Influence of Clinical Instructor Experience on Assessing Doctor of Physical Therapist Student Clinical Performance: A Mixed-Methods Study

Abstract

Introduction. Formative and summative feedback are essential for physical therapist students' professional growth. Achieving objectivity in student clinical assessment has been a longstanding concern for health care educators and ambiguity surrounds what is meant by competent clinical practice. According to a sociocultural perspective, clinical performance is socially constructed and based on an individual's perception of what is taking place, which may explain differences identified in the literature between novice and experienced assessors of student clinical performance. However, it is not known whether novice clinical instructors (CIs) differ from experienced CIs in their assessment practices of student physical therapists. The purposes of this study were to examine whether novice and experienced CIs' assessment practice differ and explore the reasons for these differences (if any). Methods. Novice and experienced CIs for physical therapist students' 3 full-time clinical education experiences served as participants for this study. A mixed-methods research design was used. In the quantitative phase, novice and experienced CI-assigned midterm and final student ratings of the Clinical Performance Instrument (CPI) were compared. In the qualitative phase, semi-structured interviews, document review, and participant observation were conducted. Results. Experienced CIs awarded higher ratings on the CPI than novice CIs, but ratings on only a few of the performance criteria were significantly different. Qualitatively, both novice and experienced CIs were similar in terms of the importance assigned to professional behavior and safety. However, novice CIs were more literal and concrete and experienced CIs were more flexible and varied. Three CI roles (CI as student, CI as clinician, and CI as assessor), CI self-confidence, reflection, context, assessor approach, and assessor agreement emerged as strong themes throughout. Discussion and Conclusion. The low number of statistically significant differences between novice and experienced CIs' awarding CPI ratings suggests that there were few true quantitative disparities between the assessors. Both study cohorts' backgrounds as former students and as current clinicians as well as their stage of CI professional development seem to have influenced their approach to clinical assessment.