Student–clinician agreement in clinical competence as a predictor of clinical placement performance in Australian undergraduate physiotherapy students

Abstract

ABSTRACTObjectives: The opportunity for student self-reflection and the accuracy of that reflection are critical to the acquisition of professional competencies. The relationship between student–clinician agreement and clinical performance in physiotherapy students has not yet been investigated. The aim was to determine whether a simple measure of student–clinician agreement assessed midway during a clinical placement predicts final placement score. Participants: 100 undergraduate Monash University Bachelors of Physiotherapy students and their clinical educators. Main outcome measures: Assessment of Physiotherapy Practice (APP). Method: Clinician and student ratings of student performance across all clinical placements from January 2012–June 2013 at two time-points (midway and final) were entered into a purpose-built, web-based platform, and then averaged across the number of placements undertaken. The relationship between midway student–clinician agreement (student minus clinician APP score) and final APP score (determined by the clinician) was analyzed via forward regression. Sub-group comparisons were performed investigating the stability of the relationship across placements. Results: On average, midway agreement was associated with a −0.50 (95% CI −0.67 to −0.33) unit decrease in final placement APP% score. This model was highly statistically significant (p < 0.001) but only explained 24% of the total variance (based on the adjusted r-squared statistic). This relationship was similar in early and late placements. Conclusions: Student–clinician agreement is related to clinical performance. A midway evaluation may provide an important opportunity to identify students “at risk” of poor clinical outcomes enabling timely implementation of support strategies. Further work is required to improve the predictive accuracy of the proposed model.