Teaching the ICF or using the ICF to teach? Lessons from first-time clinical practice.
Ilse du Plessis, Lunelle Pienaar, Heather Talberg
Second-year physiotherapy students at one South African university self-rated their overall ICF understanding at 9 out of 10 after first clinical placements, up from 6 before.
Yet 39% still mapped functional mobility tasks to impairments rather than activity or participation.
Key findings
1Students self-rated their overall ICF understanding at a mean of 6 before clinical blocks and 9 after, and reported comfort in applying the ICF at a mean of 8.0 in both cohorts.
2The subjective patient interview was the assessment task most strongly linked to understanding participation (91%) and activity (86%) levels, while respiratory and musculoskeletal assessments were most strongly linked to impairments (98% each).
3A substantial proportion of students still mapped functional tasks to the impairment level: 39% associated functional mobility activities and 36% associated transfers with impairments, even though these tasks are primarily activity-level assessments.
Still to come
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The questionnaire was self-developed for formative course evaluation and was not subjected to formal psychometric validation, so the scores reflect perceived understanding rather than measured competence. The cross-sectional design meant individual pre-post changes could not be tracked; a longitudinal design would have provided stronger evidence of learning progression. The study was limited to a single institution and a single year group, which limits transferability to other educational contexts. The perspectives of clinical educators, who play a central role in shaping students' use of the ICF, were not included. No inferential statistical testing was performed; all results are descriptive. The instrument primarily reflects alignment with course learning outcomes rather than an established measurement construct.
Declared interests
Funded by the University of Cape Town Educational Leadership Fellowship. No industry funding or conflicts of interest were declared.
The easy way to misread this
Do not read the 9-out-of-10 self-ratings as evidence that these students can apply the ICF framework in practice. The questionnaire was not validated, the scores are perceptions rather than measured competence, and the same students still mapped 39% of functional mobility assessments to impairments rather than activity or participation.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →