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Validation of the Clinical Internship Evaluation Tool

LM Fitzgerald, PT, MEd, PCS, is Assistant Professor and Director of Clinical Education, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pa 15261 (USA).
A Delitto, PT, PhD, FAPTA, is Professor and Chair, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh.
JJ Irrgang, PT, PhD, ATC, Associate Professor and Director of Clinical Research, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa.

Address all correspondence to Ms Fitzgerald at: lfitzger{at}pitt.edu

Background and Purpose: Graduates of physical therapist education programs should be expected to function as competent clinicians. Instead, the benchmark for many clinical performance assessment tools has been "as good as an entry-level graduate." The authors developed the Clinical Internship Evaluation Tool (CIET), which measures clinical performance of the student relative to a "competent clinician." The purpose of this study was to provide evidence for validity of the tool.

Subjects and Methods: The CIET was used to evaluate physical therapist student clinical performance from 1999 to 2003. Data from 228 student evaluations, a survey of 26 clinical instructors (CIs), and an item review by 7 faculty members were used to collect validity evidence. The relevance of items on the CIET was examined by the survey and the item review. Coefficient alpha was calculated to estimate internal consistency among the items. A Spearman correlation was used to examine the relationship between 2 measures of clinical competence. A repeated-measures analysis of variance (ANOVA) compared the student scores at each clinical time frame to confirm expected improvements in performance longitudinally. Evidence for practicality was collected by the CI survey.

Results: Based on the faculty item review and the CI survey, all items were representative of skills and behaviors considered important for a clinically competent physical therapist. The internal consistency (alpha) was .98 for the patient management items. The average correlation of the 2 measures of clinical competence was .76. The repeated-measures ANOVA was significant and demonstrated improved patient management scores as the student progressed through the program. The CI survey results indicated that 96% of respondents agreed or strongly agreed that the instrument was short and easy to use.

Discussion and Conclusion: The results of the study suggest that the CIET is representative of skills and behaviors necessary for students to perform at the level of a competent therapist and that the instrument is practical to use for busy clinicians. The CIET appears to be a valid tool for measuring student clinical performance and can be a time-efficient alternative for CIs in today's demanding clinical environment.

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