2021 pce clinical component - alliancept.org

2021 PCE CLINICAL COMPONENT CANDIDATE ORIENTATION MANUAL

Last Updated September 2, 2021

2021 PCE CLINICAL COMPONENT CHAPTER 1: ADMINISTRATIVE POLICIES AND PROCEDURES

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TABLE OF CONTENTS

CHAPTER 1: ADMINISTRATIVE POLICIES AND PROCEDURES............................................ 3 RULES OF CONDUCT FOR THE PHYSIOTHERAPY COMPETENCY EXAM .................................... 3

REQUEST FOR ALTERNATIVE ACCOMMODATIONS ..................................................................... 4

EXAM-RELATED ISSUES ON EXAM DAY ....................................................................................... 4

EXAM RESULTS ............................................................................................................................ 4

CHAPTER 2: TAKING THE EXAM ............................................................................................ 5 STRUCTURE AND DELIVERY MODEL ........................................................................................... 5

EXAM BLUEPRINT ......................................................................................................................... 5

EXAM DELIVERY SOFTWARE ........................................................................................................ 6

REQUIRED, PERMITTED AND PROHIBITED ITEMS ..................................................................... 6

REQUIRED PROPS AND FURNITURE ........................................................................................... 8

CHAPTER 3: APPROACHING A VIRTUAL CLINICAL STATION ............................................. 9 STEP-BY-STEP APPROACH TO A VIRTUAL CLINICAL STATION .................................................... 9

STRATEGIES FOR THE VIRTUAL ENVIRONMENT...................................................................... 10

VIRTUAL CLINICAL STATION MARKING .................................................................................... 12

VIRTUAL PRACTICE STATIONS .................................................................................................. 13

WATCH: IN-PERSON VS. VIRTUAL APPROACH TO CLINICAL STATIONS .................................. 13

CHAPTER 4: PREPARING YOUR PHYSICAL ENVIRONMENT ............................................. 14 CONSIDERATIONS FOR CHOOSING YOUR TESTING SPACE .................................................... 14

REQUIREMENTS OF YOUR TESTING SPACE............................................................................. 15

EXAMPLES OF ACCEPTABLE AND UNACCEPTABLE TESTING SPACES ................................... 16

SETTING UP YOUR COMPUTER AND/OR WEBCAM ................................................................. 17

CHAPTER 5: TECHNICAL REQUIREMENTS ........................................................................ 21 SYSTEM REQUIREMENTS ......................................................................................................... 21

CHAPTER 6: INTRODUCTION TO NAVIGATING QPERCOM ................................................ 25 GETTING STARTED .................................................................................................................... 25

QPERCOM BASICS ..................................................................................................................... 29

EXAM STATES AND STATION FLOW .......................................................................................... 30

APPENDIX A: PRACTICE STATIONS FOR THE VIRTUAL ENVIRONMENT ........................ 32

CHAPTER 1: ADMINISTRATIVE POLICIES AND PROCEDURES

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CHAPTER 1: ADMINISTRATIVE POLICIES AND PROCEDURES

RULES OF CONDUCT FOR THE PHYSIOTHERAPY COMPETENCY EXAM

By participating in the Physiotherapy Competency Exam, you agree to the following rules:

• The Physiotherapy Competency Exam and its contents are the exclusive property of the Canadian Alliance of Physiotherapy Regulators (CAPR).

• You will not memorize, record, or attempt to record, digitally or otherwise, exam content during the exam.

• You will not engage in cheating, as defined below in Section 1.1. Doing so may result in the termination of your exam, the decision not to mark your exam, or other appropriate action.

• You will not engage in disruptive behaviour or commentary regarding the exam that intentionally disturbs or causes anxiety to other candidates.

• You will behave professionally and respectfully at all times during the exam. This includes treating Standardized Clients and Examiners with dignity and respect.

1.1 Cheating

It is assumed that you are participating in the Clinical Component of the PCE in a good faith attempt to pass. Any actions or behaviours in contravention of this assumption will be considered “cheating.” This includes anything that could affect your results, the results of another candidate, or the results of a potential future candidate. It also includes behaviours that CAPR considers analogous to cheating, such as modifying CAPR documents in order to give the false impression of having passed the exam. Some examples of cheating are listed below; however, this list is not exhaustive:

• Impersonating a registered candidate or having a non-registered candidate take the exam on your behalf;

• Bringing study materials, or any other prohibited resources (e.g., electronic devices) into the exam;

• Giving or receiving help during the exam;

• Engaging in any conduct during the exam that disturbs or is disrespectful toward exam staff;

• Receiving or distributing information about the Clinical Component either before or after the exam;

2021 PCE CLINICAL COMPONENT CHAPTER 1: ADMINISTRATIVE POLICIES AND PROCEDURES

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• Sharing information about the diagnoses, tasks or activities included in the exam or discussing

information about exam stations with other candidates or examiners, even after the exam.1

• Disregarding instructions from the exam proctor, examiner or any exam staff;

• Modifying exam results letters or other CAPR documentation to give a false impression of having passed the exam or misrepresenting your exam status;

• Any activity that would be considered illegal, such as assault, harassment, or theft.

REQUEST FOR ALTERNATIVE ACCOMMODATIONS

For information about requesting alternative accommodations, please visit the CAPR website. You must submit requests for accommodations relating to the Clinical Component 65 days before the date of your exam.

If a situation that requires alternative accommodations arises after the submission deadline and before exam day (e.g., a new injury requiring the use of an assistive device), you must send an urgent request to [email protected]. We cannot accommodate requests made on the day of the exam. If you have been approved for alternative accommodations, you must inform your proctor as soon as possible after connecting to your exam session.

EXAM-RELATED ISSUES ON EXAM DAY

If you have complaints or concerns about any aspect of the exam (e.g., technology, process, administration, etc.) you must submit these complaints or concerns to [email protected].

