Simulation-based clinical assessment identifies threshold competence to practise physiotherapy in Australia: a...

Area of Science:

• Health Professions Education
• Medical Simulation
• Professional Competency Assessment

Background:

• Limited evidence exists for high-fidelity simulation in high-stakes professional competency assessments.
• The Australian Physiotherapy Council (APC) developed an alternative simulation-based assessment model using standardized patients.
• This study investigated the equivalence of simulation-based versus real-life assessments for physiotherapy registration.

Purpose of the Study:

• To compare outcomes of simulation-based assessment with real-life assessment for physiotherapy registration.
• To evaluate the validity of simulation-based assessment in identifying threshold competence.
• To assess the suitability of simulation for high-stakes professional evaluations.

Main Methods:

• A randomized crossover trial was conducted with internationally trained physiotherapists (Study 1: n=25, Study 2: n=144).
• Participants underwent both real-life and simulation-based assessments in matched practice areas.
• Competency was assessed using the standard 90-minute Moderated Assessment Form (MAF) procedure.

Main Results:

• Real-life assessments yielded higher overall pass rates (Study 1: 50% vs 42.7%; Study 2: 55.6% vs 44.4%).
• High to moderate exact matching of pass/fail grades was observed between assessment types (Study 1: 73.4%, Study 2: 58.3%).
• Simulation-based assessment results significantly predicted real-life pass/fail grades and scores.

Conclusions:

• Simulation-based assessment is a significant predictor of clinical performance.
• This assessment method can successfully identify high-stakes threshold competence for physiotherapy practice in Australia.
• Simulation offers a viable alternative for professional competency assessment.