Background

As the international organisation representing orthopaedic manipulative physiotherapy (OMT), IFOMT is committed to the promotion and ongoing development of this area of clinical specialisation.  A major function of IFOMT is to ensure the quality of postgraduate training in orthopaedic manipulative physiotherapy.  The qualities of a programme that concern IFOMT relate to both generic and professional skills that are essential for the graduate to perform in the field of OMT. 

The IFOMT Standards Document provides a detailed guide to the standards of education for postgraduate programmes that are considered acceptable to IFOMT.  This process of IFOMT international monitoring, accepted at the AGM in Cape Town, March 2004 sets out to ensure that educational programmes accepted by IFOMT are satisfying these education standards and producing physiotherapists who are able to deliver a high standard of patient care in the area of orthopaedic manipulative physiotherapy, beyond that of initial IFOMT membership. 

The process will focus on the professional and generic skills identified in the IFOMT Standards Document.  IFOMT recognises the diversity in OMT programmes throughout the world.  The process that has been formulated in this document is considered the most appropriate method for determining standards whilst allowing programmes to preserve their individuality. 

The process for continued evaluation of educational standards to IFOMT will be administered and implemented by the Standards Committee of IFOMT.  The committee members will independently review the submission from the Member Organisation (MO). Their recommendations will be collated by the Chair of the Standards Committee (SC) to be discussed at a planned meeting. Once a decision has been agreed, a report will be written making recommendation to the IFOMT Executive.

Educational standards

The quality of education has received increased attention in recent years, in particular through external factors reflecting the developing educational, political and economic contexts (Stuart, 1994). The nature of quality in education has been debated (Doherty, 1994), but there is agreement that improving quality needs to focus on learning, teaching and the establishment of an effective framework within which these activities can occur (Preedy et al, 1997). Quality can be considered as possessing two distinct components:

1. Quality assurance - related to 'feed-forward' mechanisms aimed at developing the ongoing quality of a course. This encompasses systems to determine strengths, weaknesses and problems (e.g. planning and running a course) and ensure that outcomes are achieved (i.e. matching aims and outcomes).

1. Quality control - related to 'feedback' mechanisms aimed at checking outcomes after the educational processes have occurred to identify strengths, weaknesses and problems (Preedy et al, 1997).

Most educational systems have typically placed emphasis on quality control of their output (Cuttance, 1997). This commonly takes the form of inspection or external examining and monitoring processes. For educational standards to be effective therefore, it can be argued that both quality components are important and that any model that aims to maintain educational standards should encompass both.

The model adopted here places emphasis on quality assurance for the individual courses and their working with the MO. In addition, quality control is central to the MO’s monitoring of standards, and this international monitoring by the SC of IFOMT.

International monitoring of existing member organisations

This document forms part of the Standards Document, so that new members will have a built in system for monitoring their educational programme. This is a quality control mechanism that will evaluate outcomes and progress. In addition it will take the MOs through a development process. Each MO will demonstrate achievement of the following processes through its mechanisms of quality control.

Process of monitoring for an existing MO:

1. Evaluation of an educational programme may take many different forms, ranging from verbal to more extensive written reports. There are guidelines regarding good practice in relation to programme structure and development (Appendix A). Each educational programme of an MO will demonstrate its processes of evaluation to the satisfaction of the MO.

1. An External Assessor will be appointed to each educational programme, who will work to the specifications of the guidelines, to look at the quality of the ongoing educational programme and the processes of programme evaluation that are already taking place. See guidelines for the criteria for External Assessors (Appendix B). The External Assessor must be independent of the course, to enable them to fulfil their role (Appendix C) e.g. Ann Moore who is based at the University of Brighton, is the External Assessor for the University of Birmingham educational programme in the UK (2004/5). The name and CV of the appointed External Assessor should be forwarded to the MO at the time of appointment to the programme, for the MO’s endorsement of the quality and the impartiality of the appointed Assessor.

