Title: Utilization of Summative Assessment in Physical Therapy Education to Establish Foundations of Clinical Science Knowledge

Purpose: Doctor of Physical Therapy [DPT] students' ability to apply, integrate, and synthesize foundations of clinical science knowledge is vital to success in clinical practice. The aim of this case study was to explore summative examination quantification of foundational clinical science knowledge as a benchmark toward competence-based education in the first year of a DPT program. Methods: First year DPT students from a private New England University took the Physical Therapy Foundations of Clinical Science [PT-FCS] exam at the end of the second semester following completion of foundational clinical sciences coursework. The PT-FCS exam is a multiple-choice exam comprised of three clinical science categories: human anatomy, kinesiology, and neuroanatomy. Retrospective analysis of PT-FCS exam scores for 223 students over three cohort years was performed to investigate test reliability by cohort and relationships with first year cumulative GPA and progression in the program. Results: PT-FCS scores were reliable across 3 cohorts: 2019, 2020, 2021 (KR20 = 0.74-0.82). Exam scores showed significant (p = 0.01 two-tailed) moderate correlations with current core course GPA with Pearson Correlation coefficients by individual cohorts (r = .70, .73, and .80) and all cohorts combined (r = .73). Conclusion: A retrospective analysis of three years of data informs validation of the PT-FCS for use as an assessment touchpoint to quantify foundational clinical science knowledge in first-year doctoral physical therapy students. Findings of this first-year learner performance outcome may contribute to development of longitudinal benchmarks for assessing disciplinary specific knowledge of foundational clinical science and to inform educational frameworks necessary for clinical competency in physical therapy education. Ultimate predictive ability, and educational value, of summative testing of foundational clinical science will be explored in future categorical and item level analysis in order move toward more competency-based teaching and learning in physical therapy.