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The Development and Testing of APTA Clinical Performance Instruments

Kathryn Roach, PT, PhD, is Associate Professor, Department of Physical Therapy and Department of Orthopaedics and Rehabilitation, and Associate Director for Research, University of Miami School of Medicine, Coral Gables, Fla. She was Assistant Professor, Department of Physical Therapy and Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, at the time of the study. She was primarily involved in the conceptual development, design, ongoing revision of the instruments, design of pilot and field studies, management and coordination of data entry with the assistance of graduate students from the University of Miami, and resultant data analysis. She wrote portions of this article and reviewed and edited the final manuscript prior to submission
Jody Gandy, PT, PhD, is Director, Department of Physical Therapy Education, American Physical Therapy Association, Alexandria, Va. She was Director of Clinical Education, American Physical Therapy Association, at the time of the study. She served as staff liaison to this group and was responsible for project management by ensuring that the Task Force met its charge in accordance with American Physical Therapy Association policies and expected timelines, budgeted and procured the necessary funds to complete the project, and assumed responsibility for data collection. She wrote portions of this article and reviewed, coordinated, and edited the final manuscript prior to submission
Susan S Deusinger, PT, PhD, is Director, Program in Physical Therapy, and Associate Professor of Neurology, Washington University School of Medicine, St Louis, Mo. She was primarily involved in the conceptual development, design, ongoing revisions, design of pilot and field studies, and resultant data analysis, and she reviewed and edited the final manuscript prior to submission
Sherry Clark, PT, MS, is Associate Professor, School of Pharmacy and Allied Health Professions, Creighton University, Omaha, Neb. She was Center Coordinator of Clinical Education, Shepherd Spinal Center, Department of Physical Therapy, Atlanta, Ga, and Associate Professor and Co-Academic Coordinator of Clinical Education, Department of Physical Therapy, School of Allied Health Sciences and Graduate Studies, Medical College of Georgia, Augusta, Ga, at the time of the study. She served as co-chair of this group and was primarily involved in the conceptual development, design, and ongoing revision of the instruments
Pamela Gramet, PT, PhD, is Chairperson and Associate Director, Department of Physical Therapy Education, State University of New York Upstate Medical University, Syracuse, NY. She was Associate Professor and Academic Coordinator of Clinical Education, Department of Physical Therapy Education, College of Health Profession, SUNY Health Sciences Center at Syracuse, State University of New York at Syracuse, Syracuse, NY, at the time of the study. She was primarily involved in the conceptual development, design, and ongoing revision of the instruments
Barbara Gresham, PT, MS, is Instructor, Physical Therapist Assistant Program, McLennan Community College, Waco, Tex. She was Program Director, Physical Therapist Assistant Program, McLennan Community College, Waco, Tex, at the time of the study. She served as co-chair of this group. She was primarily involved in the conceptual development, design, ongoing revision of the instruments, and review of the manuscript before submission
Paul Hagler, PhD, is Associate Dean, Graduate Studies and Research Faulty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada. He was Professor and Director, Faculty of Rehabilitation Medicine, Centre for Studies in Clinical Education, University of Alberta, at the time of the study. He was primarily involved in the conceptual development, design, ongoing revision of the instruments, design of pilot and field studies, resultant data analysis, and review of the manuscript before submission
Rebecca Lewthwaite, PhD, is Director of Research and Education in Physical Therapy, Rancho Los Amigos National Rehabilitation Center, Rancho Los Amigos Medical Center, Downey, Calif. She was Director, Center for Research in Biokinesiology, and Associate Director of Physical Therapy for Research and Education, Rancho Los Amigos Medical Center, at the time of the study. She was involved in the conceptual development, design, ongoing revision of the instruments, design of pilot and field studies, and resultant data analysis
Bella J May, PT, EdD, FAPTA, is President, BJM Enterprises, PC, Dublin, Calif, and Professor Emerita, Medical College of Georgia, Augusta, Ga. She was Professor and Co-Academic Coordinator of Clinical Education, Department of Physical Therapy, School of Allied Health Sciences and Graduate Studies, Medical College of Georgia, at the time of the study. She was primarily involved in the conceptual development, design, and ongoing revision of the instruments
Babette Sanders, PT, MS, is Assistant Professor, Department of Physical Therapy and Human Movement Science, Northwestern University Medical School, Chicago, Ill. She was Instructor, Programs in Physical Therapy, Northwestern University Medical School, and Part-time Clinician, Department of Physical Therapy, Evanston Hospital, Evanston, Ill, at the time of the study. She was primarily involved in the conceptual development, design, and ongoing revision of the instruments
Michael J Strube, PhD, is Professor, Department of Psychology, Washington University, St Louis, Mo. He served as consultant psychometrician from July 1996 to April 1997. He provided assistance in field study design and construction, data analysis, enhancement of psychometric properties of the instruments using a visual analog scale, and he reviewed and commented on the final manuscript before submission
Yolanda Rainey, PT, MS, is Area Supervisor, Rehab Outreach of St Louis, Mo, at Oakwood Nursing and Rehabilitation Center, Virginia Beach, Va. She was Director of Rehabilitation and Center Coordinator of Clinical Education, NovaCare Geriatric Center, Portsmouth, Va, at the time of the study. She served on this group from 1994 to 1995 and was primarily involved in the initial development of the first draft versions of the instruments

Background and Purpose. The purposes of this article are to describe the process of developing the physical therapist (PT) and physical therapist assistant (PTA) Clinical Performance Instruments (CPIs) and to present the available information on the psychometric properties of each instrument. Subjects. Two hundred seventeen PTA students and 282 PT students participated in the pilot studies of the CPIs, and 181 PTA students and 319 PT students participated in field studies. Methods. To construct each instrument, content was first gathered from a variety of instruments and American Physical Therapy Association documents related to PT and PTA practice and education. Data compiled during the pilot and field study phases of the project led to the construction of the fourth (final) versions of the CPIs, which although not studied are currently in use. Results. Intraclass correlation coefficients (ICC [2,1]) measuring the interrater reliability of the CPI total score were good (ICC=.87) for the PT total score and moderate (ICC=.77) for the PTA total score. Construct validity was supported by the substantial differences in mean CPI score for students completing first as compared with final clinical experiences, by the correlation between CPI item scores and total days of clinical experience, and by the lack of correlation with the Social Skills Inventory score. Discussion and Conclusion. Sale of the fourth (final) versions of the PT CPI occurred in November 1997 and of the PTA CPI in March 1998. Data based on psychometric evaluation of the final version have not yet been collected and reported. In the task force's opinion, the third drafts can provide reliable and valid measurements of PT or PTA student clinical performance. The fourth versions were based on this iteration.

Key Words: Clinical education • Education • physical therapy • Evaluation • Student outcomes assessment • Student performance