written Station Marking and review unexpected answers with the Written Station Coordinators. The national coordinator makes decisions about accepting unexpected answers and communicates these decisions to the Written Station Coordinators who inform the Markers. This process helps to maintain consistency of marking.

If you do not pass the Clinical Component, we review the scoring of your written station answers before we send your results to you. This final check ensures that you receive proper credit for written station answers.

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How well do candidates usually do on the exam?

Candidates perform very well on both components of the exam, and exam results have been quite consistent over time. Canadian-educated candidates tend to do better than those who did not receive their physiotherapy education in Canada.

How and why do graduates of different Canadian physiotherapy programs perform differently on the exam?
The performance of graduates of Canadian physiotherapy programs varies slightly from one exam to another. Overall, the performance of Canadian educated candidates is very consistent from year to year, and from program to program.

Many factors could explain why the performance of graduates of a particular university program might vary. It would not be fair to publish the pass rates of physiotherapy programs without information about these factors, especially since these changes in performance are very small.

CAPR provides confidential feedback about exam performance to the Canadian physiotherapy programs. The programs use this feedback in their program evaluations.

Why is the pass rate lower for internationally-educated physiotherapists?
The internationally-educated physiotherapists are a very diverse group from many different countries. Many factors affect their success on the exam, including language of education and language of clinical practice, years since graduation, and practice patterns in the country of education (whether they are similar to Canada or different).

Familiarity with the exam format may also affect the pass rate. In other words, candidates who have experienced multiple-choice or OSCE exams during their physiotherapy education program may perform better than candidates who have not experienced these types of exams.

Why do the pass rates on the Clinical Component vary from one exam to another?
The passing rate on the Clinical Component varies from year to year. The passing rate for Canadian-educated candidates is fairly consistent, but the passing rate for candidates educated outside Canada varies more. This is because there is more variety in the education and clinical practice of candidates educated outside Canada. In each exam, the group of internationally-educated candidates is different.

Clinical Component Pass Rate

Exam administration Pass rate total candidate pool Pass rate:
Canadian-educated
Pass rate:
Internationally educated
1995 92.8% (n=297) 95.5% (n=276) 67.7% (n=21)
1996 80.9% (n=372) 84.4% (n=356) 42.1% (n=16)
1997 89.4% (n=387) 95.2% (n=358) 50.9% (n=29)
1998 88.5% (n=524) 93.7% (n=492) 47.76% n=32)
1999 91.9% (n=553) 96.0% (n=497) 66.7% (n=56)
2000 89.5% (n=522) 94.1% (n=462) 65.2% (n=60)
2001 79.9% (n=529) 85.4% (n=469) 52.6% (n=60)
2002 85.0% (n=595) 91.8% (n=504) 60.3% (n=91)
2003 88.67% (n=624) 94.2% (n=531) 68.2% (n=93)
2004 87.3% (n=548) 96.8% (n=454) 59.1% (n=94)
2005 84.1% (n=572) 93.3% (n=473) 57.2% (n=99)
2006 88.5% (n=678) 94.9% (n=536) 70.7% (n=142)
2007 85.5% (n=665) 94.9% (n=505) 65.0% (n=160)
2008 85.2% (n=691) 95.3% (n=506) 66.1% (n=185)
2009 85.0% (n=758) 95.7% (n=538) 66.7% (n=220)
2010 88.0% (n=801) 96.0% (n=618) 70.0% (n=183)
2011 82.67% (n=866) 92.70% (n=603) 59.69% (n=263)
2012 72.38% (n=916) 87.69% (n=593) 44.27% (n=323)
2013 78.23% (n=859) 91.82% (n=606) 57.56% (n=253)
2014 73.85% (n=1056) 90.93% (n=642) 57.18% (n=414)
2015 75.71% (n=1375) 90.12% (n=607) 64.32% (n=768)
2016 66.71% (n=1042) 84.15% (n=621) 51.09% (n=421)
2017 60.90% (n=964) 82.67% (n=606) 42.12% (n=358)

