The Journal of Clinical Education in Physical Therapy

Academic performance of physical therapy students participating in a student-led pro bono clinic: a quasi-experimental, cohort study across two orthopedic courses

2025-09-24T17:13:54+00:00

Purpose: Prior studies have explored the influence of student-run pro bono clinics on attitudes, empathy, and professional development; however, limited research has examined the potential academic impact. The TSU Tiger Rehabilitation Clinic is a student-led clinic offering physical therapy services to underserved populations. The purpose of this study was to investigate whether involvement impacted the performance on written examinations and practical scores of second-year Doctor of Physical Therapy (DPT) students enrolled in two consecutive orthopedic courses.

Methods: A quasi-experimental crossover design was employed to investigate the effect of student-led pro bono clinic participation on the academic performance of second-year DPT students across two consecutive cohorts. Students were randomly assigned to either the experimental group (clinic participation) or the control group (fundraising) during the fall semester and switched roles in the spring. Academic performance was assessed using standardized quizzes, written exams, and practical assessments in Orthopedics I and II. Written evaluations were administered through an electronic management system with NPTE-style questions from a consistent question bank; item reliability was confirmed using platform analytics. Practical exams evaluated both clinical skill performance and theoretical knowledge, with structured remediation and safety protocols in place. A paired sample t-test and MANOVA were performed to analyze differences in academic outcomes between groups.

Results: No statistically significant differences were found between groups on any written or practical assessments. Score differences were minimal, correlations were weak, and effect sizes were consistently small, indicating a minimal to negligible measurable impact on academic outcomes from clinic participation.

Conclusion: Although clinic participation did not significantly impact academic performance, pro bono experiences may promote interpersonal and professional development that is not captured by traditional assessments. Future research should employ mixed-method designs to explore broader educational impacts and long-term outcomes of early clinical exposure.

Examining relationships between the clinical learning environment and clinical reasoning in physical therapy education

2025-03-27T21:53:14+00:00

Purpose: Newly graduated physical therapists are expected to demonstrate high levels of clinical reasoning. Doctor of Physical Therapy (DPT) programs should ensure clinical education experiences foster clinical reasoning. Minimal evidence exists regarding factors that influence physical therapy clinical learning environments (CLE). The purpose of this study was to examine associations between factors DPT students perceive to impact CLE and students’ self-efficacy in clinical reasoning.

Methods: This quantitative exploratory correlational study electronically surveyed 45 graduate physical therapy students enrolled in their final year of DPT education programs upon completing their terminal clinical education experience. The Physical Therapy Self-Efficacy Scale and the abbreviated Clinical Learning Environment Inventory-19 (CLEI-19) were used to assess self-efficacy in clinical reasoning and perceived personalization, student involvement, task orientation, innovation, and student satisfaction in CLE, respectively. Inferential and descriptive statistics assessed the relationships between self-efficacy in clinical reasoning and the previously mentioned CLEI-19 factors.

Results: Very weak to weak, positive relationships that were not statistically significant were identified between self-efficacy in clinical reasoning and perceived personalization (r_s(43) = 0.21, P = 0.163), student involvement (r_s(43) = 0.14, P = 0.375), task orientation (r_s(43) = 0.03, P = 0.867), innovation (r_s(43) = 0.16, P = 0.286), and student satisfaction (r_s(43) = 0.28, P = 0.064), respectively, in CLE.

Conclusion: DPT programs can use this study to determine which factors in physical therapy CLE relate to self-efficacy in clinical reasoning. The results of this study can be used to guide future research in identifying perceived influential factors in physical therapy CLE.

Physical therapist student and clinical instructor perceptions of the Clinical Performance Instrument 3.0 (CPI 3.0): an exploratory descriptive study

2025-03-27T22:45:47+00:00

Purpose: The Clinical Performance Instrument (CPI) has been adopted by US academic physical therapist (PT) programs as a key measure of clinical education performance. In May 2023, the APTA released an updated version, the CPI 3.0, which included significant changes. The purpose of this study was to explore perceptions of students (SPTs) and clinical instructors (CIs) who were the initial users of the CPI 3.0.

Methods: Retrospective study utilizing an investigator-created electronic survey meant to measure the constructs of technology, scoring, and stakeholder burden compared to the previous version. The survey was sent out to five cohorts of students and their CIs who used the CPI 3.0 for a full-time clinical experience during the inaugural release. IRB approval was obtained.

