title: The assessment of physiotherapy practice (APP) is a reliable measure of professional competence of physiotherapy students: a reliability study.
abstract: OBJECTIVE
  What is the inter-rater reliability of the Assessment of Physiotherapy Practice (APP) instrument, and what is the error associated with individual scores?
  
  
  METHODS
  Cross-sectional inter-rater reliability study. Thirty pairs of clinical educators each assessed one student after observing student practice over a 5-week clinical placement.
  
  
  METHODS
  Sixty clinical educators from five Australian universities formed 30 independent pairs of assessors.
  
  
  METHODS
  Each pair completed two independent assessments of one student, providing 60 completed APP assessments and an associated Global Rating Scale score for analysis.
  
  
  METHODS
  Correlational coefficients and measurement error expressed in APP scale units were computed to provide a comprehensive analysis of the likely utility of APP scores and to enable score and change score interpretation.
  
  
  RESULTS
  Percentage of agreement between assessors for each item ranged from 56% (Item 19, evidence-based practice) to 83% (Item 20, risk management) and across all items averaged 70% (SD 7). The ICC(2,1) was 0.92 (95% CI 0.84 to 0.96) for the total APP score and 0.72 (95% CI 0.50 to 0.86) for the Global Rating Scale. The standard error of measurement for the total score (scale width 0-80) was 3.2 APP points and the MDC(90) was 7.86 representing 9% of the scale width. Bland-Altman analyses identified no systematic differences between raters.
  
  
  CONCLUSIONS
  Clinical educators demonstrated a high level of reliability when using the APP instrument to assess physiotherapy students' level of professional competence in workplace-based practice.
authors.affiliation: Department of Physiotherapy, Monash University, Australia. megan.dalton@monash.edu
authors.forename: Megan
authors.initials: M
authors.lastname: Dalton
authors.forename: Megan
authors.initials: M
authors.lastname: Davidson
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Keating
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004521:Educational Measurement / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D059825:Physical Therapists / Q000193:education* / Q000592:standards*; D015203:Reproducibility of Results; D013336:Students, Health Occupations / Q000706:statistics & numerical data; D055815:Young Adult