New Jersey Ofce of the Attorney General
Division of Consumer Affairs
State Board of Physical Therapy Examiners
124 Halsey Street, 6th Floor, P.O. Box 45014
Newark, New Jersey 07101
(973) 504-6455
Application for Continuing Education
Approval for Course Sponsors
Courses for consideration for continuing education credit must be accompanied by this completed form with all of the required
attachments. Please email your application and supporting documents to physicaltherapyce@dca.lps.state.nj.us. An invoice
(per course) for the nonrefundable administrative fee of $100 will be emailed to you upon receipt of your application. Checks
must be made payable to: New Jersey State Board of Physical Therapy Examiners and mailed to the address listed above with
the invoice, or you may pay by credit card by completing the credit card section of the invoice.
Date of request: _______________________________ Date(s) of course: ______________________________________________
Sponsor: ____________________________________________________________________________________________________
Street address: _______________________________________________________________________________________________
Email address: _______________________________________________________________________________________________
Co-sponsor (if any): __________________________________________________________________________________________
Contact person: ______________________________________________________________________________________________
Daytime phone number: _____________________________________ Fax number: _____________________________________
(include area code) (include area code)
Course name: ________________________________________________________________________________________________
Course hours: __________________________________ Lecture hours: ____________Break time: __________________________
Course location(s):____________________________________________________________________________________________
Course lecturer(s): ____________________________________________________________________________________________
Enclose the following attachments with your application:
Application must be complete. Providers must maintain the original copies for four (4) years and provide them to the Board upon request.
Complete Curriculum Vitae of all lecturers (resume and/or biography not acceptable);
Detailed outline for the course (including method of instruction);
A statement indicating how the course is appropriate for physical therapists and physical therapist assistants and is
appropriate to improve physical therapy knowledge;
The course brochure that describes the course;
Course objectives stated in measurable and behavioral terms (Refer to Bloom’s Taxonomy);
The course schedule including lecture, lab and break times broken down by minutes;
The bibliography/reference/resource list with at least ve (5) citations from reputable peer reviewed journals published
within the past ve (5) years that support the content of this course;
A course evaluation form;
Verication of attendance form with sign in/sign out times with signatures for each, license numbers and dates clearly
indicated (sample enclosed);
A certicate of completion form that clearly indicates the contact information of the sponsor, the date of the course,
the CE credits awarded and the approval number for the course;
Evidence that the course was advertised or made available to all physical therapy licensees on a non-discriminatory
basis. (See applicable law: N.J.S.A. 45:9-37.34f); and
Audience commensurate with postprofessional education.
TOTAL credits requested ______________ (Please note: 1 credit = 1 hour (60 minutes) of instructional time)
What is a Peer-reviewed Journal?
A “peer-reviewed” or “refereed” journal is a scholarly journal which has an independent editorial board or panel of experts
who judge the quality of a submitted article. The editorial Board/expert determine acceptance, rejection, or revision-required
of all articles the journal publishes. (Revision-acceptance process can take up to a year). Authors are identied experts who
use professional/technical language directed at knowledgeable readers. Publishers are usually professional organizations or
research institutions or organizations. The review is typically “blind,meaning the reviewers do not know the name(s) of the
authors. Sometimes the review is “double blind” meaning the names of the reviewers are not known, either. Such journals can
be identied by “Instructions to Authors” at the beginning or end of the journal or by other editorial statements. Some journals
actually state they are “peer-reviewed. For instance, Physical Therapy in its mission statement identies the journal as “...
international, scholarly, peer-reviewed.... Another example is “... American Family Physician, a peer-reviewed journal of
the American Academy of Family Physicians. The purpose of such journals is to publish high-quality work which contributes
reliable information to the eld.
Typically there is a formal format such as the following:
Abstract (short summary);
Keywords;
Introduction which states the problem, need for the research work, and the research question;
Literature review (this work is placed in the context of the body of knowledge);
Methodology;
Data including graphs, tables and charts;
Analysis (including statistics);
Conclusions;
Recommendations for further research; and
References/Bibliography (often extensive, and refer to footnotes).
To nd out if a journal is peer-reviewed, consult Ulrich’s International Periodicals Directory through your library.
Sources for more information:
- http://www.library.uiuc.edu/alx/peer.htm
- http://www.library.uiuc.edu/orr/get.php?instid=258215 (for Ulrich’s, but must go through a library)
- http://valnor.ca/peer-review.html
Writing Behavioral and Measurable Objectives
Google Bloom’s Taxonomy on the web. There are many options if you are unfamiliar with this taxonomy.
One URL is: http://www.nwlink.com-donclark/hrd/bloom.html.
Low-level objectives, e.g., “list,” are not consistent with postprofessional education for physical therapists. Use active verbs at
the higher levels in all domains (cognitive, psychomotor, affective) as appropriate. Words like “understand,“know,“learn” are
not behavioral and measurable in and of themselves. They are reected in the verbs which state what the learner will be able
to do or demonstrate at the end of a learning experience.
Examples of Behavior and Measurable Objectives -
At the end of this course the participant will be able to:
Differentiate chemical and mechanical pain (cognitive domain)
Design an individualized home treatment program based on the tests and measures obtained and evaluated results
(cognitive domain)
Teach the patient a progressive, individualized home program based on the above (psychomotor domain)
Identify indications and contraindication for applying this advanced intervention (cognitive domain)
Demonstrate appropriate handling techniques (psychomotor domain)
Appreciate patient resistance associated with termination of treatment (affective domain).
Examples of Unacceptable Objectives -
The participant will view slides of three patients with this condition.
This is a teaching plan for the course, not an outcome.
The participant will know the contraindications for (this intervention)
How will a course instructor determine that the participant “knows”?
The participant will understand the reasons for frequent falls in this population.
How will a course instructor determine whether the participant “understands”?
The participant will learn how to classify signs and symptoms.
How will a course instructor determine whether the participant has “learned how to”?
Patients will improve.
Not possible to do in most courses which are short; too vague.
Writing Reference Lists / Bibliographies
Sponsors must provide reference lists which include at least ve (5) citations in the past ve (5) years from reputable, peer-
reviewed (juried) journals which support the content of the course.
References may be written in either APA (American Psychological Association ) or AMA (American Medical Association) style.
Citations should be obtainable by anyone reading the list.