Supervision and Delegation: PTAs, Aides, Students, and Support Personnel
Supervision and delegation items test whether you can assign work to a PTA, an aide, or a student without crossing a legal line. Georgia's structure is consistent: the physical therapist holds the responsibility, the assistant implements, the aide supports, and the student learns under supervision. The variable is how much supervision each role requires.
Levels of supervision
Board rules distinguish supervision where the PT must be physically present and immediately available from supervision where the PT is not on site but is reachable and provides direction. The level required depends on the patient's condition, the setting, and the intervention. A PT who is unreachable is not supervising at all.
Physical therapist assistant
- Works under the PT's supervision and implements the plan of care.
- May adjust exercise parameters within the plan and report changes; may not perform the initial evaluation, establish or change the plan of care, or make discharge decisions.
- The PT must re-evaluate at intervals and remains responsible for outcomes.
Aides and support personnel
An unlicensed aide may perform non-treatment tasks: transporting patients, clerical work, cleaning and setting up equipment, and maintaining supplies. An aide may not apply a modality, instruct a therapeutic exercise, perform soft tissue work, or make clinical decisions, even under direct supervision. Delegation is limited by the aide's training and by the rule, not by the PT's confidence in the aide.
Students
Students enrolled in accredited programs may perform interventions as part of clinical education under the supervision of a PT or PTA. The student is not counted as staff and does not replace required supervision; the supervising therapist remains responsible for the patient.
Worked example
A PT leaves for lunch and asks a PTA to evaluate a new patient with shoulder pain and start a plan. This violates two rules at once: the evaluation and the plan are PT-only, and the PT is not available to supervise or re-evaluate. The correct approach is for the PT to evaluate, write the plan, and then have the PTA carry out the outlined interventions with the PT reachable.
Traps
Assuming an experienced PTA can evaluate; assuming direct supervision of an aide permits treatment; assuming the supervising therapist's license covers an unsupervised student; ignoring setting-specific supervision ratios the Board's rules impose.