Results: Students (n = 63) and CIs (n = 47) reported that the CPI 3.0 platform was easy to access (95.2% SPT; 76.6% CI) and navigate (93.5% SPT; 72.3% CI). However, submission problems were experienced. More than 90% of students and CIs agreed that the CPI 3.0 was able to capture an accurate reflection of student performance. In addition, 91.1% of CIs reported that the tool would enable them to capture student performance difficulties that would put them at risk of not passing. Those that used the previous version of the CPI agreed that the CPI 3.0 was less time consuming (64.3% SPT; 76.3% CI) and burdensome (60.5% SPT; 68.4% CI).

Conclusion: Students and CIs perceived the CPI 3.0 favorably in terms of ability to capture performance, time to complete, and overall burden.

Exploring the relationship of diagnostic reasoning, self-efficacy, and clinical reasoning of physical therapy students

2025-01-14T22:42:35+00:00

Purpose: One of the primary objectives of entry-level physical therapy education is to develop students’ clinical reasoning (CR) skills to provide optimal, patient-centered care. However, CR is a highly contextualized concept, and the assessment of CR development to ensure students have the requisite skills for safe patient care prior to clinical experiences is challenging within an education program. Self-assessment tools may provide a time-efficient opportunity to assess students’ CR development across their education. Both diagnostic reasoning and self-efficacy have been correlated with CR performance in physical therapy. This study aimed to explore the relationship between diagnostic reasoning, self-efficacy, and CR development among physical therapy students.

Methods: Diagnostic reasoning was assessed through the Diagnostic Thinking Inventory (DTI). Self-efficacy was measured by the New General Self-Efficacy (NGSE) scale and Physical Therapist Self-Efficacy (PTSE) scale. CR ability was evaluated through the Think Aloud Standardized Patient Examination (TASPE) performed during a standardized patient simulation, and scores for the CR performance criteria as assessed by clinical instructors on the Physical Therapist Clinical Performance Instrument Version 2006 (CPI).

Results: There was no correlation between self-assessment scores on the DTI, NGSE, PTSE, and CR performance assessed by faculty during a standardized patient simulation (TASPE) or clinical instructors using the midterm and final CPI during a 12-week full-time clinical experience.

Conclusion: This study was unable to identify a self-assessment tool or a student performance indicator that could accurately predict CR performance during upcoming full-time clinical experiences.

Association of residents’ personality traits with clinical performance in an orthopedic physical therapy residency program

2025-03-06T23:39:56+00:00

Purpose: Despite the lack of validity and reliability, residency programs use various assessments to admit residents and anticipate their future performance that include admission interviews and letters of recommendation. The purpose of this study is to examine whether there is a valid, reliable, or predictive association between physical therapy residents’ personality traits and their clinical performance in the domains of live patient examination, clinical productivity, and patient satisfaction during residency training.

Methods: This study was an observational cohort study. Each resident completed a standardized 16 Personal Factors Questionnaire (16 PF) on their respective hire date prior to matriculation in the physical therapy residency program.

Results: Results of the Spearman’s rho correlation indicated there was a strong positive association between those residents who were classified as more even-keeled (r = 0.473; p = 0.02) and meeting clinical productivity goals at 3 months. Better performance on the live patient examination was associated with residents who were identified as being people-oriented (r = 0.531; p = 0.02), gregarious (r = 0.464; p = 0.04), and fearless (r = 0.521; p = 0.02), while worse performance was associated with residents who were self-disclosing (r = -0.673; p = 0.00) and self-confident (r = -0.520; p = 0.02).

Conclusions: Identification of residents’ personality traits may be helpful in determining whether residents are likely to meet expectations in the domains of clinical productivity and performance on a live patient examination during the first 3 months of a post-professional physical therapy residency program.

The relationship between physical therapy students’ communication skills during a standardized patient examination and professionalism domain performance on a first full-time clinical experience: an exploratory cohort study

2025-01-27T15:07:04+00:00

Purpose: Physical therapy education lacks validated tools for assessing student communication and professional behavior skills before clinical experiences (CE). The Gap Kalamazoo Communication Skills Assessment Form (GKCSAF) has been used in medical education to assess student communication skills. This study investigated: (1) the relationship between scores on a modified GKCSAF (mGKCSAF) during a standardized patient (SP) examination and professionalism domain scores on the Clinical Performance Instrument 2.0 (CPI) during a first full-time CE1 and (2) differences in mGKCSAF ratings across SPs, clinical instructors (CIs), and student self-assessments.

