Understanding and enhancing the user experience of the Physiotherapy Entrustable Professional Activities Assessment (PEPAA) for the assessment of competence during clinical placement

Background: Competency-Based Education (CBE) emphasizes learner-centred approaches that prioritize demonstrated competence over time-based progression. Within physiotherapy (PT) education, the Physiotherapy Entrustable Professional Activities Assessment (PEPAA) was developed at Queen’s University, M.Sc. Physical Therapy program to support frequent, formative Entrustable Professional Activity (EPA) assessments as part of a programmatic approach to competency assessment. This dissertation research aimed to understand and enhance their user experience through an integrated, user-centered quality improvement approach. Methods: Two exploratory sequential mixed-methods studies—one with students and one with clinical instructors—were embedded within two Plan-Do-Study-Act (PDSA) cycles. Semi-structured interviews were conducted followed by a user-experience survey guided by Morville’s User Experience Honeycomb framework. A panel of knowledge users and educational scholars co-developed actionable recommendations to enhance the PEPAA user experience with improvements based on integrated findings from both studies. Results: For students (n=12), four key themes were constructed: Ease of use and completion, Feedback for learning, Understanding of EPAs, and Credibility and breadth of assessment. Students found the PEPAA intuitive and valued its ability to promote timely formative feedback. They viewed the process as credible and representative of physiotherapy practice, though certain EPAs were perceived as less relevant in certain settings. For clinical instructors (n=13), five themes were identified: Ease of completion, Elentra platform visual appeal, Using the PEPAA to support learning, Understanding EPAs and their relevance, and Credibility, validity, and trustworthiness. Clinical instructors highlighted the platform’s efficiency and clarity but emphasized the need for clearer interpretations of multiple EPA assessments. Across both surveys, (students =96 | clinical instructors =74), participants rated credibility, accessibility, and usefulness highest, with lower scores for usability and findability, indicating that interface refinements were needed. Quality Improvement to the PEPAA process included refined orientation materials, detailed EPA descriptions, and guidelines for clinical instructors on initiating EPAs. Conclusions: The integration of rigorous mixed methods methodologies within a user- centred quality improvementapproach generated evidence- informed recommendations to improve the PEPAA user experience, including real- time notifications, dashboard tracking, and enhanced orientation materials. This research demonstrates how a continuous, user-experience focused quality improvement approach can strengthen assessment within competency-based physiotherapy education.

Department dc:contributor.department

Rehabilitation Science

Year dc:date.issued

2026

Author dc:creator

• Yu, Lawrence

Advisor dc:contributor.supervisor

• Miller, Jordan

• competency-based education
• entrustable professional activities
• physiotherapy student assessment
• Rehabilitation Science

Language dc:language.iso

eng

Handle dc:identifier.uri

https://hdl.handle.net/1974/36160

OAI identifier oai:identifier

oai:queensu.scholaris.ca:1974/36160