Translation, cross-cultural adaptation and validation of the Spanish version of "Assessment of Physiotherapy Practice" (APP-S)

“物理治疗实践评估”(APP-S)西班牙语版本的翻译、跨文化适应和验证

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Abstract

BACKGROUND: Clinical education is a key component of the undergraduate education of physiotherapy students, as it provides the context for the development of essential clinical competencies. These competencies can be assessed in a variety of ways, with scales being one of the most widely used. Among these, the “Assessment of Physiotherapy Practice” (APP) has demonstrated robust psychometric properties and is used in several countries. The objective of this study is to translate and cross-culturally adapt the APP into Spanish (APP-S) and assess its psychometric properties (reliability, content validity, and structural validity) and edumetric properties (acceptability and feasibility). METHODS: This study involved 27 clinical educators (CEs) and 145 physiotherapy students (92 students in the fourth year and 53 students in the third year) from two Spanish universities. Students were assessed at the end of a clinical placement period during the last semester of the academic year. Ten CEs and 35 students evaluated content validity in terms of relevance, comprehensiveness and comprehensibility, using the Content Validity Index for each item (I-CVI) and for the entire scale (S-CVI). Structural validity was examined using exploratory factor analysis, while reliability was assessed using Cronbach’s alpha (α). Finally, eight CEs assessed acceptability and feasibility using a 12-item feedback form. Their ratings were then analysed using Aiken’s V coefficient and the percentage of agreement was calculated. RESULTS: The scale demonstrated acceptable content validity (I-CVI ≥ 0.89, S-CVI >0.95) and an excellent internal consistency (Cronbach’s α = 0.971). Exploratory factor analysis revealed a two-factor solution: dimension 1, items 6–20; dimension 2, items 1–5. CEs provided positive feedback regarding acceptability and feasibility, with Aiken’s V values ≥ 0.78 and a high percentage of agreement. CONCLUSIONS: The APP-S is an appropriate tool for assessing students in clinical placement, and it was well accepted and positively rated by CEs. Further studies are needed to consolidate its psychometric properties. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-025-08002-z.

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