Clinical Performance Instrument (CPI) Definitions

Performance Dimensions

Supervision/ Guidance

Level and extent of assistance required by the student to achieve entry-level performance.

• As a student progresses through clinical education experiences, the degree of supervision/guidance needed is expected to progress from 100% supervision to being capable of independent performance with consultation and may vary with the complexity of the patient or environment.

Quality

Degree of knowledge and skill proficiency demonstrated.

• As a student progresses through clinical education experiences, quality should range from demonstration of limited skill to a skilled performance.

Complexity

Number of elements that must be considered relative to the task, patient, and/or environment.

• As a student progresses through clinical education experiences, the level of complexity of tasks, patient management, and the environment should increase, with fewer elements being controlled by the Cl.

Consistency

Frequency of occurrences of desired behaviors related to the performance criterion.

• As a student progresses through clinical education experiences, consistency of quality performance is expected to progress from infrequently to routinely.

Efficiency

Ability to perform in a cost-effective and timely manner.

• As the student progresses through clinical education experiences, efficiency should progress from a high expenditure of time and effort to economical and timely performance.

Rating Scale Anchors

Beginning performance

• A student who requires close clinical supervision 100% of the time managing patients with constant monitoring and feedback, even with patients with simple conditions.
• At this level, performance is inconsistent and clinical reasoning* is performed in an inefficient manner.
• Performance reflects little or no experience.
• The student does not carry a caseload.

Advanced beginner performance

• A student who requires clinical supervision 75% - 90% of the time managing patients with simple conditions, and 100% of the time managing patients with complex conditions.
• At this level, the student demonstrates consistency in developing proficiency with simple tasks (eg, medical record review, goniometry, muscle testing, and simple interventions), but is unable to perform skilled examinations, interventions, and clinical reasoning skills.
• The student may begin to share a caseload with the clinical instructor.

Intermediate performance

• A student who requires clinical supervision less than 50% of the time managing patients with simple conditions, and 75% of the time managing patients with complex conditions.
• At this level, the student is proficient with simple tasks and is developing the ability to consistently perform skilled examinations, interventions, and clinical reasoning.
• The student is capable of maintaining 50% of a full-time physical therapist's caseload.

Advanced Intermediate performance

• A student who requires clinical supervision less than 25% of the time managing new patients or patients with complex conditions and is independent managing patients with simple conditions.
• At this level, the student is consistent and proficient in simple tasks and requires only occasional cueing for skilled examinations, interventions, and clinical reasoning.
• The student is capable of maintaining 75% of a full-time physical therapist's caseload.

Entry-level performance

• A student who is capable of functioning without guidance or clinical supervision managing patients with simple or complex conditions.
• At this level, the student is consistently proficient and skilled in simple and complex tasks for skilled examinations, interventions, and clinical reasoning.
• Consults with others and resolves unfamiliar or ambiguous situations.
• The student is capable of maintaining 100% of a full-time physical therapist's caseload in a cost-effective manner.

Beyond entry-level performance

• A student who is capable of functioning without clinical supervision or guidance in managing patients with simple or highly complex conditions, and is able to function in unfamiliar or ambiguous situations.
• At this level, the student is consistently proficient at highly skilled examinations, interventions, and clinical reasoning, and is capable of serving as a consultant or resource for others.
• The student is capable of maintaining 100% of a full-time physical therapist's caseload and seeks to assist others where needed.
• The student is capable of supervising others.
• The student willingly assumes a leadership role* for managing patients with more difficult or complex conditions.