The pandemic has taught us many things in life, but also valuable lessons in physical therapy education. It has brought to light some opportunities for learning as it relates to the CPI especially when we had students unexpectedly suspended last spring.
One lesson is the value of completing the CPI on or before the midpoint date of the clinical experience (week seven of our 14-week clinical experience). With the unexpected suspension around week nine for many, those who completed the CPI at week seven had two more weeks of student work to be able to evaluate. There were others, unfortunately, that did not have any additional time after the midterm CPI and therefore could not give any updated information. We recognize there are very legitimate reasons the CPI cannot be scheduled at week seven at times, but in these cases, our recommendation is to complete it earlier rather than later.
Another lesson is an opportunity to review the scoring of the CPI. It is important to remember to consider all the performance dimensions when selecting a rating. These include level of supervision/guidance, but also quality of work, complexity of the task/patient/environment, consistency of performance, and efficiency of performance. The rating scale anchors also have very specific definitions in terms of percent of supervision required for both simple and complex cases, as well as the percent of caseload that a student shows the capability to maintain. For example, advanced intermediate performance includes <25% supervision for complex patients, independence with simple patients, and capability of maintaining 75% caseload. Capability is an important word to pay attention to, as at times situations (like a pandemic) are limiting caseload numbers, so the CI may need to make a judgment as to the percent of caseload a student is capable of managing. Please note, the concept of capability and managing a percent caseload kicks in at the intermediate level and beyond.
Finally, the CPI is not intended to 'leave room' for the student to reach entry-level at their next clinical rotation, or even 'leave room' for them to progress after midterm during a current clinical experience. Rather, the intent is for the CI to assess the student based on clinical performance and ability in your setting and at that point in time, regardless of where the student is in terms of clinical experiences remaining. The approach of leaving room for improvement did present a dilemma in the spring when clinical were suspended early but within the allowable COVID-19 timeframe from CAPTE. There were cases when the documented CI ratings on the CPI did not match the verbal communication from the CI that the student should pass the clinical experience, with the rationale given that the CI had left room for the student to progress. The CPI is designed to be progressive, and we expect students to progress along the continuum with each of their clinical experiences, but it also has the flexibility to allow each CI to rate based on performance in each setting. We do not expect or require entry-level at earlier clinical rotations but rely on the CI using the definitions and anchors, to give us critical and valuable input. Using the performance dimensions and rating scale anchor definitions, as well as the sample behaviors, should allow the CPI to be completed objectively and accurately For those students excelling in their environment, the selection of beyond entry-level is a means to show continued growth with achievement of advanced goals.
The CPI is not a perfect instrument and can be long and tedious to complete, but it has been researched and found to be valid. When used with its definitions and anchors, it provides necessary, important, and highly valuable information on student physical therapists' work. Thank you to all our clinical partners for the extra time it takes to complete this tool with each of your students. We read every comment and we greatly appreciate it!