You must also document your complaints or concerns in the feedback survey you will receive following your exam.

EXAM RESULTS

CAPR will release the exam results for each testing window 8 weeks after the final exam session in the window. Since the PCE is a national competency assessment, candidates who take the exam come from a wide variety of educational programs and backgrounds and take many different paths to get to the exam. The only way we can ensure the results of the exam are valid and fair is to continue to follow internationally recognized best practices in exam scoring. You can read more about exam validity and reliability and exam scoring on our website.

1 Candidates who will be taking the exam in the future (either for the first time or as a repeat test taker) may be at an unfair advantage if they learn about actual content that was administered on previous exams.

https://www.alliancept.org/taking-the-exam/exam-application-information/alternative-accommodations/

mailto:[email protected]


https://www.alliancept.org/taking-the-exam/exam-validity/

https://www.alliancept.org/taking-the-exam/exam-validity/

https://www.alliancept.org/taking-the-exam/pce-quick-facts/does-capr-use-a-bell-curve-to-make-pass-fail-decisions/

2021 PCE CLINICAL COMPONENT CHAPTER 2:

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CHAPTER 2: TAKING THE EXAM

STRUCTURE AND DELIVERY MODEL

The 2021 Clinical Component is an Objective Structured Clinical Exam (OSCE), which is administered remotely using online assessment software. The exam is comprised of six 10-minute clinical stations and six five-minute clinical stations. There is no written element to any of the 12 stations.

You will complete the exam in one day by participating in two circuits of six stations each—a 10-minute station circuit and a 5-minute station circuit. In each exam session, all candidates will be divided into two groups; one group will start with the 10-minute circuit and the other group will start with the 5-minute circuit. When both groups complete their first circuit, there will be a short break. After the break, the two groups will complete their second circuit of stations—either the 10-minute circuit or the 5-minute circuit.

EXAM BLUEPRINT

Each 12-station Clinical Component delivered in 2021 will be built to satisfy the 2009 PCE Blueprint. You can review the blueprint here.

Sample Exam Session

Group 1 10-minute station circuit 10 10 10 10 10 10


SHORT BREAK (~15 minutes)



https://www.alliancept.org/taking-the-exam/preparing-for-the-exam/exam-blueprint/

CHAPTER 2: ABOUT THE EXAM

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EXAM DELIVERY SOFTWARE

We are delivering the exam using the Qpercom Observe platform. Qpercom Observe is a digital software solution made specifically for clinical assessment exams, such as Objective Structured Clinical Examinations (OSCEs). To read more about Qpercom, please visit the Qpercom website.

An introduction to navigating Qpercom Observe is provided in Chapter 6 of this guide. You will also have access to Qpercom orientation videos prior to the exam, which will show you the exam experience from a candidate’s perspective.

REQUIRED, PERMITTED AND PROHIBITED ITEMS

You are required to have certain items with you in order to participate in the exam. There are also several items that you are not allowed to have with you during the exam. The tables below list items that are required, prohibited, and permitted (if you personally require or desire them) during the exam.

https://www.qpercom.com/observe/

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Required Prohibited

• Government-issued photo identification (see section 4.1 for more information)

• Keyboard (attached with wire or Bluetooth/wireless permitted)

• Laptop/PC with testing platform application installed, with onscreen scratchpad for taking notes

• Microphone / Speakers (built-in only)

• Mouse (attached, Bluetooth or wireless)

• Web camera (built-in or attached) • All required props (listed on Page 9, below)

• Stethoscope

• Lab coat

• Notebook, paper, pen, pencil, highlighter

• Food, beverages (other than water)

• Hair accessories (unless for religious reasons)

• Headphones/earphones and/or microphones connected to computer

• Jewelry (unless for religious reasons)

• Outwear, hat

• Calculator of any kind

• Published materials and other testing aids

• Purse, wallet, bag, briefcase

• Smartphone / Cell phone, pager, any other electronic devices including any wearable technology

• Watch

Permitted Items

• One dry-erase whiteboard, no larger than 12 in. x 12 in. or one laminated sheet of paper

• Two dry-erase pens

• Eyeglasses, if required

• One clear, plastic bottle of water, label removed

• Tissues or paper towels (for erasing whiteboard, as well as for personal use)

• Medications (no packaging or paper inserts)

• One whiteboard eraser

• You may have one post-it note or one index card with your username and password for Qpercom and ProctorU


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Your room/environment will be reviewed by the ProctorU proctor using a webcam or your laptop’s camera. If you are taking the exam on a desktop, you will complete the room scan with your cell phone. In this case, you may keep your cell phone nearby until after the room scan. You will have to turn it off and leave it outside your exam room after the room scan. All candidates are allowed to have a cell phone nearby and outside your exam room, with the ProctorU support phone number and email address: 1-855-772-8678, as well as the CAPR exam support email [email protected].

4.1 Photo Identification Requirements

Candidates are required to show government-issued photo identification as part of the proctoring process.

Only the following types of government-issued photo identification are accepted:

• Canadian or International Passport

• Canadian Driver’s License

• Canadian Permanent Resident Card

This identification must:

• be original as issued (no photocopies or electronic copies)

• be valid (not expired)

• exactly match the name the candidate used to register for the exam with CAPR

• include a photograph that resembles the candidate’s current physical appearance

Candidates must contact CAPR at [email protected] prior to exam day if they:

• are unable to provide one of the acceptable forms of ID;

• have any concerns about the ID they plan to use for the exam.

4.2 Additional Notes about Prohibited Items

• All required and permitted items and all props are subject to inspection during the exam proctoring process.

• Prohibited items are not allowed in the testing space at any time during the exam. You will be instructed to remove any prohibited item(s) during proctoring. If a prohibited item is detected in the space upon review of exam recordings, you will be subject to the Rules of Conduct provided in Chapter 1, Section 1.1.

