The Assessment of Physiotherapy Practice Tool Provides Informative Assessments of Clinical and Professional Dimensions of Student Performance in Undergraduate Placements: A Longitudinal Validity and Reliability Study

J Physiother. 2020 Apr;66(2):113-119. doi: 10.1016/j.jphys.2020.03.009. Epub 2020 Apr 11.


Questions: Do one or two factors best represent clinical performance scores obtained via the Assessment of Physiotherapy Practice (APP) and what is the nature of their characterisation? To what extent are the same number of factors and their interpretation, and item scaling captured equally over time and across contexts (eg, clinical subdisciplines) for assessments of clinical performance via the APP?

Design: Archival and longitudinal study of undergraduate students' clinical performances for each of four final-year clinical placements.

Participants: A total of 561 undergraduate physiotherapy students from one Australian university who were enrolled to complete their final-year clinical placements between 2014 and 2017.

Outcome measures: Clinical educators' assessments of student performance across seven key domains of clinical practice: professional behaviour, communication, assessment, analysis and planning, intervention, evidence-based practice and risk management.

Results: Factor analyses supported the superiority of a two-factor representation of the APP, including dimensions characterised by professional and clinical domains, when compared with a unidimensional structure of an overarching 'clinical performance' factor. It was also found that the two-factor representation and item scaling was consistent across four clinical placements covering typical areas of physiotherapy practice. In other words, the same constructs are being assessed equally well across context and time.

Conclusions: The APP is the nationally adopted assessment tool that is used to evaluate clinical competence to practise as a physiotherapist in Australia and New Zealand. These findings provide new evidence for an updated scoring protocol in which clinical factors are distinguished from professional competencies.

Keywords: Clinical education; Exploratory structural equation modelling; Physical therapy; Professional competence; Psychometric.