Cumulative Integrated Practical Examinations as a Model for Assessment and Provision of Formative and Summative Feedback


Background & Purpose: Cumulative integrated practical examinations (CIPE) are used throughout the Doctor of Physical Therapy (DPT) program to provide both summative and formative feedback about clinical readiness. Students should regularly be provided with clear expectations and feedback regarding clinical performance across all three domains of learning. Full-time clinical internships require students to integrate all of their skills and a scaffolding method of assessment across five examinations provides both summative and formative feedback for this to occur.


Model Description: This CIPE model describes a comprehensive, cumulative and integrated assessment tool used throughout the curriculum. It includes assessment of student performance each semester incorporating cognitive, psychomotor and affective skills from the initiation of the DPT program. Faculty members develop patient case scenarios that increase in complexity each semester incorporating previous and current coursework. Faculty are CIPE examiners and feedback from standardized patients is utilized. Examinations are videotaped and used for formative feedback and in some cases for grading discrepancies. Students review and reflect on their CIPE video and meet with examiners for formative feedback. Formative feedback continues with academic advisors and the Director of Clinical Education. Insufficient performance on CIPE results in a repeat examination. Failure to pass this second attempt results in dismissal from the program following departmental policies for dismissal and appeal.


Outcomes: CIPE serves as a formative and summative assessment process over five semesters integrating all coursework from the initiation of the DPT program. The formative process provides feedback to students about how they are integrating, retaining and developing their skills over time so they can make adjustments to improve their professional growth. The summative process identifies students who have not attained the expected level of clinical competency. The fifth and final CIPE provides an assessment of student readiness which leads to participation in full-time internships or dismissal from the program.

Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education

Importance to members: The CIPE process is an assessment tool that provides both summative and formative feedback to assist students and faculty in determining clinical readiness. Due to the formative nature of the consecutive CIPE process, students are able to receive accurate and timely feedback about their ability to integrate cognitive, psychomotor and affective skills in relation to provision of patient care. The academic program has a method to assess integration of these skills and level of clinical readiness prior to full-time internships.


Jette DU, Nelson L, Palaima M, Wetherbee E. How do we improve quality in clinical education? Examination of structures, processes, and outcomes. J Phys Ther Educ. 2014;28(suppl 1):6-12.

McCallum CA, Mosher PD, Jacobson P, Gallivan S, Giuffre S. Quality in physical therapist clinical education: a systematic review. Phys Ther. 2013;93(10):1298-1311.

Sass K, Frank L, Thiele A, et al. Physical therapy clinical educators’ perspectives on students achieving entry-level clinical performance. J Phys Ther Educ. 2011;25(3):46-52.

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  • Control #: 2527615
  • Type: Platforms
  • Event/Year: ELC2016
  • Authors: Kimberly Nowakowski, Deborah Pelletier, Elizabeth Montemagni, Kathleen Pappas, Angela Campbell
  • Keywords:

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