Meeting the Standard for Standards Review and Development

Standards of Practice (Professional Standards, and Code(s) of Conduct) set the obligations of health and non-health professionals across the country as they go about their licensed practice. They set the stage for what clients and patients can expect when they interact with regulated professionals and the regulatory backstop for if poor conduct concerns arise.

For profession regulators across the country, the ongoing need to refine, review and develop Standards is work that can daunt even the most efficient and effective of regulatory teams and Committee(s) of the Board. As every profession regulator knows, there are always competing demands for team capacity. Depending on depth of review or development, it’s common for a Standards project to occupy team members for up to three years (or more!) Sometimes getting help not only hastens the process, but it also allows for deeper insights from a greater number of participants.

In the first half of 2023, Pivotal Research has been privileged to support over 25 profession regulators and associations with various projects related to Standards of Practice. From jurisdictional scans on emerging practices for a profession to complete redevelopment projects, to engagements aimed at providing validation for updates, our work has complemented the expertise and profession-specific knowledge of professional regulators across the country.

Clinical Counsellors

For the BC Association of Clinical Counsellors (BCACC) we undertook a national best-practice scan and key informant interviews. The research informed our work redrafting Practice Standards and a Code of Ethical Conduct in keeping with regulated professions across the country.

Upon acceptance of the drafts, we validated the new set of 12 expanded and consolidated Standards through a survey with the Association’s 7,000 Registered Clinical Counsellors across the province, similar profession regulators across the country, and other regulators in BC.

The result is a finely tuned and comprehensive set of 12 Standards of Practice that have been provisionally approved for staggered implementation by the BCACC Board. While we undertook validation, we also analyzed feedback to inform implementation and guidance needs, especially as they approach becoming a regulated profession.

The set of Standards included the development of a Diversity, Equity, Inclusion and Anti-Racism Standard, that while still undergoing validation by community and Advisory Panel, consolidates best-practice from national and international best practice and complements the adoption and adaptation of an Indigenous Cultural Safety, Cultural Humility and Anti-Racism (ICSCHAR) Standard originally developed by the College of Physicians and Surgeons of British Columbia (CPSBC) and the British Columbia College of Nurses and Midwives (BCCNM) in collaboration with community.

Allied Health Professions

That same ICSCHAR Standard has also been adopted and adapted by 11 allied health Colleges in British Columbia for whom we had the privilege of undertaking a benchmarking evaluative study to ascertain uptake and implementation of the Standard. 

The process of adopting and adapting the standard aimed at creating culturally safer healthcare experiences for Indigenous Peoples of British Columbia was led by representatives of the 11 Colleges and guided by Quqoq, an Indigenous consultancy. 

Together with these representatives and guides, we were able to construct a survey instrument that measured explicit racism, key enduring stereotypes and uptake of the expectations embedded in the Standards as perceived by both Indigenous and non-Indigenous registrants. The survey, sent to about 26,000 registrants of the Colleges, also gathered information on barriers to implementation, ongoing practice guidance and learning preferences, and perceptions of Indigenous-specific racism in the professions’ practice settings. 

We thank all those who participated and engaged with open hearts and minds in the process of developing, implementing, and reporting on the study. We recognize this is but one small step in the journey to reconciliation and remediation of unequal access and treatment of Indigenous Peoples in health care, but we’re grateful to have been able to contribute


And finally, for a collaborative group of 10 physiotherapy regulators across the country, we provided support and coordination to validate revisions and updates to the Core Standards of Practice for Physiotherapists in Canada. The participating regulators group, which included all provinces except Quebec, and included the Yukon, contracted us to provide coordination, design, and implementation of a registrant validation survey.

The survey, fielded to about 24,000 physiotherapists across the country on a staggered timeline, yielded text-specific revision recommendations to the draft update for the Core Standards in addition to supplying jurisdictionally differentiated research outcomes to inform strategy-setting and implementation support through meticulous analysis of registrant feedback.

The Core Standards are designed to create consistency in practice expectations across the country, elevating physiotherapy care for all Canadians and increasing jurisdictional mobility within the profession. In each participating jurisdiction, the Core Standards are used in the development of Standards that incorporate legislative needs in that geographic region.

DEI-Driven Research Engagements

Our work in diversity, equity, and inclusion (DEI) understanding and engagement is ever expanding. This year we’ve also engaged registrants, the public and patients on DEI issues for several health professions in British Columbia and Ontario. We’ve employed multiple methods, but we’re excited about the depth and richness of insights we’ve delivered clients using an innovative, interactive and customized online bulletin board in which we’re able to tackle sensitive topics in ways that aren’t always possible in person and in group settings. The specialized use of the tool allows us to provide asynchronous response options for busy professionals, analogous activities for sensitive topics, multiple modes of response (images, video, audio) and anonymity when required for safety. The moderated space has allowed us to collect a deeper understanding of responses on DEI questions versus more traditional or quantitative methods alone.

Let's Start a Conversation

We look forward to reporting on other work we’re undertaking for our regulatory partners soon and we’re always around to chat about your regulatory organization’s next big research and/or engagement need – whether that be engaging your Board, your registrants, parties to a complaint, patients, or the general public.  Contact us today!