Methods: This retrospective study examined data from 73 first-year physical therapy students who completed a SP examination and were scored using the mGKCSAF before CE1. The mGKCSAF was scored by SPs, CIs, and the students themselves. At the end of CE1, students were assessed using the CPI. Spearman’s rank-order correlations were used to determine the relationship between mGKCSAF scores and five professionalism domain scores on the CPI. A one-way Analysis of Variance (ANOVA) was performed to compare mGKCSAF ratings across rater groups. Post hoc Tukey’s Honest Significant Difference (HSD) tests further explored differences among rater groups. G*Power analysis confirmed sufficient sample size.

Results: Small statistically significant correlations existed between mGKCSAF SP ratings and CI CPI ratings during CE1 in professionalism domain categories. Student mGKCSAF self-assessment scores were significantly lower than assessments by SPs and CIs.

Conclusion: The mGKCSAF may be an effective tool to assess physical therapy student communication skills before CE1 when it is scored by SPs.

How physical therapy residents and fellows influence doctor of physical therapy students’ experiences: a single program mixed methods study

2025-07-10T13:59:10+00:00

Purpose: Physical therapy residency and fellowship programs help healthcare providers develop stronger clinical skills and professional confidence. While research shows that these programs benefit the residents and fellows, we know little about how these advanced practitioners impact entry-level Doctor of Physical Therapy (DPT) students they work with during their education. This study investigates the influence of physical therapy residents and fellows on the educational experience and professional development of DPT students through focused surveys and semi-structured interviews.

Methods: Students eligible (229) for this study were students enrolled in the DPT program from January 2018 to March 2022. Cohorts were selected based on their exposure to residents and fellows during their time in the DPT program. Students from the identified cohorts were invited to complete a web-based survey and participate in virtual interviews. An inductive content analysis approach was employed to identify and refine codes and establish themes.

Results: Twenty-three percent of students completed the survey (52), and 42 completed the interview. Seventy-three percent of students acknowledged that a residency and fellowship program associated with the DPT program positively enriched their educational experience. Additionally, 50% of students indicated that access to residents and fellows influenced their decision to pursue a residency or fellowship.

Conclusion: The findings suggest that integrating residents and fellows within a DPT program positively influences students’ educational experiences and professional development within a single university setting. While these results are encouraging, additional research is warranted to deepen our understanding of this relationship.

The bonds between academic and clinical education in physical therapy training

2026-01-16T14:38:44+00:00

Welcome to the 2025 Journal of Clinical Education in Physical Therapy (JCEPT) open-access volume. Initiated in 2019, JCEPT was indexed this year to PubMedCentral (PMC), greatly expanding the reach and impact of the work we publish. PMC indexing is vital for the expansion of educational scholarship relevant to the clinical training at the heart of physical therapy education. Scholarship indexed and accessible through the National Institutes of Health’s National Library of Medicine via PMC highlights the work of physical therapy educators to the broader community interested in contemporary biomedical and health care research and practice. Currently, PMC articles related to physical therapy clinical education number in the thousands, compared to the tens of thousands related to graduate (clinical) medical education. We aim to disseminate peer-reviewed educational scholarship related to physical therapy clinical education while strengthening the connections between academic and clinical partners.

The connection between academic and clinical physical therapy education along the professional development spectrum was apparent in this year’s volume. Drevyn et al. examined the utility of supplementing acute care clinical experience with simulation-based learning in the academic program. The relevance of clinical environment on learning outcomes (Charles et al.) and clinical reasoning (Stoddard et al.) was also explored. Assessing clinical performance remains an important area of study explored in this volume with respect to the new Clinical Performance Index (Hansen et al.), particularly in the professional (Young et al.) and clinical reasoning domains (Cunningham et al.). The importance of soft skills was underscored by work describing personality traits of successful residents (Geist et al.) and positive interactions among entry-level students, residents, and/or fellows (Bourassa et al.) which may be influential in developing such skills. The health of the PT profession is strengthened by developing and nurturing the relationship between academic and clinical partners across the continuum of learning, from entry-level education, residency/fellowship training, and continuing professional development programs.

JCEPT publishes scholarly work exploring clinical education in physical therapy addressing academic or clinical faculty; entry-level students, residents, or fellows; and curricula or teaching and learning methods. In addition to original research, systematic reviews, and innovative teaching methods, JCEPT publishes clinical education case reports, residency or fellowship case reports, excellent critically appraised topics, and the occasional perspective. JCEPT submissions have increased and the acceptance rate has decreased, yet our editorial team remains committed to the developmental aspect of our mission as we work with authors through multiple revisions. We look forward to supporting educational scholars and developing the evidence underpinning physical therapy clinical education.