Educational Competencies Matrix

The Matrix for the 4th Edition Competencies is now available. To download the Matrix, contact the Executive Committee for Education, (617) 353-7499 or

Comparison of Third & Fourth Editions (PDF)

Order the 4th Edition Competencies

For questions regarding the 4th edition competencies/matrix please visit the Competencies/Matrix Question and Answer page.


Matrix/Competencies Questions & Answers

Before submitting your question, please check the Q&A section below to see if your question has previously been addressed.


Q1. Is the correct interpretation of the matrix that we can only have two columns completed for the cognitive and psychomotor with one column for the proficiency?


Answer: That interpretation of the completed matrix is correct. The additional columns in the matrix are only present to allow those programs that cover competencies in more than one course a way to record that aspect of their program.


Q2. There are several items that appear in the matrix that do not appear in the hard copy of the competencies. For example, in the hard copy, Conditioning and Rehabilitative Exercise has one clinical proficiency. In the matrix, there are 49 individual proficiencies. Why is the matrix so different from the hard copy?


Answer: The rationale for the difference between the Clinical Proficiencies and the Matrix is explained in the introductory statements in the following content areas: Orthopedic Clinical Examination and Diagnosis, Medical Conditions and Disabilities, Therapeutic Modalities, and Conditioning and Rehabilitative Exercise. The Clinical Proficiency in each of these sections should encompass and/or address each of the body areas, modalities, or exercises listed in the introductory section of each content area.


Q3. In the hard copy of the 4th edition competencies, cognitive competency #9 under Conditioning and Rehabilitative Exercise is missing, but is listed in the matrix. Which one is correct?


Answer: A printing error resulted in the omission of Conditioning and Rehabilitative Exercise, Cognitive Competencies #9. An announcement was sent via email to all programs and an insert has been placed in all subsequent requests for the printed competencies.

For accreditation purposes, programs are expected to show compliance with the matrix, which includes all required information.


Q4. In the comparison tables for the 3rd and 4th editions of the competencies, what does the small “p” stand for after some numbers?


Answer: The small “p” is meant to indicate that a portion of a 3rd Edition Competency was integrated into the respective 4th Edition Competency. 


While some programs may be tempted to “cut and paste” from the 3rd Edition Matrix directly into the 4th Edition Matrix without scrutiny or review, program administrators are strongly encouraged to thoroughly review the entire 4th Edition document and Matrix before determining that a course(s) fulfill(s) the required content described in each Competency. This process will help to familiarize program administrators and instructional faculty with the contents of the Educational Competencies.


Q5. I’ve noticed several cells that are filled with “x’s.” What is the purpose?


Answer: The cells containing “x’s” are only associated with Clinical Proficiencies. The nature of a Clinical Proficiency is that the base knowledge and skill is taught and measured in didactic courses and laboratory experiences. After this knowledge(s) and skill(s) have been practiced on actual patients, the student’s competence in the Clinical Proficiency is measured based on their knowledge and skill application, and on their ability to demonstrate decision-making and skill integration.

As such, the instruction associated with a Clinical Proficiency will have occurred previously in a multitude of classes and labs, and does not have to be identified or recorded in the matrix.


Q6. May psychomotor competencies continue to be introduced and evaluated in more than one course throughout the curriculum?


Answer: Yes. The ATEP is encouraged to consider the most sound and appropriate manner by which instruction and evaluation skills are conducted.


Q7. Regarding the citation of Standard IIA2b, is it possible for a program to initially introduce and assess a psychomotor competency at the beginning of a semester and perform the reassessment later in the same semester or must a full semester intervene between the two? What would be considered a “full semester?”


Answer: Under the 3rd edition of the competencies, “learning over time” was operationally defined as instructed and evaluated in one semester, and then re-evaluated at least one semester later.   On only a very limited basis for skills that did not require a great deal of practice (i.e. administrative, reading a chart, taking a blood pressure), “learning over time” allowed for skills to be taught and assessed initially early in the semester and then reassessed for learning over time at the end of the semester.  This exception was not deemed appropriate for skills such as therapeutic modalities and/or evaluation techniques.

However, in the 4th edition of the NATA Educational Competencies, “learning over time” is a process that does not apply to a discrete knowledge or skill (i.e., one particular cognitive or psychomotor competency), but rather to an initial evaluation of a discreet knowledge and skill, opportunities for the student to utilize that knowledge or practice that skill in actual or simulated experiences for a minimum of one semester, followed by an evaluation of “learning over time” in the form of the comprehensive assessment of that skill, along with the others identified as part of the associated clinical proficiency.  This entire process constitutes “learning over time” under the 4th edition of the NATA Educational Competencies.  Again, on only a very limited basis for skills that did not require a great deal of practice (i.e. administrative, reading a chart, taking a blood pressure), “learning over time” allowed for skills to be taught and assessed initially early in the semester and then reassessed as part of a clinical proficiency evaluation for learning over time at the end of the semester.  There must be sufficient time between the initial instruction and the time of clinical proficiency evaluation to assure that students are able to practice and integrate the learning.  The method by which a program may determine “sufficient time” should be based upon the students’ abilities to perform the clinical proficiency correctly and at a level expected of an entry-level professional.

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