Comparing Clinical Education Assessment Methods in USA and Taiwan DPT Programs: A Focus on Professionalism

To compare clinical education assessment methods between Taiwan and United States DPT programs, with emphasis on professionalism, and evaluate the ABPA's ability to demonstrate student growth over time in Taiwan.

Faculty members conducted a comparative analysis of the ABPA and CPI 3.0, matching corresponding items and calculating percentages to identify focus areas. The ABPA evaluates 10 core values of professionalism with 2-7 items examined within each core value. The CPI 3.0 assesses 12 performance criteria across three areas: professional practice, patient management, and practice management, providing examples of non-exhaustive behaviors for each criterion. Additionally, ABPA scores of 34 Taiwanese DPT 5th-year students were analyzed at initial, middle, and final stages of clinical internship. Scores were standardized (0=not pass, 0.5=needs help, 1=pass) and analyzed using Generalized Estimation Equations (GEE) to examine changes in student performance over time.

Comparative analysis revealed that 33% of items in the ABPA corresponded to both "Professional Growth" and "Communication" categories in CPI 3.0, followed by 8% in "Ethical Practice". CPI criteria less represented (≤5%) in ABPA included "Legal Practice", "Inclusivity", "Documentation", "Financial Management and Fiscal Responsibility", and "Responsibility for Guiding and Coordinating Support Staff". ABPA did not cover patient management criteria due to its focus on professionalism. The results of GEE analysis showed significant improvements in ABPA scores from the initial to final stages of clinical internship in commitment to learning (p = .008), interpersonal skills (p = .03), communication skills (p = .04), effective use of time and resources (p = .01), and responsibility (p = .02). These items primarily corresponded to CPI's "Professional Growth", "Communication", "Financial Management and Fiscal Responsibility", and "Responsibility" categories.

The comparison revealed important differences between the Ability-Based Professionalism Assessment (ABPA) and Clinical Performance Instrument (CPI) 3.0. ABPA's lack of legal practice, financial management, and documentation elements likely reflects Taiwan's national health insurance system. CPI 3.0's focus on inclusivity underscores the United States' emphasis on cultural competence. While some ABPA scores improved significantly, the lack of overall score increase suggests some aspects of professionalism may develop over longer periods or require different educational approaches. 

To enhance ABPA's effectiveness, consider integrating documentation and financial management elements tailored to Taiwan's healthcare context. Expanding the assessment to include ethical practice and inclusivity could provide a more comprehensive evaluation of students' readiness for modern physical therapy practice while respecting cultural differences. These modifications could better prepare Taiwanese physical therapists for an increasingly interconnected world and improve the tool's ability to demonstrate student growth over time.