 

Why don’t you adjust the pass rate so the same percentage of candidates passes each time?
The leading psychometric standard-setting body, the American Educational Research Association (AERA), specifically recommends that credentialing tests do not use a norm-reference approach – that is, adjusting the passing rate to pass a specified percentage of candidates. Standard 14.17 says

  • The level of performance required for passing a credentialing test should depend on the knowledge and skills necessary for acceptable performance in the occupation or profession and should not be adjusted to regulate the number or proportion of persons passing the test.12
12American Educational Research Association, American Psychological Association, National Council on Measurement in Education. (1999). Standards for educational and psychological testing. WashingtonDC: American Educational Research Association.

I heard that you use a “bell curve” to mark the exam. Is this true?
No. CAPR does not use a “bell curve” to mark the exam. Bell curving means assigning scores according to a pre-determined frequency. This approach controls the passing rate and is not recommended by testing experts (see above).

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How do you set exam fees?

CAPR is a non-profit organization. The money we need to administer the PCE comes from the exam fees you pay. The fees must cover all the expenses related to the exam program. We do not make a profit from the exam and we cannot operate the exam at a loss.

You pay the same fee to take the exam no matter where in the country you take it.

We set exam fees in advance so that you can budget for the expense. If something happens to increase our costs, we do not charge you more.

What is the money used for?
Exam fees cover many different kinds of expenses:

  • Direct costs for the exam program. These include exam sites and personnel, exam consultants, and special needs costs.
  • Committee costs for development of exam items and stations, and for exam scoring decisions. These include the written and clinical test development groups and the Board of Examiners.
  • Research and quality assurance activities. These include research projects like the Analysis of Practice, and quality assurance reporting.
  • Operating expenses for rent, salaries and office supplies.
  • Indirect expenses associated with CAPR activities. These include meeting expenses for the Evaluation Services Committee, the Executive Committee and the Board of Directors. These committees spend some of their time on exam activities.

Not included in these costs is the significant number of volunteer hours contributed by physiotherapists from across the country who spend time on committee activities related to the exam. These include members of the test development groups, members of the Evaluation Service Committee and members of the Board of Examiners. These individuals are not paid for the hours they work on exam activities.

Why do I have to pay extra for additional feedback?
The exam operates on a break-even basis. You must pay the costs of any additional services that you request.

Why do exam fees go up?
We pay careful attention to exam expenses and revenue. We sometimes have to adjust exam fees to cover increasing costs. When this happens, we publish the new fees in advance so that you can budget for these expenses.

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Who does what for the exam program?

Many individuals and groups are involved in the exam program. Most of them are volunteers who use their clinical, management and measurement skills to provide advice to CAPR. Some of the groups are listed below.

Written Test Development Group and Written Item Generation Teams

Physiotherapists from across Canada who develop and revise questions for the Written Component.

Clinical Test Development Group and Clinical Item Generation Teams

Physiotherapists from across Canada who develop and revise stations for the Clinical Component.

Exam Steering Group

The National Chairs of the Written and Clinical Test Development Groups and CAPR’s National Director of Evaluation Services who provides advice and guidance on the operation of the exam program.

Board of Examiners

Physiotherapists from across Canada who sets the standard for passing the Physiotherapy Competency Examination. The Board of Examiners includes one or more bilingual physiotherapists. The Board reviews critical incidents and sets passing scores for the exams.

Evaluation Services Committee

A group of physiotherapists, measurement experts and credentialing experts who provide oversight for the credentialing and exam programs. The Evaluation Services Committee is responsible for setting and monitoring standards for the credentialing and examination programs and assuring the effective delivery of these services.

Do you decide whether a candidate can be registered or licensed to practice physiotherapy? 
CAPR does not decide who can be licensed to practice physiotherapy because it is not a regulator. We provide exam results to the physiotherapy regulators. The regulators make decisions about who can and cannot register to practice.