• You must turn off all smartphone(s)/cell phone(s) and all other electronic devices during the exam. As prohibited items, these must be stored outside the testing space.




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REQUIRED PROPS AND FURNITURE

You should have the following props and furniture available in your testing environment during the exam. Only those props listed may be used during the exam. The “Instructions to Candidate” for each station will list the props that may be used in that station.

PLEASE NOTE: This list includes all the props that candidates are permitted to use during all administrations of the virtual clinical exam. Not all props will be appropriate for every exam session. All props will be inspected during proctoring.

Quantity Item

2 Chairs without arms *

1 Chair with arms *

1 Small table or desk (in addition to the surface for your computer) **

3 Pillows without pillowcases

1 Bath towel—not rolled (approximately 30" x 46" or 76cm x 117cm)

1 Bath towel—rolled (to approximately 6" diameter (15cm), 12" length (30cm))

1 Hand towel (approximately 28" x 15" or 72cm x 38cm)

1 Belt (e.g., from a bathrobe) or strap (approximately 3ft or 1m in length)

1 Broomstick, meter stick, pole or cane (approximately 3ft or 1m in length)

1 Laundry basket, empty (approximately 10" x 15" x 22" or 25cm x 42cm x 55cm)

1 Can of soup—large (approximately 23fl oz or 680mL)

1 Can of soup—small (approximately 10fl oz or 300mL)

1 Bottle of water—large (approximately 34fl oz or 1L)

1 Bottle of water—small (approximately 17fl oz or 500mL)

1 Stopwatch

* Chairs should be sturdy, appropriate for providing support when necessary. You may use two chairs without arms in place of a treatment table to demonstrate exercises in supine or in sitting with the leg supported. You should not try to demonstrate exercises in prone or side-lying.

† Table should be sturdy : useable as a surface for demonstrating upper extremity exercises or for support when necessary.

2021 PCE CLINICAL

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CHAPTER 3: APPROACHING A VIRTUAL CLINICAL STATION

CHAPTER 3: APPROACHING A VIRTUAL CLINICAL STATION When you are preparing for the 2021 Clinical Component, keep in mind that the only significant change to the exam is the method of delivery. The exam remains an Objective Structured Clinical Exam (OSCE). During the exam, you will engage in 12 clinical encounters or stations. In each station, you will interact with a Standardized Client, while being observed by an Examiner.

STEP-BY-STEP APPROACH TO A VIRTUAL CLINICAL STATION

1.1 Before you enter the station

1. Prepare to begin each station sitting in a chair close to your computer/camera.

2. You will be presented with the “Instructions to Candidate”.

3. Review the instructions carefully and ask yourself:

• Who is my client?

• What information am I given about them?

• What am I being asked to do?

o Are the instructions specific (e.g., “Use X to do Y” or “teach X to the client”)?

o Or do they require you to decide (e.g., “Perform three techniques”)?

• Where is the clinical encounter taking place?

• What props and furniture am I allowed to use in this station?

• What might be the precautions?

• Am I given any information about the physical situation of the client? (e.g., will they be lying on a hospital bed or treatment plinth?)

• What other information am I given?

CHAPTER 3: APPROACHING A VIRTUAL STATION

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Taking notes for use in the station

If you wish to take notes while reviewing the “Instructions to Candidate”, you may use a dry erase whiteboard or piece of laminated paper no bigger than 12 in. x 12 in. and a dry erase pen. You will be able to reference your notes for the duration of the station. You will also be able to access the “Instructions to Candidate” through the platform at any time during the station. You will be asked to demonstrate to the examiner that you have erased your writing surface after the last (sixth) encounter in the circuit. The Administrator will pause the encounter when the time runs out and you will get a notification on the screen when it is time to do this. You are not permitted to use physical paper, pencils or pens during the exam.

1.2 Upon entering the station

1. When you are connected to the station, a Standardized Client will be visible on your screen. The Examiner will also be in the virtual room, but you will not see the Examiner on your screen (i.e., the Examiner’s camera will be disabled so that their image is not a distraction to you).

2. Begin the interaction with the Standardized Client. This interaction should be guided by the

“Instructions to Candidate”.

STRATEGIES FOR THE VIRTUAL ENVIRONMENT

All clinical stations being used for the 2021 Clinical Component have been selected or modified for their suitability for the virtual environment. You will not be presented with any clinical scenarios that are impossible to complete in the virtual environment.

In the virtual environment, there are many ways you can demonstrate your ability to safely and effectively apply the principles and processes of physiotherapy practice.

These include:

1. Communicating verbally

To assess or observe the Standardized Client, you may ask them to:

• adjust their position;

STUDY TIP:

Use the above list of questions when approaching all practice stations provided by CAPR, as well as any practice stations you develop yourself. This will keep you focused on your client, their history, diagnosis, condition, etc., and on what is required of you in the station.


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• move around the room;

• turn around to face sideways or away from the camera;

• perform specific movements;

• repeat an action;

• speak louder or repeat themselves.

Remember to keep the “Instructions to Candidate” in mind when asking the Standardized Client to adjust their location or position. Also, if the “Instructions to Candidate” specifically ask you to describe what you are doing, you must verbalize your actions in order to receive credit for them.

2. Demonstrating

To teach the Standardized Client a movement, exercise, posture, correction, etc., you might choose to demonstrate the desired motion yourself. You may use any of the props indicated in the “Instructions to Candidate” for that station to assist your demonstration. A complete list of the props you may have with you to use in the exam is included on Page 7.

3. Asking for Feedback

If you are unsure what the Standardized Client is feeling, ask them for verbal feedback. Do not rely only on cues from the Standardized Client’s facial expressions—verbal feedback will provide you with more accurate and specific information.

PLEASE NOTE:

Do not ask the Standardized Client (SC) to adjust their camera angle. The optimal camera angle for each station has been determined prior to the examination

! based on what is required in the station and how you might reasonably be expected to complete the station requirements. In some stations, the SC has been trained to adjust the camera to benefit the candidate’s experience in the station. The SC will not adjust the camera if asked.

