Mapping Clinical Competency Assessment: Comparing Taiwanese DPT Tools to the U.S. Clinical Performance Instrument

Background: To align Taiwan's physical therapy clinical education with international standards, this study aimed to: (1) map Taiwan's clinical assessment tools—the Ability-Based Professionalism Assessment (ABPA) and the Mini-Clinical Evaluation Exercise (Mini-CEX)—to the competency domains of the United States (U.S.) Clinical Performance Instrument (CPI) 3.0; (2) examine longitudinal changes in student clinical performance; and (3) explore whether developmental patterns correspond to competencies emphasized by the assessment framework. Methods: This study integrated qualitative framework mapping and quantitative longitudinal analysis. Thirty-four fifth-year students enrolled in a six-year Doctor of Physical Therapy program at National Taiwan University who completed clinical internships during the 2022–2023 academic year were included. Students were evaluated using the ABPA and Mini-CEX. Assessment items were qualitatively mapped to CPI 3.0 competency domains. Quantitative analyses examined performance changes across early, middle, and late clinical education stages, and student self-reflections were qualitatively reviewed to contextualize findings. Results: Mapping revealed that communication (29%), professional growth (16%), and interventions/education (15%) were most strongly represented, whereas physical examination, clinical reasoning, and management competencies were less emphasized. Students showed significant longitudinal improvement in communication, professionalism, responsibility, and counseling skills, while gains in clinical judgment and organizational efficiency were modest. Self-reflections consistently highlighted time and resource management as ongoing challenges. Conclusions: Students' developmental trajectories closely mirrored the emphases of the assessment tools, highlighting the formative influence of evaluation design. Expanding assessment coverage and strengthening training in underrepresented competencies may better support comprehensive clinical readiness.