Competence Behaviour Cultivation Among Physiotherapy Graduates with Programmatic Clinical Portfolio: A Behavioural Change Intervention

Creating a competent healthcare workforce that can meet the demands of the 21st century’s globalised healthcare system is a top priority. The purpose of this study was to understand how competency behaviours of final-year physical therapy students are promoted through an evidence-based Programmatic Clinical Portfolio (Pro-CP). If Pro-CP can develop competency behaviours, this study further explores the factors contributing to the development of competency behaviours. The Pro-CP instrument was developed based on contemporary principles of the programmatic assessment model, which provides a valid measure of workplace competence. A phenomenological study design was used to capture the experiences of final-year physical therapy graduates. The sample (n = 32) was drawn from both public and private settings during a four-week clinical internship. Data from the focus group discussions (FGDs) were coded deductively using the Theory of Planned Behaviour (TPB) to assist in answering the research questions. Five themes emerged from the thematic analysis, namely, (a) Increased behaviours towards Pro-CP; (b) Decreasing subjective norms towards Pro-CP; (c) Increased self-efficacy towards Pro-CP; (d) Increased learning autonomy towards Pro-CP; (e) Need for institutional support. This qualitative study highlights the key elements of behavioural beliefs, normative beliefs, and perceived behavioural control concerning self-efficacy to understand the cultivation of competence behaviours. Consideration of programmatic assessment principles in the design of the competence assessment instrument holds promise for providing a valid value that genuinely defines the competency behaviours of physical therapy graduates. This study adds new thinking to competence assessment instrument in physical therapy.