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Student-clinician agreement in clinical competence as a predictor of clinical placement performance in Australian undergraduate physiotherapy students

机译：学生与临床医生在临床能力方面的协议，作为澳大利亚本科理疗专业学生临床实习表现的预测指标

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Objectives: The opportunity for student self-reflection and the accuracy of that reflection are critical to the acquisition of professional competencies. The relationship between student-clinician agreement and clinical performance in physiotherapy students has not yet been investigated. The aim was to determine whether a simple measure of student-clinician agreement assessed midway during a clinical placement predicts final placement score. Participants: 100 undergraduate Monash University Bachelors of Physiotherapy students and their clinical educators. Main outcome measures: Assessment of Physiotherapy Practice (APP). Method: Clinician and student ratings of student performance across all clinical placements from January 2012-June 2013 at two time-points (midway and final) were entered into a purpose-built, web-based platform, and then averaged across the number of placements undertaken. The relationship between midway student-clinician agreement (student minus clinician APP score) and final APP score (determined by the clinician) was analyzed via forward regression. Sub-group comparisons were performed investigating the stability of the relationship across placements. Results: On average, midway agreement was associated with a -0.50 (95% CI -0.67 to -0.33) unit decrease in final placement APP% score. This model was highly statistically significant (p < 0.001) but only explained 24% of the total variance (based on the adjusted r-squared statistic). This relationship was similar in early and late placements. Conclusions: Student-clinician agreement is related to clinical performance. A midway evaluation may provide an important opportunity to identify students at risk of poor clinical outcomes enabling timely implementation of support strategies. Further work is required to improve the predictive accuracy of the proposed model.
机译：目标：学生自我反思的机会和反思的准确性对获得专业能力至关重要。尚未研究过理疗学生与临床医生之间的协议与临床表现之间的关系。目的是确定在临床安置期间中途评估的学生与临床医生协议的简单测量是否可以预测最终安置分数。参加者：100名莫纳什大学物理治疗本科生及其临床教育者。主要结局指标：物理治疗实践评估（APP）。方法：将自2012年1月至2013年6月在两个时间点（中途和最终）的所有临床实习生的临床表现和学生对学生表现的评价输入到基于网络的专用平台中，然后对实习数进行平均承担。通过前向回归分析中途学生与临床医生之间的协议（学生减去临床医生的APP得分）与最终APP得分（由临床医生确定）之间的关系。进行亚组比较以调查跨展示位置的关系的稳​​定性。结果：平均而言，中途达成协议的最终安置APP％得分降低了-0.50（95％CI -0.67至-0.33）。该模型具有高度的统计学意义（p <0.001），但仅解释了总方差的24％（​​基于调整后的r平方统计量）。在早期和晚期的安置中，这种关系是相似的。结论：学生-临床医生的同意与临床表现有关。中途评估可能会提供一个重要的机会，以识别处于不良临床结果风险中的学生，从而能够及时实施支持策略。需要进一步的工作来提高所提出模型的预测精度。

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