PLEASE NOTE:

Treat each station/interaction as a virtual clinical encounter. You will not be able to

! touch or provide tactical prompts with the Standardized Client. The station is not meant to represent a full telehealth encounter. You are not expected to perform full telehealth protocols when engaging with the Standardized Client. Please refer to the Candidate Presentation referenced in Section 5, below, for further clarity.


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VIRTUAL CLINICAL STATION MARKING

For each station, the Examiner grades the candidate’s performance using a Master Checklist and a Global Ratings scale. These grading tools are described in the table below.

Grading Tool When it’s used Description

Master Checklist

During the station

The checklist for each station correlates directly with the “Instructions to Candidate” for that station. The checklist contains a list of all the items for which a candidate can potentially receive marks during the clinical encounter. Example checklists are available in section 6 of this module.

Global Ratings

When the station is complete

At the conclusion of the station, the Examiner rates the candidate’s overall performance using a 5-point Global Rating scale.

For the 10-minute stations, ratings are given in the following categories:

• respecting the client;

• taking an organized approach;

• using appropriate techniques;

• using effective verbal communication; and,

• listening to the client.

For the 5-minute stations, ratings are given in the following categories:

• respecting the client;

• taking an organized approach; and

• using appropriate techniques.


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VIRTUAL PRACTICE STATIONS

In Appendix A of this guide, you will find seven virtual practice stations. The Master Checklist for each station is included to provide you with further insight into what is being assessed in each station.

WATCH: IN-PERSON VS. VIRTUAL APPROACH TO CLINICAL STATIONS

The following excerpt from CAPR’s Candidate Presentation about the PCE discusses general approaches to clinical stations and how these approaches work in both the in-person and virtual environments.

Click here to access the excerpt.

STUDY TIP:

When practicing stations with friends and colleagues, use a teleconferencing application, such as Zoom or Teams to simulate the virtual environment.

https://youtu.be/lA9F8cVXAf4

2021 PCE CLINICAL

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CHAPTER 4: PREPARING YOUR PHYSICAL ENVIRONMENT

CHAPTER 4: PREPARING YOUR PHYSICAL ENVIRONMENT

Because the 2021 Clinical Component is a remote assessment, you will take the exam from a private location/space of your choosing. While we want to be as flexible as possible about exam space requirements, your testing environment must allow you to perform the exam as designed and must demonstrate adequate privacy and security to ensure the integrity of your performance.

CONSIDERATIONS FOR CHOOSING YOUR TESTING SPACE

You should choose your testing space based on the three principles provided below. Doing so will not only help you complete the proctoring process quickly and easily but also create the most favourable conditions for you to have a successful exam experience.

Privacy—You must be alone in the space, unable to hear or see another person or be heard or seen by another person. This ensures not only the independence of your performance and the security of the exam material but also that you will not be distracted or disadvantaged by noise or movement.

Connectivity—Your internet connection must be private, secure, stable and not burdened by additional users. This is essential to ensuring your exam is not interrupted, disrupted or terminated due to technical issues.

Simplicity—Your space must not be excessively cluttered or furnished with items that could benefit your performance either intentionally or unintentionally. This is important to ensure quick and easy proctoring and to eliminate any impression of misconduct during the exam.

CHAPTER 4: PREPARING THE PHYSICAL ENVIRONMENT

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REQUIREMENTS OF YOUR TESTING SPACE

The below table provides the detailed requirements of the physical testing space. These requirements are meant to ensure:

1. you have enough space and privacy to perform the exam as intended;

2. the Examiners and Standardized Clients can hear and see you throughout the exam;

3. you can quickly and easily demonstrate the security of your space during proctoring.

Consideration Requirements

General • an indoor location with four walls and a door that can be closed

• free of background noise, disruptions, distractions

Size • enough space to demonstrate movements of your legs and arms in both sitting and standing

• in standing, you should be able to raise your arms over your head and out to the sides in all directions

Wall behind/in front of candidate

• bare/blank (no posted or hanging items)

Lighting • well-lit from behind and/or above your computer/webcam (i.e., not backlit from behind you)

Objects/items • all non-essential items (i.e., papers, books, electronic devices, etc.) removed or covered, except the props and furniture listed in Chapter 2 of this guide, and any other items CAPR has approved in writing (i.e., for alternative accommodations)

Occupancy • no other people or pets allowed in your room/space for the duration of the exam, even if your space is an open-concept area


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EXAMPLES OF ACCEPTABLE AND UNACCEPTABLE TESTING SPACES

The following are examples of acceptable and unacceptable spaces, items and network conditions, based on the three principles provided above. Please note that application of these three principles (i.e., privacy, connectivity, simplicity) is implied for everything that appears in the acceptable list. These lists are not exhaustive. When in doubt, rely on the principles.

ACCEPTABLE

Locations*

Enclosed room with door (ideal)

Bachelor or studio apartment

Open concept space

Clinic or office space*†

Hotel room*

Items

Bookcase

Shelving, storage unit

Additional furniture (couches, beds, etc.)

Paintings, photographs

Network Conditions Private/secured, wired internet connection, with no other users (ideal)

Private/secured WiFi connection with stable, uninterrupted service and no other users

* If you are using a location that is not your private residence (e.g., hotel, clinic, office) it is your responsibility to confirm that the on-site network meets the technical requirements listed in Chapter 5.

† If you are using a clinic or office space, you will need to ensure that no one else is in the same office space or the same section of the clinic as you.


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UNACCEPTABLE

Locations

Private space where roommates and/or family members are within earshot

Main floor clinic or office space with no privacy from the perspective of the street (i.e., open or no floor-to-ceiling blinds/curtains)

Public space (library, café)

Items

Posters, diagrams, models (e.g., anatomical models, skeletons, etc.)

