Influence of Race/Ethnicity on Clinical Instructor Evaluation of Physical Therapy Student Performance
Purpose/Hypothesis: Racial and ethnic minorities are underrepresented in the physical therapy (PT) profession. Currently only 19% of practicing PTs are from underrepresented minorities (URMs). PT educators, including clinical instructors (CIs), play an important role in the academic success of PT students. Several studies reveal a relationship between CI covert bias and lower scores among URM PT students. In 1997, Haskins et. al. reported disparities in CI perceptions of physical therapy student actors from different racial/ethnic backgrounds who read the same standardized patient report. In this case the Black student’s performance was rated lower than the White, Asian, and Hispanic students. The purpose of this study is to examine the relationship between PT students’ race/ethnicity and CI evaluation of student performance.
Number of Subjects: 394
Materials and Methods: Four female students who self-identify as White, Black, Hispanic, or Asian, were video recorded giving a patient report to a CI using a standardized script. A survey was developed that includes participant background demographics, one of the four video recordings, and a student evaluation form derived from the Clinical Performance Instrument (CPI). Six specific CPI categories were included in the student evaluation form: Professional Behavior, Communication, Professional Development, Clinical Reasoning, Evaluation, and Plan of Care. Prospective PT participants were recruited via email through the following APTA sections: Private Practice, Geriatric, Orthopedic, Oncology, Pediatric, Neurologic, and Health Policy and Administration. Survey responses were excluded if the participant was not a licensed PT currently working at least part time, if the survey was incomplete, or if final consent was not provided. Participants were blinded to the true nature of the study until the conclusion of the survey, at which point they were asked to provide final consent before survey response was submitted for data collection. The study was approved by the University IRB.
Results: 394 viable responses were collected. This study was a between-subjects design, using one-way ANOVAs to analyze the relationship between student race/ethnicity and student evaluation scores. Significant differences (p<0.05) were found between student scores in all CPI categories with the Black student consistently rated lowest and the Asian student consistently rated highest. The order of student ratings stayed consistent in each CPI category (Black, White, Hispanic, and Asian).
Conclusions: These findings support the hypothesis that implicit racial bias persists in clinical education and may affect how CIs rate PT student performance.
Clinical Relevance: This study contributes to a larger body of evidence on the topic of implicit racial bias and its influence on URM student success in PT education. Continued research in this field is imperative to further explore existing disparities in the grading of URM groups.