The External Assessor has access to all material for example, programme documentation and student assessment, and specifically will observe the clinical assessment and sample the students’ written assessments. This ensures quality but also continuous development of the educational programme. The External Assessor writes a report annually to the MO (Appendix D), indicating whether the educational programme is achieving its aims (and therefore the IFOMT standards).

1. The annual report goes to the MO for consideration. This is to ensure that the educational programme is of a standard to lead to membership to that MO. By implication, the educational programme will therefore meet IFOMT standards. The EA therefore monitors programmes for the MO on a yearly basis.

1. The IFOMT SC will receive the reports from the External Assessors and the minutes of the meetings at which the reports were considered by the MO, on a three yearly basis. The SC will consider the reports and report to the IFOMT Executive. The SC therefore monitors the working of the MO on a three yearly basis.

1. Any submission of a new educational programme within the country of an existing MO, would need to be submitted to the MO for scrutiny and will then go through the process described in points 1-4 on an annual basis. Guidelines for the evaluation of new programmes are provided (Appendix E).

Cost of the process of monitoring:

The costing of this process will be dependent on travel costs. In the UK, for example, there is a flat fee for the year’s activity, which is ~£250.00 for an External Assessor. The payment is made on the submission of the written report. Any incurred travel costs will be in addition to the flat fee.

The advantage of having an external person is that in the report there will inevitably be suggestions of development. If it is not possible to appoint an External Assessor from the MO’s own country, then it is possible to seek an Assessor from a different country. Bringing someone in from another MO country may further benefit any development. The overall cost should not be prohibitive to the process, and will be an investment for the MO.   The IFOMT resource centre has a list of names from MOs of appropriate people to fulfil the role of External Assessor.

International monitoring for incoming manual therapy groups.

The above process will need to be established in the developing stages of new Manual Therapy groups and educational programmes as a prerequisite for membership to IFOMT. This document will be incorporated into the present Standards Document, as an additional requirement for membership as of January 2005.

Requirements from member organisations

(All documentation must be submitted in English)

1.   Title page, to include:                      

• Name of Member Organisation
• Contact person
• Role of Contact Person within Member Organisation
• Address
• Telephone
• Fax
• Email address
• Date of submission

2. Overview of MO process of monitoring educational standards. Maximum of 2000 words To include details of all educational programmes recognised as providing membership of MO.

3. External Assessor reports for each educational provider for the previous 3 years / the maximum time available.

4. Minutes of the meeting(s) of the MO when the External Assessor reports were considered.

5. The completed documentation should be sent to the secretary of IFOMT by the required date.

6. Appendix F details the proforma for the review of the submitted documentation by each member of the SC of IFOMT.

7. Following decision of the SC

• The MO is sent a copy of the final report and statement regarding the recommendations of the SC
• The recommendations from the SC will be made to the IFOMT Executive.
• In the event the MO is unsuccessful, the MO will be advised on the areas where the MO failed to meet the standards.  The report would also recommend any follow-up that would be required by the SC. 

References

Cuttance P (1997). Monitoring educational quality. In: Preedy M, Glatter R, Levacic R (Eds). Educational Management: Strategy, Quality and Resources. Buckingham, Open University Press.

Doherty GD (1994). Developing Quality Systems in Education. London, Routledge.

Preedy M, Glatter R, Levacic R (1997). Introduction: managing quality, resources and strategy. In: Preedy M, Glatter R, Levacic R (Eds). Educational Management: Strategy, Quality and Resources. Buckingham, Open University Press.

Stuart  N (1994). Quality in education. In: Ribbins P, Burridge E (Eds). Improving Education: promoting quality in Schools, London, Cassell.

For further information regarding the establishment of a committee as part of the MO to monitor quality, see:

Rushton A, Petty N (2002). The Course Approval Board of the Manipulation Association of Chartered Physiotherapists, Manual Therapy, Vol.7, No.4, pp.222-228.

Appendices:

A.            Guidelines for good practice of educational programmes

2. Criteria for External Assessors

3. Role of the External Assessor

• Guidelines for External Assessor regarding their annual report to the MO

• Guidelines for the evaluation of new programmes