History AHT Credential

The history of the development and implementation of the AHTA Accredited Hand Therapist Credential.

Tracey Clark, Accredited Hand Therapist, as awarded by the AHTA (September 2023)

2013 -2014. AHTA commenced efforts to seek recognition by key stakeholders of hand therapy as a specialist scope of practice. Activities included the preparation of a White Paper and the appointment of a lobbyist.

2015. The AHTA Management Committee held a strategic planning meeting in May of this year, at which a decision was made to develop an Australian hand therapy credential based on 100% assessable standards, which would, if agreeable to the voting membership, replace the existing “Full Membership” category of AHTA membership. Subsequently, an Accreditation Steering Committee was raised by invitation and chaired by the author (AHTA President). The other members were Elizabeth Ward (former AHTA Vice President), Dave Parsons (AHTA Treasurer) and Helen Burfield (AHTA President-Elect), with Jane Skeen (AHTA Newsletter Editor) contributing project work. The steering committee developed an accreditation framework entitled Accredited Hand Therapist (AHT) to distinguish it from the USA Hand Therapy Certification Commission Credential (HTCC) Certified Hand Therapist (CHT). Research by the committee involved the review of accreditation models of like organisations, including the HTCC, as well as Australian Mental Health Nurses and Dietitians Australia, whose credentialing criteria included practice hours, continuing professional development and mentorship. The ISO/IEC 17024 (a global standard that sets out the requirements for the competence of personnel certification bodies and the certification of individuals) was purchased as a reference guide.

The credential was to be competency-based and comprised of 3600 clinical practice hours, 12 months of mentorship and 300 hours of education, which was to be developed to and assessed at an Australian Quality Framework (AQF) level 8, in line with the standard for a Graduate Certificate. Candidates would be AHPRA registered for a minimum of 3 years before being eligible to submit a completed AHT application. The maximum timeframe for completion of all elements was to be 5 years. Reaccreditation by clinical practice hours and continuing professional development would be required every 5 years.

The intention was to develop two pathways to the AHT, the first, an experiential pathway underpinned by AHTA coursework, the other an academic pathway in which four core AHTA courses would be credited toward a postgraduate qualification (Graduate Certificate/Diploma/Master of Hand Therapy). Pearse Fay of Deakin University championed the cause for the AHTA but was ultimately defeated when the University determined that the course was not financially viable without a guaranteed number of candidates each year.

In October 2015, the draft AHT framework was presented to AHTA members at the AGM, who voted to pursue the development and implement the credential on January 1, 2018. A budget of $30,000 was allocated.  Existing AHTA Full Members of good standing were to be grandfathered into the credential on December 31, 2017, and given the title AHTA Accredited Hand Therapist. Existing Associate Members were given 2 years' notice to apply for Full membership under the current portfolio-based membership scheme. During this time 157 Associate Members upgraded to Full Membership, 75 of them in the six months prior to Dec 31, 2017. This created an unprecedented workload for Membership Secretary Katie Whittle and AHTA staff member Sarah Dixon, who had in previous years processed an average of 25 Full Member applications.

2016-2017. The Accreditation Steering Committee worked with the AHTA Education Committee to revise existing AHTA Education Courses (Fundamentals of Hand Therapy, Closed Trauma, Open Trauma and Orthotic Fabrication – Mobilisation) to form the four core courses for AHT. Learning outcomes were aligned with HTCC competencies. Each course represented 50 learning hours, including assessment. Two elective units would make up the balance of the coursework.  Orthotic Fabrication - Immobilisation was to be offered as an elective course.  An online thermal and electrical modalities course (Exploring Hand Therapy) was identified as a second elective with Occupation Therapist candidates obliged to complete this course to meet Physiotherapy threshold competencies in modalities. The HTCC Certified Hand Therapist (CHT) Credential could be used as 2 elective units. The Master of Hand Therapy (Derby University, UK) could be used in lieu of all 6 courses as an academic pathway. The HTCC was agreeable to the use of its mentor manual as a basis for the 12-month mentorship program, and relevant modules were selected for inclusion. The mentorship was to include a minimum of 40 hours of face-to-face content, and at the end of the 12-month mentorship period, the mentor would be required to confirm that the candidate had demonstrated a minimum of 75% of the competencies identified in the HTCC mentor manual.

AHT candidates would be eligible to commence mentorship after completing two core courses and could choose their mentor, who was to be an Accredited Hand Therapist. The Steering Committee sought expressions of interest from “Full Members” to create a pool of available mentors in time for the launch of the credential.

