The aim in this systematic review was to synthesize physiotherapy clinical competence assessment instruments and gather valid evidence and authentic principles for their application in physiotherapy assessment practices. The research questions were focused on: (1) What are the clinical competence assessment instruments in physiotherapy clinical education?, (2) What is the validity evidence of these assessment instruments?; and (3) Does the assessment instrument adheres to any of the authnitc principles of the assessment ? 4) What are the behavioural changes observed when using assessment tools?, and 4) Do the assessment instruments adhere to modern theories of performance measurement?.
Six major electronic databases (Scopus, PubMed, Google Scholar, ProQuest, EBSCOHost, and Ovid) were searched for articles published until 2024. Key journals from the reference lists of the selected articles were also extracted. Articles related to clinical competence assessment in physiotherapy and rehabilitation were reviewed. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were used for conducting this systematic review. Two reviewers evaluated the selected papers.
A total of 24 papers matched our inclusion criteria in this study. The 24 articles illuminated eleven clinical assessment instruments practiced across the globe. The evidence of validity reported by these instruments varied and was inclined towards psychometric properties. The Blue MACS, Clinical Performance Instrument (CPI), Common Assessment Form, and Clinical Competence Evaluation Instrument. Australian Physiotherapy Practice, Treatment Planning Assessment, Standardised Assessment Form, Open Station Clinical Examination with checklist and validated feedback form, three instruments based on reflection, and the Clinical Internship Evaluation Tool have been identified. Clinical performance assessment tools with evidence of adherence to the principles of authentic assessment is limited. The behavioural changes reported by these instruments were mostly within levels 1 and 2 of the Kirkpatrick evaluation.
Our findings revealed a scarcity of substantial evidence that reported on the current validity of competence-performance assessment instruments practiced within physiotherapy. To measure the complex clinical competence behaviour, physiotherapy educators must utilize a valid assessment instrument that adheres to the principles of authentic assessment in its design. A shift in mindset, beyond psychometric measures, is needed to pave the way for better assessment designs to enable robust and confident measurement of competence for best quality of graduates.
This systematic review offers important contributions to the literature. The eleven clinical assessment tools in this review suggest that physiotherapy assessment practices are still homegrown and independent in its assessment designs. Evidence of assessment tools adherence to current contemporary principles of authentic assessment is scarce. A shift away from the traditional views of clinical competence is pertinent in order to design and develop a valid and robust assessment instrument to measure clinical competence.
physiotherapy
clinical competence
