Nordrum, Jon T.

Background Based on changes in core physical therapy documents and problems with the earlier version, the Physical Therapist Clinical Performance Instrument (PT CPI): Version 1997 was revised to create the PT CPI: Version 2006. Objective The purpose of this study was to validate the PT CPI: Version 2006 for use with physical therapist students as a measure of clinical performance. Design This was a combined cross-sectional and prospective study. Methods A convenience sample of physical therapist students from the United States and Canada participated in this study. The PT CPI: Version 2006 was used to collect CPI item–level data from the clinical instructor about student performance at midterm and final evaluation periods in the clinical internship. Midterm evaluation data were collected from 196 students, and final evaluation data were collected from 171 students. The students who participated in the study had a mean age of 24.8 years (SD=2.3, range=21–41). Sixty-seven percent of the participants were from programs in the United States, and 33% were from Canada. Results The PT CPI: Version 2006 demonstrated good internal consistency, and factor analysis with varimax rotation produced a 3-factor solution explaining 94% of the variance. Construct validity was supported by differences in CPI item scores between students on early compared with final clinical experiences. Validity also was supported by significant score changes from midterm to final evaluations for students on both early and final internships and by fair to moderate correlations between prior clinical experience and remaining course work. Limitations This study did not examine rater reliability. Conclusion The results support the PT CPI: Version 2006 as a valid measure of physical therapist student clinical performance.

Background and PurposeThis administrative case report documents the development of a mechanism by which systematic triage was used to assign patients to therapists in acute care settings. The primary objective was to develop a triage tool to improve patient access to medically necessary therapy services.Case DescriptionA unique triage tool and a decision tree were developed to determine which patients referred to therapists for acute care therapy required skilled services. The triage tool was used to examine therapy referrals for patients from 2 large academic hospitals; 6 criteria were used to determine which evaluations should be cancelled. During the trial period, the predictive ability of individual triage criterion items was analyzed, the tool was modified and validated, and a decision tree was established. Descriptive and chi-square analyses were performed on all variables of interest.OutcomesThe systematic triage system reduced the number of therapy evaluations that were not appropriate by 29%, resulting in an improvement in the availability of therapy services for patients who required skilled care. The average number of patients per therapist per workday decreased from 18.9 to 12.1 and from 15.1 to 12.8 in the 2 hospitals. An improvement in a newly developed “workload index” related to missed patient visits also indicated the success of this project.DiscussionA novel systematic triage system reduced the number of therapy evaluations that were not appropriate, resulting in an improvement in the availability of therapy services for patients who require skilled intervention.