Perspectives on the PT Cpi from Directors of Clinical Education and Clinical Instructors
Purpose:
Directors of Clinical Education (DCEs) in Doctor of Physical Therapy (DPT) programs build relationships with clinical sites for students’ clinical education experiences. 1 During DPT students’ clinical education experiences, DCEs play a key role in the education and training of clinical instructors (CIs). In DPT education, a minimum of 30 weeks of full-time clinical education experience is required by the Commission on Accreditation in Physical Therapy Education (CAPTE).2 During these full-time clinical education experiences, licensed physical therapists serve as CIs to mentor DPT students. DPT students are expected to learn and develop the clinical skills necessary to perform successfully in multiple clinical practice settings.
To assess DPT students’ clinical learning and performance, academic programs and CIs must have a valid and reliable instrument. The most widely used instrument to assess clinical learning and performance of each DPT student is the Physical Therapist Clinical Performance Instrument (PT CPI).3 Recently, CIs and DCEs have raised concerns regarding the PT CPI.3 There is a lack of documented evidence regarding the strengths, concerns, and suggestions about the continued use of the PT CPI.
The purpose of our investigation was to determine and compare the perspectives of CIs and DCEs in the Northern Plains Clinical Education Consortium (NPCEC) regarding the strengths and concerns of the PT CPI, and identify suggestions to address those concerns.
Methods/Description:
As approved by the University of Jamestown Institutional Review Board, CIs and DPT program DCEs4 located in the states of the NPCEC (ND, SD, MN, NE) were invited to complete our electronic survey. Our electronic survey consisted of one yes/no question and four open-ended questions regarding the strengths, concerns, and suggested improvements of the PT CPI. The survey was sent to 1393 CIs and 16 DCEs via email. All responses to the electronic survey were anonymous.
Qualitative thematic analysis was conducted on de-identified survey responses. Three researchers independently coded the open-ended survey responses. Following the independent coding, the researchers discussed the independent findings and came to a consensus on a coding scheme that was representative of the participants’ responses to each survey question. The coding scheme was then used to code each survey response. Reliability of the coding scheme was confirmed by 100% agreement among the researchers.5 The codes used in the coding scheme were then categorized into themes for the strengths, concerns, and suggestions on the PT CPI. Trustworthiness of the data was ensured through the presentation of direct quotes from the participants to support the themes.5
Results/Outcomes:
221 (15.9%) CIs and 14 (87.5%) DCEs completed our electronic survey.
Consistent themes emerged from both the CIs and DCEs survey responses. Regarding the strengths of the PT CPI, four themes emerged: (1) universal, (2) comprehensive, (3) delivery of the instrument (i.e. online, rating scale, sample behaviors), and (4) opportunity for feedback. Regarding the concerns of the PT CPI, three themes emerged: (1) time consumption, (2) redundancy, and (3) applicability. For suggestions to improve the PT CPI, two major themes emerged: (1) condensing and (2) adaptability.
Conclusions/Relevance to the conference theme:
As a widely used instrument, it is not surprising that a strength of the PT CPI is that it is a universal instrument used by many institutions to evaluate DPT students’ clinical learning and performance at multiple time points. Given the reliability and validity research6,7 and development process of the PT CPI,8 it is expected that the PT CPI is comprehensive.6 The identification that the delivery of the PT CPI was a strength was noteworthy and may indicate that CIs and DCEs are accustomed to the universal assessment instrument.
Given the time constraints on physical therapists in the clinical environment, the concerns regarding time consumption were expected. Both CIs and DCEs frequently commented on the redundancy or overlap of many of the PT CPI criteria. Our findings of time constraints and redundancy align with the theme “condensing,” which emerged as a suggestion to improve the PT CPI.
Applicability of the PT CPI was a concern. Specifically, CIs and DCEs were concerned that the PT CPI does not adapt to each student, clinical setting, length of clinical experience, or timing of the clinical experience within the DPT curriculum. The concern regarding the applicability of the PT CPI aligned with the suggestion theme of “adaptability.” Both CIs and DCEs suggested that the PT CPI should be able to adapt to the variations in full-time clinical education experiences.
The perspectives of CIs and DCEs represented in our regional study are important to consider as we work to enhance the role of the clinical educator as a mentor. As clinical educators, CIs should expect a reliable and valid instrument to evaluate DPT students’ clinical learning and performance that provides an opportunity for informative and summative feedback as part of the mentorship process.