All learning guides

A student who scores a 2 has demonstrated practice at a beginning practitioner level (enty-level) with respect to that item on the APP, whereas a score of 3 means that the student’s performance is better than a passing standard but not at an excellent level yet.

No, half scores are not useful in measuring the student’s performance – the APP tool is designed to be used consistently across different clinical contexts and disciplines of practice, and half scores do not help in making a decision about a student’s performance.  It is best to make a decision in whole numbers.

No, the APP should not be altered or modified for students who are at the start in their first clinical placement or in their final clinical placement and it should be applied in the same way.  Although students are likely to improve over the course of their placement experiences, the tool is designed to ensure that students on their first or last placement are measured consistently.  The tool is not appropriate for first and second year placements in an undergraduate program.

By collecting evidence throughout the placement, scoring of the student is streamlined.  Practice examples gathered can be used in feedback during the placement as well, and this can also feed into setting and changing of learning objectives through the placement. By identifying if further learning opportunities are required during the placement and assisting the student in having opportunities to demonstrate requisite skills, scoring of the student is also made simpler.

Early identification of a student at risk of failing is important as this will provide the student with as much time as possible to improve their performance. Clearly identify the reasons why you think the student is at risk of failing.  Use the APP to reflect on the student’s performance relating this to direct observation and the gathering of observable evidence of the student’s performance in the practice context.  Reviewing the performance indicators in the APP tool can be used to identify the issue concretely and assist with determining the behaviour/s the student should stop or start. It may also be useful to ask a colleague to review the students’ performance if possible.  Provide the student with clear and goal-directed feedback on their performance. Contact the university involved and collaborate with the student and the university to gain a clear and joint perspective on why the student is at risk and which learning strategies, goals or opportunities need to be provided to optimise the learner’s development.  Continue to monitor and provide feedback on subsequent performance and acknowledge positive gains.

See Day 1 of a Clinical Placement and Logbook.

Failing a student on placement is appropriate when the evidence gathered using the APP instrument supports your assessment decision.   If you think a student is at risk of failing, it is essential that you identify this early, contact the university, provide feedback to the student and collaboratively develop strategies to assist the student to improve their performance.
If at the end of the placement, despite early identification of the student’s learning needs and a collaborative plan for improvement, the student is not performing at an entry level across some domains on the APP, a decision will need to be made to fail the student.  In consultation with the Clinical Educator, the University will then work out the most appropriate plan for the student. Most commonly the student will need to have more time in clinical practice to demonstrate adequate levels of performance.

See Day 1 of a Clinical Placement and Logbook.

Prior to the unit commencing Clinical Educators and students need to familiarise themselves with the learning requirements of the placement and to set up a plan to ensure that relevant learning opportunities are provided to the student to enable you to assess the student’s performance.   Students may still be successful in their placement with you, even if there are some competencies that they have not had the opportunity to demonstrate, for example discharge planning in a context of long term care. These competencies would be marked as not assessed (N/A).
The mid unit formative feedback session provides an excellent opportunity for the Clinical Educator and student to review any areas of practice that the student has not had experience in or that the Clinical Educator has not sufficient opportunities to observe the student’s performance. Once these areas have been identified planning for the second half of the unit will help manage this.
It is important to plan learning so that sufficient evidence to support a judgement about passing or failing a domain on the APP is able to be gathered. The student can play an active role in identifying particular experiences that they need, and communicate with you when they will be working with a client that you can take this opportunity to assess their performance.
In most situations the student will have opportunities to demonstrate competency on all 20 items. If an item is not assessed it is not scored, and the total APP score will be adjusted for the missed item.

Development of the student’s self-assessment skills (or reflection on their practice) is one of the goals of clinical education.  Frequent opportunities to consider goals and outcomes can enhance learning achievements. Some students require more assistance in the development of these attributes to be realistic about their performance and the outcomes.  Formative feedback that encourages good dialogue between the student and supervisor, with clarification of expectations of practice can assist this process. Feedback based on the APP tool performance indicators may assist in the student developing the requisite skills to practice competently. For the over confident student, it may help them to receive feedback from multiple sources (clinical educators or peers) to reinforce the external judgement of their practice, and encourage them to recalibrate their own self evaluation.

See Day 1 of a Clinical Placement and Logbook.

Part of the clinical placement experience is the development of the student’s self-assessment skills to reflect on their practice.  Frequent opportunities to consider goals and outcomes can enhance learning achievements. Students need varying levels of support to make the most of learning opportunities in the initial stages of their clinical placements.  Formative feedback that encourages a positive dialogue between the student and supervisor, and clarifies expectations in a positive way can assist this process.

See Day 1 of a Clinical Placement and Logbook.