Electronic devices (other than computer and webcam being used for the exam)

Network Conditions

Public or open WiFi connection

Multiple candidates on the same network during the same exam

Roommates or family members using the candidate’s network during the exam

SETTING UP YOUR COMPUTER AND/OR WEBCAM

It is highly recommended that you plan the placement of your computer and webcam prior to the first day of your exam. If you are using a space that you will not have access to until exam day, schedule some extra time ahead of the exam so that you can place your computer and webcam properly and become familiar with the space.

Space Requirements

Set up your room so that you have enough space behind you to move away from the camera to demonstrate movements in sitting or standing. You will not be required to demonstrate movements in a lying position during the exam.

Why it’s important:

During the exam, you may wish to demonstrate movements to the Standardized Client as part of an assessment and/or treatment. You may also be required to demonstrate movements/ techniques to the Examiner.


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Figure 1: showing general space requirement for exam

Camera Angle

To make it easier for you during the exam, it is highly recommended that you set up your computer camera/webcam so that your entire body—from arms reaching over your head to your feet on the floor—is visible within the camera frame when you are standing back from the camera. Depending on your height and the size of your space, you may choose to plan to make minor adjustments to the angle of your camera during the exam to ensure your extremities are adequately visible. You are not allowed to move the location of your camera during the exam, except during proctoring.

Why it’s important:

The Standardized Client and Examiner must be able to see all your movements during the exam. If you are ever in doubt about whether you can be seen, you may ask for verbal confirmation.


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Figure 2: showing optimal camera angle


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Figure 3: Showing minor adjustment to camera angle to capture upper and

lower extremities

COMPUTER AND WEBCAM SET UP TIPS:

• Use masking tape or painter’s tape to mark the correct placement of your computer and webcam upon your desk/table. This will allow you to quickly and confidently place/replace these items before the exam and following your check in with the remote Proctor.

• Note the angle of your computer screen or webcam to ensure you can efficiently replicate the desired camera angle.

• Place masking tape or painter’s tape on the floor of your testing space to mark your ideal positioning when sitting in front of the camera (e.g., when speaking to the Standardized Client) and standing back from the camera (e.g., to demonstrate a posture or exercise).

2021 PCE CLINICAL

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CHAPTER 5: TECHNICAL REQUIREMENTS


The 2021 Clinical Component will be delivered using virtual OSCE software called Qpercom Observe. You are responsible for confirming that your computer system meets the requirements detailed in this chapter. Please do this well ahead of the exam to support a smooth exam experience from a technical standpoint.

SYSTEM REQUIREMENTS

The below tables provide detailed information about the hardware, software and network requirements for the exam.

1.1 Hardware Requirements

Hardware Recommended System Requirements

Minimum System Requirements

Computer • laptop or desktop computer;

• Mac or PC

• no tablets, smart/cell phones, etc.

--

CPU speed • Dual Core Processor • Dual Core Processor

Available hard drive space • 8 GB • 5 GB

Total memory (RAM) • 8 GB • 4 GB

Monitor • single monitor

• screen resolution of 1920 x 1080 is recommended at a scale of 100%

• no dual-monitor configurations

--

Webcam • free-standing or built-in with a minimum resolution of 640 x 480 p

--


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Microphone/Speakers • built-in microphone and speaker

• no wired and wireless headphones or headsets

• desktop microphone and speakers

Power • directly plugged into a power source

• no docking station

--

1.2 Software Requirements

Software Recommended System Requirements


Operating system • Windows 10 (S Mode not supported);

• MacOS 10.15 or higher

• Windows 8 or higher (Windows 10 S Mode not supported);

• MacOS 10.13 or higher

Google Chrome(1) • Google Chrome current version

• You cannot use Firefox, safari, or any other browser

--

Anti-virus software • All third-party antivirus software and pop-up blockers must be turned off

--


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1.3 Network Requirements

Network Recommended System Requirements


Stable internet connection (2) • Download Speed of 12 mbps

• Upload speed of 3 mbps

• Wired internet connection to reduce the likelihood of connectivity issues during the exam

• download speed: 3 mbps

• upload speed: 1 mbps

• Wi-Fi only if you are unable to establish a wired connection (3)

No other connected devices • disconnect unnecessary or prohibited devices such as printers, second monitors, etc. and remove them from the room

• no other people should use your internet network during the exam, as activities such as online gaming and music and video streaming will limit available bandwidth and may cause connectivity issues

--

VPN • If you have a VPN connected to your computer this must be deactivated for the exam period

2) To test the speed of your internet, click here: https://www.speedtest.net/ here https://fast.com or here speedtest.googlefiber.net

3) If you must use WiFi and have concerns about the stability of your internet connection, we strongly advise that you seek technical support to strengthen your connection well in advance of your exam.

PLEASE NOTE:

! We highly recommend that you use a wired internet connection (i.e., an ethernet cable plugged directly into your modem or router, using a USB port adapter if needed).

https://www.speedtest.net/

https://fast.com/

http://speedtest.googlefiber.net/


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1.4 Summary of Prohibited Technology

Summary of Prohibited Technology

• no tablets, smart/cell phones, etc.

• no dual-monitor configurations

• all third-party antivirus software and pop-up blockers must be turned off

• no docking stations • no wired or wireless headphones or headsets

• Windows 10 S Mode not supported

In the unlikely event that you experience a technical issue during your exam and are disconnected from the Qpercom exam platform, you may leave your exam room to email us at [email protected]


2021 PCE CLINICAL

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CHAPTER 6: INTRODUCTION TO NAVIGATING QPERCOM

CHAPTER 6: INTRODUCTION TO NAVIGATING QPERCOM The exam is administered using a platform called Qpercom Observe. Prior to your exam, CAPR will email you the Qpercom Observe URL, as well as your Qpercom credentials. You must login to Qpercom to create your own unique password, which will “activate your account”. This step must be done before your exam day.

