Education Centre

An educator observing a student and patient during an assessment conversation.

Purpose of the Education Centre

For clinical educators supervising physiotherapy students on professional practice placements. Explore when to use the APP, how to assess performance, who to involve, and video examples showing different performance standards across four clinical areas.

What is the APP instrument?

The Assessment of Physiotherapy Practice (APP) has 20 items across seven domains: professional behaviour, communication, assessment, analysis and planning, intervention, evidence-based practice, and risk management.

Each item includes performance indicators to support learning and assessment. These illustrate expected behaviours without listing everything an educator might observe.

The APP is supported by a substantial and growing body of research into how well it measures physiotherapy competence. Foundational studies by Megan Dalton, Megan Davidson and Jenny Keating established evidence for its validity and reliability, with subsequent research extending this evidence across universities and placement settings.

Research behind the APP

  • Validity — measuring professional competence. Dalton and colleagues’ 2011 study analysed 644 assessments from nine Australian and New Zealand universities. Rasch analysis supported the APP’s use as a measure of entry-level competence, with overall model fit in both the initial and validation samples. Dalton et al., 2011
  • Reliability — consistency between assessors. In the 2012 study, 30 pairs of clinical educators independently assessed students after a five-week placement. Agreement for the total APP score was high: an intraclass correlation coefficient (ICC) of 0.92 (95% confidence interval 0.84–0.96). The standard error of measurement was 3.2 points on the 80-point scale, providing context for interpreting small score differences. Dalton et al., 2012
  • Continuing evidence at scale. A 2025 study co-authored by Dalton examined 9,387 placements involving 1,865 students at 19 Australian and New Zealand universities. It supported two related dimensions — professional behaviour and clinical skills — with internal consistency (omega) of 0.80 and 0.96 respectively, and evidence of comparable measurement across placement types, settings and repeated assessments. Reubenson et al., 2025
Key publications
  1. Dalton M, Davidson M, Keating J. (2011). The Assessment of Physiotherapy Practice (APP) is a valid measure of professional competence of physiotherapy students: a cross-sectional study with Rasch analysis. Journal of Physiotherapy, 57(4), 239–246. doi:10.1016/S1836-9553(11)70054-6.
  2. Dalton M, Davidson M, Keating JL. (2012). The Assessment of Physiotherapy Practice (APP) is a reliable measure of professional competence of physiotherapy students: a reliability study. Journal of Physiotherapy, 58(1), 49–56. doi:10.1016/S1836-9553(12)70072-3.
  3. Reubenson A, Ng L, Lawton V, et al. (2025). The assessment of physiotherapy practice is a robust measure of entry-level physiotherapy standards: Reliability and validity evidence from a large, representative sample. PLOS ONE, 20(4), e0321397. doi:10.1371/journal.pone.0321397.

When to use the APP

Use the APP for feedback and assessment throughout placement, particularly at these three stages.

  1. Before placement

    Clarify expectations, agree on learning goals, and establish a shared understanding of assessment and feedback.

  2. During placement

    Give formative feedback regularly to support improvement, with a formal APP assessment at mid-unit.

  3. At the end of placement

    Provide summative feedback and give the completed assessment to the student and University.