Trademark applications were lodged for the AHT logo and name. By-Laws were drafted. Terms of reference for a Credentialing Council, who would be responsible for the operations of the AHT, were written. The Council was to be made up of two members of the steering committee, two hand therapy academic members (one each from Occupational Therapy and Physiotherapy), two AHT members, the AHTA Management Committee Membership Secretary and two independent members from outside hand therapy, with complementary skills and experience. Academic and AHT members were invited by the steering committee, and independent members were recruited via advertisements in board publications.

Tracey Clark and Elizabeth Ward met with James Fitzpatrick of the Australian Physiotherapy Association (APA) to commence talks aimed at aligning the AHT credential to the titling process within the APA and seeking recognition of the AHT as a pathway to titled membership. We also explored whether an Accredited Hand Therapist fitted within their definition of an Advanced Scope Practitioner.  Whilst initial talks were favourable, there was little interest from the APA in progressing recognition because physiotherapists who practice hand therapy represent such a small percentage of the total number of physiotherapists in Australia. Occupational Therapy Australia was not approached regarding AHT recognition because they had no equivalent credentialing or titling process.

2018. The AHT credential was launched January 1, 2018, and the Credentialing Council met for the first time in February. The inaugural Council members were Tracey Clark (Chair), Elizabeth Ward (former steering committee member), Andrea Bialocerkowski (Physiotherapy Academic), Lisa O’Brien (Occupational Therapy Academic), Celeste Glasgow (AHT member), Melanie McCulloch (AHT member), Katie Whittle (AHTA Membership Secretary), Leigh Clarke (Independent member), Geoff Barbaro (independent member).  It was agreed that the Credentialling Council would meet every 2 months to progress the credential and assess new applications for AHT.

Work continued on mentorship. Mentor contracts were drafted, and educational webinars were developed and presented by Celeste and Melanie. Web pages were written for the AHTA website. Andrea and Lisa worked with the Education Committee to assist with course revision, writing learning outcomes and advising about assessment. Potential electives were identified (Wound Care, Imaging and Pain Management) and placed on the Education Committee development agenda. Policies were written for the assessment of university subjects as electives.

2019. The first AHTA Accredited Hand Therapists to complete the new program were awarded their credential at the AHTA conference in October.

2020 - 2022. The Accredited Hand Therapist Credentialing model was presented at the NSW Hand Surgery Association Annual Scientific Conference by Tracey and Elizabeth and by Celeste at the Queensland Hand Surgery Association Conference.  The AHT credential was recognised by worker's compensation authorities in Queensland, New South Wales, and Victoria.

Four electives were added to the suite of courses (Arthritis, Elbow, Pain Management, Wrist). Four university subjects from Auckland University of Technology, University of Melbourne and Derby University were recognised as electives.

Work commenced on preparation for re-accreditation. Continuing professional development guidelines were revised. Reaccrediting AHTs were obliged to verify 2000 hand therapy clinical practice hours, 100 hours of Continuing Professional Development and 20 hours of contributions to the profession in a 5-year period. More than 400 reaccreditation applications were received and processed in the last quarter of 2022. The AHTA Board announced a PhD scholarship to support research into the evaluation and customisation of the Accredited Hand Therapist credential for hand therapy practitioners in Australia.

2023. Tracey Clark was awarded the AHTA PhD scholarship and commenced candidacy at Griffith University. A wound management course was added to the elective suite and work was finalised on an additional elective in imaging (to be added in 2024).

 At the national conference in Adelaide, the AHTA celebrated 10 years of working toward the recognition of Hand Therapy through the development and implementation of the AHT. At this time 122 AHT credentials had been awarded, and 95 candidates were undertaking mentorship.

Members of Steering Committee (2015-2018)

Helen Burfield

Tracey Clark

Dave Parsons

Jane Skeen

Elizabeth Ward

Members of the Credentialing Council (2018-2023)

Tracey Clark – Steering Committee Member (2018 – current) (Chair 2018-2020)

Elizabeth Ward – Steering Committee Member (2018 – 2022)

Mel McCulloch – AHT Member (2018 – current)

Celeste Glasgow – AHT Member (2018 – 2023) (Chair 2021-2023)

Andrea Bialocerkowski – Academic Member (2018 – current) (Chair 2023-current)

Lisa O’Brien – Academic Member (2018 – 2021)

Katie Whittle – Management Committee Membership Secretary (2018 – 2019)

Leigh Clarke – Independent Member (2018 – 2019)

Geoff Barbaro – Independent Member (2018 - 2019)

Elissa Campbell – Independent Member (2019 - current)

Dave Parsons – Board Representative Member (2020– 2023)

Judith Hannan – Independent Member (2020 - 2022)

Alison Love – Independent Member (2022-current)

Nicola Massey-Westropp – Academic Member (2022-2022)

Sara Brito – Academic Member (2022-current)