The assessment of physiotherapy practice is a robust measure of entry-level physiotherapy standards: Reliability and validity evidence from a large, representative sample

The Assessment of Physiotherapy Practice (APP) is a 20-item assessment instrument used to assess entry-level physiotherapy practice in Australia, New Zealand and other international locations. Initial APP reliability and validity evidence supported a unidimensional or single latent factor as the best representation of entry-level physiotherapy practice performance. However, there remains inconsistency in how the APP is interpreted and operationalised across Australian and New Zealand universities offering entry-level physiotherapy programs. In essence, the presumption that the psychometric integrity of the APP generalises across people, time, and contexts remains largely untested. This multi-site, archival replication study utilised APP assessment data from 8,979 clinical placement assessments, across 19 Australian and New Zealand universities, graduating entry-level physiotherapy students (n=1865) in 2019. Structural representation of APP scores were examined via confirmatory factor analysis and penalised structural equation models. Factor analyses indicated a 2-factor representation, with four items (1–4) for the professional dimension and 16 items (5–20) for the clinical dimension, is the best approximation of entry-level physiotherapy performance. Measurement invariance analyses supported the robustness of this 2-factor representation over time and across diverse practice areas in both penultimate and final years of study. The findings provide strong evidence for the psychometric integrity of the APP, and the 2-factor alternative interpretation and operationalisation is recommended. To meet entry-level standards students should be assessed as competent across both professional and clinical dimensions of physiotherapy practice.