Student Name
Facility/Experience
Note: a rating of 0 or 1 indicates that minimum acceptable competency has not been achieved.
A total score of 50% or greater is required to pass each Learning Outcome (grey headings)
LO 1. Professional Behaviour
Select/Tick one number only
Demonstrates an understanding of client rights and consent
2. Demonstrates commitment to learning 0 1 2 3 4 not assessed
Demonstrates ethical, legal & culturally responsive practice
Demonstrates collaborative practice
5. Communicates effectively and appropriately - Verbal/non-verbal 0 1 2 3 4 not assessed
6. Demonstrates clear and accurate documentation 0 1 2 3 4 not assessed
Conducts an appropriate client-centred interview
8. Selects and measures relevant health indicators and outcomes 0 1 2 3 4 not assessed
9. Performs appropriate physical assessment procedures 0 1 2 3 4 not assessed
LO 4. Analysis & Planning
10. Appropriately interprets assessment findings 0 1 2 3 4 not assessed
Identifies and prioritises client's problems
Sets realistic short and long term client-centred goals
Selects appropriate intervention in collaboration with the client
14. Performs interventions appropriately 0 1 2 3 4 not assessed
15. Is an effective educator 0 1 2 3 4 not assessed
16. Monitors the effect of intervention 0 1 2 3 4 not assessed
17. Progresses intervention appropriately 0 1 2 3 4 not assessed
18. Undertakes discharge planning 0 1 2 3 4 not assessed
LO 6. Evidence-based Practice
Applies evidence based practice in client-centred care
20. Identifies adverse events/near misses and minimises risk 0 1 2 3 4 not assessed
associated withassessment and interventions
In your opinion as a clinical supervisor, the overall performance of this student in the clinical unit was:
Scoring rules:
Select/Tick only one number for each item
Select/Tick not assessed only if the student has not had an opportunity to demonstrate the behaviour
If an item is not assessed it is not scored and the total APP score is adjusted for the missed item.
Evaluate the student's performance against the minimum competency level expected for an entry level physiotherapist
Not adequate Adequate Good Excellent
4 Demonstrates most performance indicators to an excellent standard
not assessed = item was not assessed
Assessment of Physiotherapy Practice
0 Infrequently demonstrates performance indicators
1 Demonstrates few performance indicators to an adequate standard
2 Demonstrates most performance indicators to an adequate standard
3 Demonstrates most performance indicators to a good standard
