PTA Supervision, Delegation, and Scope of Duties
What the exam tests
This domain tests the boundary between PT and PTA practice, the meaning of supervision, and what may be delegated. Most questions turn on whether the task requires the PT's judgment or only implementation.
Delegation rules
- The PT performs the initial examination and evaluation, establishes the plan of care, identifies goals, and decides discharge. These are non-delegable.
- The PTA may perform delegated interventions, collect data, and report the patient's response. The PTA may not independently evaluate a new patient, change the plan, or discharge.
- The PT must supervise the PTA at the level required by the Act and Board rules; the PT remains responsible for the patient's care. Supervision must be documented and must be sufficient for the patient's condition and setting.
- Unlicensed aides may perform only non-skilled tasks. They may not perform skilled interventions or replace a PTA.
Scope of duties
A PTA's competence and the delegation must match. A PT should not delegate a complex intervention to a PTA who has not demonstrated competency. When the patient's condition changes materially, the PTA must stop and notify the PT.
Worked example
A PTA is performing gait training when the patient reports new chest pressure and shortness of breath. The PTA stops the session, checks vital signs if trained, and contacts the PT. The PTA does not work through it or alter the plan. The PT evaluates the change, determines whether emergency referral is needed, and documents the event.
Traps that cost marks
Do not let a PTA perform an initial evaluation or discharge just because the PT is busy. Do not treat general supervision as no supervision. Do not let an aide perform ultrasound, exercise prescription, or manual therapy. Do not assume the PTA can sign the PT's name or finalize the plan.