The regulator’s role is to protect the public. Regulators do this through various processes, including registration requirements. Some regulators in Canada require successful completion of the PCE as a condition of registration. Some regulators will allow you to work under a temporary certificate of registration while you are waiting to complete the PCE. Each regulator has different processes and rules that apply if you fail a component of the exam.

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How do you develop the physiotherapy competency examination?

We develop the PCE by analyzing current physiotherapy practice, creating the exam blueprint and writing the questions.

Who decides what goes on the exam?
We determine the content of the exam by researching the activities that physiotherapists in Canada perform as part of their practice. The Analysis of Practice 2008[1]studied the activities physiotherapists in Canada do, how often they do them and the consequences of doing them incorrectly. We used data from this study to update the exam blueprint. A subsequent Analysis of Practice was completed in 2017. The new blueprint, slated to come into effect for 2019 examinations (both Written and Clinical), will be created using the data from this study.

[1] Canadian Alliance of Physiotherapy Regulators (2008). Analysis of practice 2008: A report on physiotherapists’ practice in Canada. Toronto: Author.

What is the exam blueprint?
The exam blueprint is a guide to the content of the Written and Clinical components. It shows how much each area of practice and function is worth on the exam. The Written and Clinical Test Development Groups use the blueprint as a guide when they write questions. Each exam matches the blueprint for the proportions from the areas of practice and the functions.

Who writes the questions?
Item generation teams write the exam questions and stations. These teams are located across the country. Members of the teams are physiotherapists who have experience in all areas of physiotherapy practice. Some of the team members are recent graduates of Canadian physiotherapy programs. Written item generation teams write multiple-choice questions for the Written Component, and clinical item generation teams develop stations for the Clinical Component.

Who approves the questions?
The national test development groups approve the questions and stations. The Written Test Development Group (WTDG) approves the multiple-choice questions, and the Clinical Test Development Group (CTDG) approves the clinical stations. The members of both the WTDG and CTDG are physiotherapists from across the country, and have experience in all areas of physiotherapy practice. Some members teach in Canadian physiotherapy programs.

We review exam questions and stations regularly, and we make changes based on statistical feedback and feedback from staff, volunteers and candidates. The review of clinical stations includes a review of the task, the instructions to the standardized client, the checklist and the answer key.

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How do you maintain the quality of the exam?

We continuously review and maintain the quality of the Physiotherapy Competency Examination (PCE) through the Exam Monitoring and Evaluation Program.

What is the Exam Monitoring and Evaluation Program?
The Exam Monitoring and Evaluation Program is a comprehensive research and quality assurance program for the exam. It oversees the research and quality assurance activities related to the exam, and it makes improvements to the exam based on the results of these activities.

What research do you do related to the exam?
Some examples of recent research projects are

  • Inter-rater Reliability Study
  • Analysis of Practice 2008: A Report on Physiotherapists’ Practice in Canada
  • Physiotherapy Practice Profile (“Triple P”) project.

What quality assurance processes do you use for the exam?
Incident reports, site feedback reports and feedback from examiners, standardized clients and candidates are all part of our regular quality assurance.

To improve exam processes, we provide feedback to everyone involved. We report to the exam sites on organization, catering and staff; to the item development committees on station content and scoring; and to CAPR staff on materials and procedures.

Who oversees the Exam Monitoring and Evaluation Program?
The Evaluation Services Committee (ESC) provides advice to CAPR’s Board of Directors about research and quality assurance for the exam. The ESC reviews planned research, research reports and quality monitoring reports, and makes recommendations to the Board of Directors. Members of the ESC include physiotherapists, regulators, exam consultants and external advisors.

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How do you translate exam materials?

We have a multi-staged translation process to ensure that each exam question is accurate in both languages before we print and distribute the exam materials.