A range of reasons may impact on the level of engagement of a student in placement learning experiences.  These may include the student being unsure of the relevance of the task, not having a clear understanding of the goals of certain activities or if the student is experiencing stress either due to placement or personal circumstances. Rather than hypothesising reasons for learner lack of engagement, it is a good strategy to ask the learner directly how they are finding the placement and whether there are any reasons for the observed behaviours. Including students in goal setting and being clear with the learning objectives of the tasks they are required to perform can assist in this.  Frequent opportunities to consider goals and outcomes can enhance learning achievements. The APP tool can be useful in setting learning objectives with the student. Students need to recognise the importance of being present and active in their placement and may require support in the form of ideas and options to achieve this.  If you are concerned about the emotional well being of the student contact the university as they may have access to specific counselling options for the student.

Ongoing clear and specific feedback on a student’s performance is important from the outset of the placement.  Through this formative feedback students become aware that you are noticing when they are achieving or doing well on placement.  Some students will maintain a constant focus on their ratings on the APP therefore it is important to assess them at the level that represents their current performance as this is a fair approach to assessment.  Clear feedback on their performance needs to match their rating and this feedback is used to assist students to value the progress they have made even if this does not translate to a higher rating.  Linking performance outcomes to the rating provided aims to give the student information on an overall performance outcome despite ratings remaining the same.

When two or more clinical educators are involved in the student’s assessment it is important that all are providing consistent feedback on the student’s performance as well as ensuring clear and consistent placement information and performance expectations from the outset. Establishing a process for all the clinical educators to communicate with each other on the student performance is important. Any variations in perspectives about how the student is performing will need to be communicated during the set contact time between educators. Devise a plan for how you will all manage the student disagreeing or raising variations in evaluations of performance, for example identifying one educator as the primary contact for that student may assist with managing discrepancies and concerns.  All communications to and from the student around concerns are channelled through that primary educator. Overall collaboration and coordination are important.

This may be a practice that you choose to develop as a supervisor with specific goals related to supporting the student to gain a thorough understanding of the APP, as a guide to engaging the student in self-reflection on their performance or as a means of assisting students at risk of failing to document key learning goals and strategies based on performance feedback. Ideally, educators should ask learners to populate the self-assessment APP prior to half way and final verbal feedback sessions.

Yes they can. The individual item ratings refer to a specific competency with associated behaviours (performance indicators). The global rating scale allows the CE to consider the student’s performance from an overall more holistic perspective and provide a rating that reflects this. So a  student may be rated less than a 4 on some items but overall their performance is excellent. It is not appropriate though that a student scoring all 2’s on the items would then be rated as excellent on the global rating scale.

Yes most definitely. Part of the clinical placement experience is the development of the student’s self-assessment skills.  Frequent opportunities to consider goals and outcomes can enhance learning. Some students require more assistance in the development of these attributes to be realistic about their performance and the outcomes.  Formative feedback that encourages good dialogue between the student and supervisor, and clarifies expectations in a positive and motivational way can assist this process. Feedback based on the APP tool performance indicators may assist in the student developing the requisite skills to practice competently.

Certainly! Raters have a tendency to avoid scale extremes, however, it is very important to use the entire score range.  Students should be given the worst or best scores if that is the most appropriate rating. All students should be told what it is they need to do to score a 4 and they should aim for excellence. It is important that educators remember that the student is aiming for day 1 new graduate excellence, not the excellence that you would expect after some time in practice.

The short answer to this question is NO!   All students are marked against beginning practitioner/entry  level standards independent of where the student is at in the their overall program.

An advantage of marking students against entry level standards is that, theoretically at least, all assessors are assessing against the same standard. The results from focus group discussions about entry level/beginning physiotherapist standards have demonstrated a clear consensus from clinical educators regarding a global definition of minimally competent performance. The alternative model of grading students against ‘the expected competency during the first practice block in third year’ or ‘the expected competency during the last practice block in fourth year’ reduces confidence that consensus in scale use is operating. The target of clinical education is acquisition of a minimum acceptable level of skills and this target enables ranking of students relative to a common standard.

Describe to the student the behaviours they would need to demonstrate in order for you to feel comfortable about their abilities and award them a 3, or be delighted with their abilities and award them a 4. Students need to be clear about why you think their behaviours demonstrate the minimal acceptable performance level. The aim of feedback is to encourage students to become the best practitioners they can be. Provide the student with specific examples to illustrate behaviours that would achieve a higher grade.

When making rating decisions:

• Substantiate your decisions regarding ratings and written feedback with concrete examples of what you have observed the student doing.
• Base your formative ratings on your Trainee’s overall performance for each item from the beginning of the term until the Formative Feedback session. It is important that where possible your comments/feedback refer to more than one example of your Trainee’s performance otherwise they may feel they are being evaluated on the basis of a single incident.
• Avoid altering standards. The standards against which you rate the Trainee’s performance at Formative Feedback and final evaluation should remain the same.
• Avoid marking conservatively at halfway to allow room for improvement. Give your Trainee the rating that corresponds with their actual performance. Your assessment needs to provide an accurate message about performance. Trainee’s report becoming confused and frustrated when they sense or are told there is a disparity between feedback and the rating. While you might want to indicate to your student improvement over time, remember that increased standards on the rating scale is only one way to do this. The use of verbal and written feedback is a very effective way of indicating improvement.