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Coursework Tools History

Learn how coursework tools were developed

Prior to 1955 the oversight of physical therapist education came under the auspices of the American Medical Association (AMA). These standards were established by the AMA’s Council on Medical Education and Hospitals.


Coursework tools (CWT) for foreign educated physical therapists (CWT 1-6)

When APTA took on this oversight function, they adopted AMA’s educational criteria. These criteria and expectations were for physical therapists, physical therapist clinics and physical therapy programs to be under the direction and prescription of the physician. CWT 1 reflects the educational program required of a physical therapist who graduated prior to 1978.

In 1978, the APTA House of Delegates adopted and implemented the first changes in the evaluative criteria since 1955. CWT 2 reflects those changes in philosophy and criteria for PT education.

By 1990, the Commission on Accreditation in Physical Therapy Education (CAPTE) had been created for the purposes of accrediting physical therapy programs within the standards set by the U.S. Department of Education. CAPTE established new guidelines and Evaluative Criteria for the PT educational programs, which were adopted by the APTA House of Delegates. Implementation occurred in 1992. CWT 3 was developed from these standards.

In 1998, the CAPTE evaluative criteria were revised. CWT 4 is based upon the 1998 criteria. In addition, FSBPT used information compiled by the FSBPT Foreign Educated Physical Therapist Committee from 1998-1999, A Normative Model of Physical Therapist Professional Education: Version 97, APTA, 1997 and reviewed catalogs of institutions offering physical therapist educational programs and guidelines from 49 jurisdictions for licensing foreign educated physical therapists. Research done by the New Jersey State Board of Physical Therapy Education Committee and an analysis of requirements of 53 licensing jurisdictions completed by International Credentialing Associates were also considered in the establishment of CWT 4.

CWT 4 was validated against the 1988 Evaluative Criteria for Accreditation of Educational Programs for the Preparation of Physical Therapists, and modified in 2002 to include terminology and concepts published in professional reference documents that describe contemporary education and practice in the US such as the Guide to Physical Therapist Practice Second Edition, APTA, January 2001.

During this timeframe, INS (now USCIS) published rules requiring agencies that provided visa screening for healthcare workers to conduct ongoing validation studies of the tools used to assess candidates for certification. This requirement applied to the coursework tool because FCCPT, an agency recognized by USCIS to provide visa screenings, used (and uses) the FSBPT coursework tool. A validation study conducted at Northwestern University was completed in 2003. Modifications in terminology to CWT 4 were made from recommendations from the Validation Study to bring it into compliance with the then-current CAPTE evaluative criteria.

CWT 5 was prepared and validated by FSBPT upon the publication of the Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists effective January 1, 2006. It was adopted by the FSBPT board of directors to be used beginning July 1, 2009. This date reflects graduation of students taught under the 2006 criteria.

CWT 6 is based upon the Commission on Accreditation of Physical Therapy Education (CAPTE) Evaluative Criteria for PT Programs August 2014, which will be implemented by FSBPT on January 1, 2017.

Chronologically, the first coursework tool actually developed was CWT 4, which encompassed the accreditation standards in place at the time of its development around 1999-2000. In 2004, the Federation’s delegate assembly charged the board of directors to develop and validate different forms of the CWT, based upon earlier versions of the CAPTE evaluative criteria. The delegate assembly’s rationale was as follows:

“Currently, U.S. physical therapy graduates of a CAPTE accredited program and licensed in a U.S. jurisdiction, are routinely granted licensure in another jurisdiction without being required to meet the requirements of the 2004 CWT. Use of the 2004 CWT is unfair for any  licensed physical therapist, domestic or foreign, who graduated prior to CAPTE’s movement to a post-baccalaureate degree. While the determination for licensure is a responsibility of the jurisdiction, the Federation, through its mission, attempts to achieve regulatory uniformity, equality and fairness in the treatment of all licensure candidates. The adoption of this motion will create a first step toward addressing this regulatory inequity in the treatment of foreign educated physical therapists currently licensed in U.S. jurisdictions seeking licensure in other U.S. jurisdictions.”

When the additional three versions of the coursework tool were brought back to the 2005 delegate assembly by the board of directors, the delegate assembly approved motion DEL-05-10, which recommended the following use of the coursework tools.

“The credentials of foreign educated physical therapist licensure applicants should be evaluated using the version of the FSBPT coursework tool that covers the date the applicant graduated from their respective physical therapy education program. Credentialing agencies should use the version of the CWT that coincides with the professional educational criteria that were in effect on the date the applicant graduated from their respective physical therapy education program. This same process should be used for both first time licensees and those seeking licensure through endorsement.”

Jurisdictions may need to update their practice act in order to use the CWTs based on the applicant’s date of graduation. Based on the experience of our licensure boards, the following language is recommended to be used in the rules section of a jurisdiction’s practice act.

“To determine substantial equivalency, the approved credentialing evaluation agency shall use the appropriate coursework tool ("CWT") adopted by FSBPT. The appropriate CWT means the CWT in place at the time the foreign educated physical therapist graduated from their physical therapy program.”


Coursework tool for foreign educated physical therapist assistants (PTA Tool 2007)

PTA tool 2007 was developed by the Federation in response to the 2008 published regulation number CMS-1385 by the Centers for Medicare and Medicaid Services (CMS) for Medicare reimbursement. This CMS regulation requires a foreign educated physical therapist assistant to show certification of education which is substantially equivalent to an entry-level physical therapist assistant’s education in the United States.

PTA tool 2007 reflects the minimum foundational studies and applied science and technical education for substantial equivalence with respect to a U.S. first degree for a physical therapist assistant.

PTA tool 2007 is validated against the CAPTE Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapist Assistants adopted April 2006 and effective July 1, 2007.