Who participates in the translation process?
French-speaking and bilingual physiotherapists and physiotherapy faculty members participate in the translation process. Here is a brief explanation of the main contributors involved and their primary responsibilities:

Name of group Members Responsibility
Exam Steering Group
  • Chair of WTDG
  • Chair of CTDG
  • CAPR’s National Director of Evaluation Services
Oversee translation requirements for the exam.
External translators Individual translators or translation services contracted by CAPR Prepare and check translations.
Physiotherapists Bilingual physiotherapists who speak French as their first language Verify translations and physiotherapy terminology
CAPR staff Assist with preparing and checking translations.

What are the steps in translating and checking exam questions?
We translate new questions for both the Written and Clinical Components of the PCE in several stages. Here is a brief explanation of the major activities during each stage:

Step 1: Identify new or changed questions for translation

  • Request translation of new or changed items (WTDG or CTDG)
  • Remove the changed items from the active item bank so they won’t be used for exams (staff and exam consultant).

Step 2: Translate the items

  • Translate the new or changed items (external translator).

Step 3: Check the translation

  • Check each translated question for accuracy and completeness (bilingual physiotherapist)
  • Proofread the translations (bilingual physiotherapist).

Step 4: Update item bank with new translations

  • Import the translated questions into the exam software (staff and exam consultant). Questions are now ready for upcoming exams.

Step 5: Prepare exam administration

  • Select exam questions according to the exam blueprint (staff and consultant)
  • Approve the English exam (WTDG chair or CTDG chair)
  • Confirm that a French translation exists for all questions selected
  • Check the translation of all exam questions (bilingual physiotherapist)
  • Review corrections (CAPR staff)
  • Approve the translations of all exam questions (bilingual physiotherapist)
  • Import corrections into the exam software (staff and consultant)
  • Proofread the final draft of exam materials (CAPR staff).

Do you compare exam scores for French and English candidates? 
After each exam, we review the French and English exam scores (when the numbers allow this) to confirm the fairness and accuracy of both French and English exams. Here is a brief description of that process:

  1. Analyze the scores from the French and English Written and Clinical components of the PCE (completed by exam consultants)
  2. Identify any significant differences between the average scores for the French and English exams
  3. Identify any items that have an unexpected response pattern (completed by exam consultants).

Exam items identified in steps two and three receive careful scrutiny.

How do you review the Written Component?

  1. Review the exam questions that we identified in steps two and three above and check them for accuracy (bilingual physiotherapist, the Chair of WTDG and Physiotherapist Advisor of exam program).
  2. Meet to discuss identified questions. This may result in
    • deleting the question from the exam score; or
    • accepting other correct responses.

How do you review the Clinical Component?

  1. Review exam stations that we identified in steps two and three above and check for accuracy (bilingual physiotherapist, the Chair of CTDG and the Physiotherapist Advisor of exam program)
  2. Adjust scoring for identified stations or parts of stations if necessary to ensure fairness
  3. Review all identified stations and other issues affecting final scores (Board of Examiners)
  4. Determine total score, number of stations and other factors required to pass the Clinical Component of the exam (Board of Examiners). The Board of Examiners considers many factors in making these decisions.

What translation reference material do you use?
Our translators use a variety of translation reference materials when they translate and check exam questions. In addition to French translation resources (dictionaries), we also use leading medical translation materials. Here are just a few examples:

  • Canadian Alliance of Physiotherapy Regulators. (2006). Lexicon of Terms/Lexique de termes. Toronto: Author.
  • Lussier, A. and Dionne, S (Eds.). (1990). Vocabulaire de sémiologie de l’appareil locomoteur Volume I: signes cliniques/Vocabulary of Signs and Symptoms of the Musculoskeletal System Volume I: Clinical Findings. Ottawa: Canadian Government Publishing Centre.
  • Lussier, A., Beauregard, G. and Dionne, S. (Eds.). (1992). Vocabulaire de sémiologie de l’appareil locomoteur Volume II: signes d’imagerie médicale/Vocabulary of Signs and Symptoms of the Musculoskeletal System Volume II: Medical Imaging Signs. Ottawa: Canada Communication Group.

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