The following sections provide general orientation to the Qpercom platform and the different exam “states” you will experience during your exam. More orientation materials, including a Student Walkthrough video and troubleshooting tips, will be provided to supplement this general orientation.

GETTING STARTED

When it’s time for your exam, you will go to the Qpercom Observe URL. capr.qpercom.com/console

Click on the Initial Login/Forgot Password? option

CHAPTER 6: INTRODUCTION TO NAVIGATING QPERCOME

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To – Window 1 Candidates,

We have had some emails to us regarding setting up your credentials and not being able to see the video tutorial on how to set up your unique password. Here is the visual version of that set up for you!

• Access the console at URL: capr.qpercom.com/console • Click on the Initial Login/Forgot Password? option

https://linkprotect.cudasvc.com/url?a=http%3a%2f%2fcapr.qpercom.com%2fconsole&c=E%2C1%2CtJvfzb6Idc1XaPr1NLk7t1RPJaeZJOVGc-M1tIYo8uXROi0_hyykUgUxfGzgTAfLmQfQlwgsiDCOjFeNpGCo0w3ZJsI6pVwnyyVrpW-8tw%2C%2C&typo=1


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• Candidates will be taken to this page where they will input their email address and click Submit

• Each candidate will receive an automated email from the system asking them to create a password to activate their account

• Candidates then will need to return to the console at URL: capr.qpercom.com/console and log in using the password they have just created

• When they click on Login they will be authenticated and authorized to view their Exam list inside the system

If you would like to watch the video for setting up your unique password you can use this link here https://youtu.be/GTrsbtmfbyc

https://linkprotect.cudasvc.com/url?a=http%3a%2f%2fcapr.qpercom.com%2fconsole&c=E%2C1%2CeiW-QVnKGIT7dHtoYxzbyMkDL707HIJz-PX18F52KLOaglY_67tsH6g3MJZDZeDy-th3JONc_r4gQWHbzuY_ihCxPQCASveYRYkneHCI3Bhi&typo=1

https://youtu.be/GTrsbtmfbyc


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Once you’ve logged in, you’ll see an “Exam list”, where your session will be listed.

Click the green “Choose” button to begin your session.

At this point, Chrome will prompt you to “Allow” Qpercom to access your microphone and camera.

Click “Allow”.


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1. 2.

3.

QPERCOM BASICS

Preview >> Preparation >> Reading Time

You will enter the exam session Waiting area, where you will see yourself onscreen. The layout of the Waiting area shows you the view you will see throughout the exam.

The key features of your screen view are described below.

1. Exam Status Bar.


2. Notifications from the Exam Administrator.

Exam Status is Preparation x

Throughout your exam session, the current exam state will always be highlighted in the green exam status bar in the centre of the screen. The exam status bar will also show you the previous and next exam states, on the left and right sides.

The exam administrator will give you real- time updates about the exam status, as well as upcoming changes, e.g., “Reading Time is about to begin”. All notifications are accompanied by a sound alert. You can close the notification boxes by clicking the “x” at the top right of the notification box.

You can click the “Help” button, located at 3. Help button.

help the bottom right of your screen, at any point during the exam to alert the exam administrator to issues.

Actors and Examiners meet in a virtual room, candidates are waiting to start reading time.


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EXAM STATES AND STATION FLOW


When you enter your exam session, the exam will be in the Preparation state. You will receive a notification from the exam administrator before the exam moves into the Reading Time for your first clinical station.

Preparation >> Reading Time >> Confirm Candidate

When a clinical station moves from Preparation into “Reading Time”, the Instructions to Candidate will pop open on your screen. You can click the “x” to close the instructions, if you wish.

You will receive a notification when you have 30 seconds left in Reading Time.

Reading Time >> Confirm Candidate >> Assessment

When Reading Time ends and you are moved into the station, you will see the Standardized Client appear on screen. At this time, the Examiner, who is also in the virtual station, will take 30 seconds to confirm your arrival and your identity before beginning the assessment. You will not be able to see the Examiner during your time in the station, as their camera will always be off.


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onfirm Candidate >> Assessment >> Reading Time

The Examiner will move the station into the Assessment stage. You may see the SC disappear for a moment while the station transitions into Assessment. Do not worry; this transition is brief and the SC will return to your screen momentarily. When you will see a notification that says, “Assessment has begun”, start your interaction with the SC.

During the Assessment, you can re- open the Instructions to Candidate by clicking the green “Open Instructions” button on the right-hand side of your screen under “Exam Details”. If appropriate for the station, you may also have the option to “Open Sharing Media”. Not all stations will include additional media.

ssessment >> Reading Time >> Confirm Candidate

When the Assessment phase ends, you will be moved into the Waiting area for the next station, where “Reading Time” for the next station will begin immediately.

You will complete six station cycles— Reading Time >> Confirm Candidate >> Assessment—in each six-station circuit.

Aside from logging in to Qpercom and choosing your exam from the Exam list at the beginning of your session, you are not responsible for doing anything to move yourself through the exam. Other than clicking the options to “Open instructions” and “Open shared media”, closing notifications from the exam administrator, and possibly using the Help button to report an issue, you shouldn’t click any buttons while participating in your circuits.

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APPENDIX A: PRACTICE STATIONS FOR THE VIRTUAL ENVIRONMENT

© 2021 Canadian Alliance of Physiotherapy Regulators

VIRTUAL PRACTICE STATION 1

INSTRUCTIONS TO CANDIDATE

Anne Saunders

58 years old

This client has osteoporosis and had a compression fracture at T4, which is now healed. Anne is independent with all activities of daily living.

You are seeing Anne today in an outpatient clinic.

• Assess her sitting posture and describe your findings to the examiner.

• Correct her sitting posture.

• Teach her the importance of correct sitting posture.

In the station, you will have the following items available to you: A chair with arms A chair without arms A foot stool Two textbooks A small towel

You have 5 minutes to complete this station.



