Can I do this now?

Decision tree
Self-determining individual scope of practice and ethical
appropriateness of activities/services tool

PURPOSE
» This decision tree should be used in conjunction with the Scope of Practice Policy.

» This decision tree is designed to help members and accredited individuals to self-assess whether
they are competent to deliver their intended services, and whether it is ethical to deliver these
services for the intended Client/population at this time.

NOTE
The individual exercise and sports science professional is responsible for ensuring that they
have the appropriate credentials, accreditation and insurance for ALL the services they provide,
irrespective of what accreditations they hold with ESSA and any other professional bodies.

DEFINITIONS

Scope of Practice The broad framework used to assess whether an individual should be able
Framework to deliver the services of a profession safely and effectively.

Foundational The minimum combination of knowledge, skills and reasoning to gain

Scope of Practice accreditation.

Advanced Scope Demonstrated evidence of increased skills, reasoning, knowledge and

of Practice experience leading to expert status in one or more areas of exercise and
sports science practice;

Expanded Scope Expertise and appropriate credentialing beyond the accepted scope of
of Practice exercise and sports science practice;

Note: formal education is usually required to expand scope of practice.

Expert A person who is very knowledgeable about and skilful in a particular area.

Credential A written form of evidence attesting to an individual’s qualifications,

status, and entitlement to privileges that are the basis of confidence in
their knowledge, skills and experience to be an exercise and sports science
professional.

Individual Scope The combination of foundational, advanced and expanded scope

of Practice of practice as it applies to an individual exercise and sports science
professional’s competence at a point in time. For example:

Professional that is a Individual scope of practice = the foundational

recent graduate scope of practice for that ESSA accreditation

Professional with over Individual scope of practice = foundational +

2 years experience advanced + expanded scopes of practice

EXERCISE & SPORTS SCIENCE AUSTRALIA www.essa.org.au

 USING THE DECISION TREE
By working through the questions in this flow chart, known as a decision tree, an individual can self-
assess whether:

» it is reasonable for them to provide the intended service(s);

» they have the essential competence and expertise, and have met any regulatory requirements, to
safely provide the intended service(s);
» it is ethical to provide the intended service(s) to the client.

EXAMPLES

ADVANCED SCOPE OF PRACTICE

An AEP working in a hospital cancer rehabilitation clinic receives a referral for a client with
leukaemia. The AEP has not seen a client with leukaemia before and reviews the decision tree to
decide whether they are competent to provide this service.

To answer the question Can I do this now? the AEP reads the AEP Professional Standards and
AEP Scope of Practice and notes that the:

» AEP Scope of Practice Section 1.0 states that ‘AEP’s specialise in clinical exercise
interventions for a broad range of pathological populations’;
» target pathologies in the AEP Professional Standards do not specifically include leukaemia.

The AEP determines that, while leukaemia is not specifically listed as a target condition, exercise
for a range of cancer pathologies is within the foundational scope of practice of an AEP.

The AEP then decides whether they can demonstrate that they personally have the required
skills and knowledge to provide exercise for a client with leukaemia.

The AEP identifies that they have:

» completed a university subject that included a topic on exercise considerations for

immunological and haematological conditions
» experience in exercise prescription for similar conditions
» experienced colleagues on-site who can provide mentoring.

The AEP considers that their knowledge, skills and experience in exercise prescription for similar
clinical conditions could be transferred to leukaemia, but determines to undertake upskilling
(e.g. research, review of evidence and best practice guidelines, and completing professional
development courses). Following the upskilling, the AEP determines that this activity is now
within their advanced scope of practice.

The AEP works through the remainder of the decision tree and decides that:

» no further action is required

» the service for leukaemia falls within their insurance cover
» the services are within their business practices and similar to services they already deliver.

The AEP accepts personal and professional responsibility for delivering exercise services for
leukaemia clients.

EXERCISE & SPORTS SCIENCE AUSTRALIA www.essa.org.au

 EXPANDED SCOPE OF PRACTICE

An AEP working in a private practice clinic is interested in offering dry needling as a service to
their clients. The AEP consults the decision tree to decide what they need to do to provide this
service safely and effectively.

To answer the question Can I do this now? the AEP reads the foundational scope of practice for
the AEP profession.

» Section 1.0 outlines that the core of AEP interventions is exercise-based active therapies. The
training and accreditation process for AEP (including the Exercise Science Standards and
AEP Professional Standards) supports this.
» Section 5.0 outlines that activities not generally accepted for an AEP include manual
therapies such as massage.

The AEP determines that dry needling is considered a manual therapy and is therefore not
within the foundational scope of practice of an AEP and therefore not within their ESSA
accreditation.

The AEP decides whether, as an individual, they can demonstrate that they have the knowledge
and skills to perform dry needling. The AEP considers:

» whether they have been assessed against a formal framework for this skill, for example, by
completing appropriate training, and
» what training is the typical and reasonable standard against which a practitioner is deemed to
be competent in providing dry needing services.

The AEP:

» identifies that they did not cover dry needling in their university degree training, and they
have not completed any training in dry needling following graduation
» decides that dry needling services are not within their individual scope of practice
» identifies that a dry needling qualification is typically gained by successful completion of a
recognised course and, as a result, would be considered expanded scope of practice.

The AEP decides they still want to provide dry needling services, so they:

» speak to a professional body or colleagues to decide what training they would need to
complete
» find and complete an appropriate course in order to gain a dry needling qualification
» identify that they now have the appropriate expertise to provide dry needling services.

