Differences in student and clinician perceptions of clinical competency in undergraduate physiotherapy

Abstract

The ability of healthcare students to accurately self-reflect is crucial to the attainment of clinical competency; however limited research has been conducted in the physiotherapy profession. This study sought to determine a) whether ratings of clinical performance on a nationally standardised tool differ between students and their clinical educators; and b) whether the magnitude of agreement differs between ratings of clinical performance measured at two different time-points during clinical placements. From January 2012 until June 2013 undergraduate physiotherapy students and clinicians independently assessed students’ clinical competency via the Assessment of Physiotherapy Practice (APP) at midway and final assessments across all clinical placements. The mean degree of agreement was compared using the Bland-Altman method. Statistical analysis revealed a mean APP% score difference (student minus clinical educator) of -7.5% (95% limits of agreement 13.7 to -28.8%) at midway and -9.7% (95% limits of agreement 7.9 to -27.4%) at final assessment. This represents student ‘underestimation’ of their clinical competency. Considerable within-subject variability was evident from midway to final assessment. Further  examination of student and clinical educator agreement in the evaluation of student performance during health professional clinical placements is indicated in light of recent research.