NOTES FOR EXAMINER

Item 3:

If the candidate corrects posture by asking for “axial extension” or any similar instruction, give credit for all 4 points.



MASTER CHECKLIST

Item Does Correctly 1. Explains purpose of interaction 1 2. Describes assessment findings:

Chin poke/head forward position 1 Increased thoracis kyphosis 1 Rounded/protracted shoulder girdle 1 Loss of lumbar lordosis 1

3. Has client demonstrate correction of: Cervical spine 1 Thoracic spine 1 Lumbar spine 1 Shoulder position 1

4. Indicates to client when correct posture is achieved 1 5. Corrects leg position:

Legs uncrossed 1 Feet supported 1

6. Tells client that: Correct posture decreases the stress on the vertebrae/spine 1 Correct posture decreases discomfort/pain 1 Good sitting posture may reduce the risk of further compression fractures 1

MAXIMUM TOTAL SCORE =15




Peter Robitaille

32 years old

The client has a 5-month history of diffuse back pain.

He has recently been diagnosed with ankylosing spondylitis.

You are seeing Peter today in the outpatient clinic.

• Teach this client 3 exercises to prevent 3 common physical limitations of this ankylosing spondylitis.

• Exercises should be done in sitting and/or standing.




NOTES FOR EXAMINER

Items 2, 3, 4:

If the candidate chooses an inappropriate exercise, do not give any marks for that exercise (i.e., selects, explains purpose, instructs, has client demonstrate)

Appropriate exercises must be performed in sitting and/or standing and include:

• Chest expansion exercises • Exercises to improve or maintain cervical range of extension, rotation, side flexion • Exercises to improve or maintain axial posture • Exercises to maintain shoulder girdle retraction and depression • Exercises to maintain shoulder ROM • Exercises to improve or maintain thoracic spine extension, rotation, side flexion • Exercises to improve or maintain lumbar spine extension, rotation, side flexion • Exercises to improve or maintain hip extension, abduction, rotation • Exercises to maintain strength of spine, shoulders/shoulder girdle or hips



MASTER CHECKLIST

Item Does Correctly 1. Explains purpose of interaction 1 2. First exercise:

Selects appropriate exercise 1 Explains purpose for doing exercise 1 Instructs client in exercise 1 Has client demonstrate exercise 1

3. Second exercise: Selects appropriate exercise 1 Explains purpose for doing exercise 1 Instructs client in exercise 1 Has client demonstrate exercise 1

4. Third exercise: Selects appropriate exercise 1 Explains purpose for doing exercise 1 Instructs client in exercise 1 Has client demonstrate exercise 1

5. One of the exercises selected is a chest expansion exercise 1 6. Instructs in parameters of exercise:

Instructs in frequency 1 Instructs in repetitions 1

7. Enquires about pain during exercises 1 8. Asks if client has any questions 1





Janet Sawchuk

65 years old

Janet fell on some wet pavement.

She underwent open-reduction internal fixation (ORIF) surgery yesterday to repair a fracture of her right femur.

The surgeon’s orders are weight-bearing as tolerated, and activity as tolerated.

You are seeing Janet today in her hospital room.

• Teach this client 3 appropriate bed exercises in supine.

You will have the following props available to you in the station: A rolled towel A belt from a bath robe

In this station you will find the standardized client lying in a bed. Please proceed as if this were a hospital bed.




NOTES FOR EXAMINER

Items 2, 3, 4:


Appropriate exercises include:

• Ankle pumping • Static gluteals • Active or active assisted hip and knee flexion • Quads over roll exercise • Active or active assisted hip abduction • Any other appropriate exercise

Inappropriate exercises include:

• Straight leg raise



MASTER CHECKLIST

Item Does Correctly 1. Explains purpose of interaction 1 2. Enquires about pain before exercise 1 3. First exercise:

Selects appropriate exercise 1 Explains purpose for doing exercise 1 Instructs client in exercise 1 Has client demonstrate exercise 1

4. Second exercise: Selects appropriate exercise 1 Explains purpose for doing exercise 1 Instructs client in exercise 1 Has client demonstrate exercise 1

5. Third exercise: Selects appropriate exercise 1 Explains purpose for doing exercise 1 Instructs client in exercise 1 Has client demonstrate exercise 1

6. Instructs in parameters of exercise: Instructs in frequency 1 Instructs in repetitions 1

7. Enquires about pain during exercises 1 8. Asks if client has any questions 1





Sandra Darome

17 years old

A physiotherapy consultation was requested by the Emergency Department.

Sandra was diagnosed with a lateral dislocation of the left patella, which happened 3 hours ago while playing volleyball.

There was spontaneous self-reduction of the patella.

Sandra reports that she injured her knee while pivoting on her left foot in order to return a volley.

She reports hearing a loud "pop" at the time of injury and that the onset of pain was immediate.

Her knee is still very painful.

• Explain to the client the factors and the mechanisms that may have contributed to her injury.

• Discuss how she might prevent recurrence of the same injury.




MASTER CHECKLIST

Item Does Correctly 1. Explains purpose of interaction 1 2. Explains mechanism of injury:

Influence of forces on knee joint (e.g., pivot, valgus stress) 1 Laxity of medial structure 1 Tightness of lateral structure 1 Weakness of medial muscles/muscle imbalance 1

3. Explains cause of pain (e.g., shearing of patella, soft tissue stretch or tear) 1 4. Discusses prevention of recurrence:

Muscle strengthening exercises 1 Stretching of tight structures 1 Avoidance of pivots 1 Use of knee brace or use of tape 1





Daniel Kerba

41 years old

This client is attending a private physiotherapy clinic and reports left foot pain.

• Take a focused history.

You have 10 minutes to complete this station. At the 8-minute mark, the examiner will ask you 2 questions about this client.



