Students achieve comparable performance scores for clinical placements in public and private sectors: a longitudinal observational study

Questions: Does student clinical performance differ according to healthcare sector? Does student clinical performance at Macquarie University differ from other Australian graduate entry-level programs? Design: A longitudinal observational study with comparison to national data. Participants: A total of 284 physiotherapy students from Macquarie University. Outcome measures: Each student's clinical performance was evaluated by a clinical educator using the Assessment of Physiotherapy Practice (APP) tool at the end of four 5-week clinical placements. Four measures of clinical performance were analysed: Total APP score, Employability Skills, Clinical Skills and a global rating of performance. A between-group difference in the APP results of 5% was nominated a priori as large enough to be considered important. Results: Of the 1,136 placements, 533 (47%) were undertaken in the private sector. Among their four placements, 99% of students had at least one private sector placement and 70% had two or more private sector placements. There were negligible differences between private and public sector placements in Total APP scores (MD 0%, 95% CI −1 to 1), Employability Skills scores (MD 2% higher in the public sector, 95% CI 1 to 3) and Clinical Skills scores (MD 1% higher in the private sector, 95% CI −1 to 3). On the global rating of performance, 88% of placements in each sector were rated as being either good or excellent. Students in the private sector were 9% (95% CI 3 to 14) more likely to be rated as excellent compared with the public sector. There were negligible differences in clinical performance between the Macquarie University and other Australian graduate-entry students. Conclusion: Macquarie University's practice of increasing private sector participation in clinical education had no adverse effects on student clinical performance, and it is likely to be beneficial in better preparing students for work in the private sector.