Fitness to practise (FTP) is fundamental to health professional education and health service delivery, impacting on both practitioner and client wellbeing. Literature exploring FTP support policies primarily identifies retrospective student support and management. This study describes student perceptions of an innovative FTP policy which supports students and staff to proactively identify FTP management strategies prior to entering the clinical environment. Forty-nine final year physiotherapy students were surveyed regarding their perceptions of self-declaring FTP. Ordinal data from Likert scales were reported using descriptive statistics. Thematic analysis was undertaken for open text responses. The response rate was 88%. Forty-two percent of students stated that they had experienced FTP concerns during the course. Concerns included physical and mental impairment and clinical competence issues. The majority of students (80%) indicated that they were “comfortable” or “very comfortable” in self-declaring FTP issues. Confidentiality, positive relationships with staff and a supportive environment enhanced likelihood of declaration. Eight students (19%) met with university staff to develop management strategies and all rated these meetings as “helpful” or “very helpful.” Students had positive perceptions of self-declaring their FTP to enable early development of management strategies. This strategy successfully navigates sensitive ethicolegal issues, empowering students to take responsibility for their own FTP. 1. Introduction Fitness to practise (FTP) can be defined as a person’s ability to practise their profession, meeting appropriate standards. This includes the practical skills, inherent knowledge, attitudes, personal characteristics, and health to perform necessary functions both effectively and safely [1]. Whilst evidence on strategies to support FTP has not yet emerged in the physiotherapy profession, literature from other health professions indicates that university FTP support policies focus on identification and remediation of students who exhibit unprofessional behavior [2–7]. FTP is a broader term than professionalism, as professionalism is often contingent upon freedom from other impairments. Parker [8] described FTP as having three specific components: (1) “freedom from impairment” (physically and mentally fit to perform duties), (2) “professional conduct and behavior” (meets appropriate codes of conduct and ethical guidelines), and (3) “clinical competence” (demonstrates adequate skills and knowledge). Health professional students within
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