NOTES FOR EXAMINER

Items 11 and 12:

If the candidate does not answer Question 11 correctly, do NOT give a mark for the answer to Question 12.



MASTER CHECKLIST

Item Does Correctly 1. Explains purpose of interaction 1 2. Enquires about past medical history 1 3. Enquires about history of diabetes 1 4. Enquires about previous history of foot or lower extremity problems 1 5. Enquires about client’s occupation 1 6. Enquires about Pain:

Onset 1 Location 1 Aggravating factors 1 Alleviating factors 1 Nature (e.g., dull, sharp) 1 Intensity 1 Duration 1 Pattern during running (e.g., constant, periodic, occasional) 1 Getting better or worse over time 1 Medication 1

7. Enquires about jogging history: Onset/initiation of jogging 1 Frequency 1 Change in intensity/distance 1 Warms up/cools down (e.g., starts slow, speeds up, slows down) 1 Stretch pre/post jog 1 Footwear 1 Running surface 1

8. Enquires if client engages in any other form of physical activity 1 9. Enquires about other signs and symptoms:

Swelling 1 Discoloration 1 Loss of strength 1 Loss of movement 1 Tenderness on palpation 1 Sensory changes 1

10. Enquires about x-ray or medical investigations 1 AT 8 MINUTES, THE EXAMINER WILL STOP EACH CANDIDATE AND ASK THE FOLLOWING QUESTIONS:

11. “Based on the focused history, what is the most likely clinical diagnosis?” (Mark only 1) Plantar fasciitis 1 Sprain of the plantar fascia, spring ligament or plantar aponeurosis 1 Inflammation of the plantar fascia, spring ligament, plantar aponeurosis 1 Overuse injury of the plantar Fascia, spring ligament, planter aponeurosis 1

Maximum possible score =1


12. “What leads you to suspect this clinical diagnosis?” (Mark only 3) Pain is over origin of plantar fascia 1 Client reports pain first thing in the morning or after prolonged rest when weight bearing 1 Overtraining – sudden increase in frequency 1 Lack of appropriate warm up and cool down, inadequate stretching 1 Overweight or overloading of feet 1

Maximum possible score =3 MAXIMUM TOTAL SCORE =34




Stephanie Raymond

32 years old

This client has constant and severe low back pain following a motor vehicle collision two days ago.

She is living alone and is independent with Activities of Daily Living (ADLs) but has difficulty with most movements.

You are seeing Stephanie today in an outpatient clinic.

The objective examination reveals:

- movement towards extension makes her pain worse - movement towards flexion relieves her pain - there are no neurological deficits - the client has been diagnosed with a low-back soft tissue injury

• Teach the client appropriate resting positions in lying.

• Teach the client to move between lying and sitting in the chair.

• Instruct the client in pain management strategies.

You will have the following props and furniture available to you in this station: 3 pillows with pillow cases 2 bath towels A sofa

In this station, please proceed as if the sofa in the station is a treatment bed.




MASTER CHECKLIST

Item Does Correctly 1. Explains purpose of interaction 1 2. Instructs client in supine rest position with hips/knees flexed and supported:

Describes position to client 1 Uses pillow or towel roll to support neck 1 Uses pillow to support knees 1 Checks comfort of position 1

3. Instructs client in side lying rest position with hips/knees flexed: Describes position to client 1 Uses pillow or towel roll to support neck 1 Uses pillow between knees 1 Uses towel roll at waits to prevent side flexion 1 Checks comfort of position 1

4. Instructs client in transitional movements: Sitting to or from side lying 1 Side lying to or from supine (log roll) 1 Has client demonstrate: Sitting to or from side lying 1 Side lying to or from supine (log roll) 1

5. Instructs client to: Avoid prone lying 1 Avoid prolonged positions (must mention more than one position) 1 Use a footstool when standing 1 Avoid lifting 1 Avoid strenuous activities 1 Take frequent rest periods, alternating with light walking and activity 1

6. Instructs client in use of ice or heat: Use ice packs to relieve pain 1 OR Use heat to relieve pain 1

Maximum possible score =1 MAXIMUM TOTAL SCORE =21




Steve Hagerman

25 years old

This client sustained a complete C7 spinal cord injury 10 weeks ago in a motor vehicle accident.

His cervical fracture was repaired surgically, and he has been at the rehabilitation hospital for 3 weeks.

He has not been performing the pressure relieving techniques he was taught.

There are no restrictions to his activity except he is not allowed any cervical spine range of motion.

• Review 3 pressure relieving techniques for the buttocks that he can do independently in his wheelchair.

• Assume the front castors on the wheelchair are positioned to prevent the wheelchair from tipping forward.

• Explain to the client the rationale for pressure relief.

In this station, you will find the client sitting in a chair with arms. Assume this is a manual wheelchair with head support and leg rests.




NOTES FOR EXAMINER

Items 3, 4, 5:


Appropriate exercises include:

• Vertical lift • Forward lean • Lateral/sideways lean



MASTER CHECKLIST

Item Does Correctly 1. Explains purpose of interaction 1 2. Enquires about reason for client not performing pressure relieving techniques 1 3. First technique:

Selects appropriate technique 1 Explains technique 1 Demonstrates technique 1 Has client demonstrate technique 1

4. Second technique: Selects appropriate technique 1 Explains technique 1 Demonstrates technique 1 Has client demonstrate technique 1

5. Third technique: Selects appropriate technique 1 Explains technique 1 Demonstrates technique 1 Has client demonstrate technique 1

6. Instructs client about: Frequency 1 Duration of pressure relief 1

7. Explains rationale for teaching pressure relief: Reduce compression forces of bone on tissue 1 Allow circulation to prevent ischemia/pressure sores 1 Emphasizes the consequences of pressure sores (i.e. bedrest) 1

8. Asks if client has any questions 1 MAXIMUM TOTAL SCORE =20

2021 pce clinical component - alliancept.org

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