Before offering dry needling services to clients, the AEP works through the remaining steps of
the decision tree and:

» seeks accreditation for dry needling with an appropriate professional body

» updates their professional indemnity insurance in consultation with their insurer
» reviews legislation and professional body policies. They identify that regulatory bodies (for
example Medicare) limit funding for AEP services to exercise-based interventions. They will
need to deliver dry needling as a separate service with full payment by the client.
» updates their business practices and paperwork around informed consent and payment for
services. They communicate to clients and other key stakeholders (for example, referrers) that
they provide dry needling as an additional full-payment, unfunded service to clients.

EXERCISE & SPORTS SCIENCE AUSTRALIA www.essa.org.au

 REFERENCES
» Dietetics Association of Australia ( – Scope of Dietetics Practice Decision. Accessed 29 June 2017
from https://daa.asn.au/wp-content/uploads/2016/06/Scope-of-Practice.jpg Tool

» O’Sullivan Maillet, J., Skates, J., & Pritchett, E. (2005) American Dietetic Association: scope
of dietetics practice framework. J Am Diet Assoc, 2005. 105(4), pp. 634–640. doi:10.1016/j.
jada.2005.02.001.

» National Council of State Boards of Nursing (2006) Changes in Healthcare Professions’ Scope of
Practice: Legislative Considerations. Accessed 29 June 2017 from https://www.ncsbn.org/Scope_of_
Practice_2012.pdf

» The Australian College of Mental Health Nurses Scope of Practice. Mental Health Nurses in Australia-
Scope of Practice 2013 & Standards of practice 2010. Accessed 29 June 2017 from The Australian
College of Mental Health Nurses Scope of Practice

EXERCISE & SPORTS SCIENCE AUSTRALIA www.essa.org.au

 Can I do this now? Is this service/activity reasonable for someone with my expertise
(i.e. am I competent and credentialed) to provide vat this time, in

Decision tree this environment/setting, to the intended client or population?

(i.e. is it within my individual Scope of Practice (iSoP))

YES NO/MAYBE

Is this activity/service within the foundational SOP

for my accreditations? (i.e. is it acceptable for my
profession(s))

YES/MAYBE

Advanced SoP What is my individual Scope of Practice (iSoP)? Expanded SoP

Can I demonstrate evidence my Activity is in SOP Activity is NOT
current skill, reasoning, knowledge What is my individual competence level for this Have I been formally assessed
or role statement activity at this time in this environment and for in SoP or role
and reasoning meet the benchmark and may be in my statement or against a relevant framework?
for this activity/service? this client/population? (i.e. for me at this time is
individual range this a Foundational activity, Advanced activity or my individual
of scope but not Expanded activity within my iSoP) competence
within my level of
NO/MAYBE expertise NO

STOP STOP

Do not proceed. This service/activity Do not proceed. This service/activity

is advanced scope of practice. It is expanded scope of practice that
may require additional supervised is outside ESSA accreditation. It
experience, formal training, formal Foundational SoP includes manual therapies and
qualifications and/or appropriate Activity is in SoP AND my dietary/nutritional advice.
upskilling. individual competence It will require additional supervised
Discuss with your employer, insurer, experience, formal training, formal
mentor, and/or ESSA . qualifications and/or accreditation
and does not earn ESSA continuing
professional development (CPD)
points.
Discuss with the relevant peak
body (for the activity), ESSA, your
employer, mentor, and/or insurer.
You should have the appropriate expertise
(knowledge, skills, experience) to provide this
Upskill to an appropriate level Formally train and/or credential
activity/service. (i.e. should be fit to provide this
activity/service)

Undertake ethical review

Ethical Practice STOP

Have I taken reasonable steps to be professionally
accountable and/or professionally responsible in
providing this service/activity and minimise any
potential for harm to the client?
NO/MAYBE It may be unethical for you to do this activity/provide this service at this time,
in this environment or to this client. Consider the ethical principles of the
activity/service (e.g. conflict of interest, anti-discrimination, informed consent,
research ethics.) (Review legislation, code(s) of conduct (ESSA and/or other),
role statement(s), your job description, scope(s) of practice, workplace policies.
Discuss with relevant professional bodies.

YES
Review insurance cover

Insurance STOP
Do I have appropriate indemnity insurance NO/MAYBE
over in place through my individual and/or It may be unlawful for you to do this activity/provide this service in
employer cover? this environment or to this client without appropriate insurance cover.
Discuss with relevant professional bodies.

YES File supporting evidence

Evidence STOP
Have I documented and filed my supporting NO/MAYBE
evidence appropriately? Legislation requires that you keep evidence of professional development for
at least 5 years. It is best practice to store evidence of education and practice
systematically in electronic and/or hard copy form.

YES

STOP
Reassess iSOP

You should reasonably be able to provide this

activity/service at this time and it would appear
proper that you could provide this service/activity Individual Scope of Practice and Foundational Scope of Practice evolve and
change over time. Consequently, at any point in time, an individual scope of
YES practice and the profession Foundational Scope of Practice may differ for
some activities or services. Where this occurs, the individual practitioner is
required to identify and treat the activities/services as advanced or expanded
practice as appropriate so as to practice within their current competence
Have I taken reasonable steps to assess/maintain and credentials. Check for reviews/changes to relevant documentation
my ongoing competence in this activity/service?
NO/MAYBE
(e.g. legislation, foundational scope(s) of practice, professional standards
for accreditation, code(s) of conduct, role statements, research guidelines,
workplace policies, job description.) Discuss with relevant professional bodies.
Upskill/undertake formal education/credentialing as appropriate.

LEGEND
iSoP – Individual Scope of Practice
SoP – Scope of Practice

EXERCISE & SPORTS SCIENCE AUSTRALIA Updated August 2022