Background Competence-Based Education (CBE) in physiotherapy aims to equip graduates with essential capabilities for safe and effective practice. Frameworks often include domains like clinical reasoning, communication, and professionalism. Despite its alignment with healthcare needs, CBE implementation in higher education remains inconsistent. Many educators still rely on behaviourist paradigms focused on passive learning and binary assessments, which inadequately reflect professional competence. Constructivist and progressive models offer more suitable alternatives yet are underutilized. Objective: This study explores the feasibility of integrating programmatic assessment (PA) to better support capability development and learner-centred education.

Method This randomized controlled trial will be conducted a University of Applied Sciences across two campuses in Switzerland. Students from Cohort PHY25 enrolled in the BSc Physiotherapy program will be included. Students are assigned to PA in two formats, individual coaching (IG A) and group coaching (IG B), or to a sham PA without any coaching or reflective support (CG). Feasibility will be evaluated through session attendance, completion of all program components, and implementation fidelity. Secondary outcomes include staff readiness, wellbeing, workload, and learning gain.

Discussion This study explores the feasibility and educational impact of implementing programmatic assessment in undergraduate physiotherapy education. If successful, PA may enhance competence development. Findings will inform curricular redesigns and support the shift toward learner-centred, capability-based assessment strategies in health professions education.

Trial registration Registry of Efficacy and Effectiveness Studies under the number: #25261.2v1.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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