Quantitative Investigation of Successful First Time Passing of the NPTE in Six Consecutive DPT Cohorts
Background and Purpose:
Not passing the National Physical Therapy Exam (NPTE) has significant consequences. If a student does not pass the NPTE on the first attempt they can retake the examination, however a student may only take the examination a maximum of three times in any 12-month period and there is a 6-time lifetime limit on NPTE attempts.
The purpose of this study was to look at multiple variables that were presented as potential factors for success to determine their impact on successful first time passing of the NPTE within the case boundaries of the University of New Mexico DPT 2012 -2017 cohorts.
Case Description:
This study was a programmatic evaluation intrinsic mixed case study design bounded with one physical therapy program over a six-year span looking at: admissions data, sex, gender, ethnicity, benchmark exam results (STEP 1 and STEP 2), undergraduate, pre-requisite and professional GPA, learning style, grit, PEAT scores and first time NPTE score. The sample consisted of all six cohorts of the DPT (n=167) from 2012-2017. Within this sample, two natural groups occurred. The first three years (Group A) did not have the comprehensive benchmark exams (STEP 1 and STEP 2) and the second three year group had all or at least one of the exams (Group B). The six cohorts were examined as one large sample and then also examined as Group A and Group B.
Outcomes:
There was no significant relationship between passing or not passing the NPTE on the first try and race and gender.
The Group A and Group B cohorts were similar in terms of gender, ethnicity, undergraduate college attended, New Mexico residency and age. They also had similar mean professional GPAs.
Admissions criteria were consistent within Group A and within Group B but not across the groups. There was a significant increase in mean GRE scores and mean prerequisite GPA from Group A to Group B, which is reflective of when the program changed the admissions criteria for the class of 2015.
The STEP 1, STEP 2 and PEAT exams all had identical mean scores of 148 across the entire sample. Of the three exams, the PEAT had more variance but it also had the largest sample size.
The first-time pass rate for the NPTE was 91% (n=152) for the entire sample. Group A had a lower percent of passing at 86.25% vs Group B was at 95.4% passing on the first attempt at the NPTE.
Of the 9% (n=15) who had to take the NPTE more than once, 80% (n=12) are working as a physical therapist today. This means 3 graduates (~2% of total sample) never successfully passed the NPTE to attain their license.
The programmatic NPTE scores have a normal distribution.
There is a significant strong correlation between NPTE score and professional GPA, STEP 1 score, STEP 2 score and the PEAT scores.
There is a significant strong correlation between STEP 1 and professional GPA and the PEAT scores.
Grit:
Mean grit for the sample was 3.958. Mean grit was about the same for students who passed and students who did not pass on their first attempt.
Mean grit scores were higher in the cohorts that had a higher rate of return of the surveys.
Learning Styles:
Learning style made a substantial shift from the “thinking” learning styles of Accommodating and Diverging to more “reasoning” based learning styles of Assimilating and Converging with 68.8% of those who returned the survey having a change from their original learning style declared in the first semester of the program.
Learning styles changed at a higher rate for those who did not pass the NPTE on their first attempt (85.7%, n=6/7).
Discussion: Was it the change in admissions criteria that helped Group B have a better success rate at passing the NPTE on the first attempt or was it the institution of the STEP exams given to Group B and not to Group A? The similarity of the groups, down to the almost identical professional GPA suggests that there is stability in the type of student the program is attracting and admitting and that Group A and Group B differences may not be related to just the admissions criteria, but rather to the institution of the STEP exams or a combination of the two changes together.
Grit relates to perseverance and reaching for long-term goals, which is certainly a description of graduates of a DPT program (Duckworth et al., 2007). The lack of grit scores from those graduates who never passed the NPTE makes it difficult to conclude if grit is related to eventual passing of the NPTE. Grit is certainly high for the group of individuals who eventually completed the DPT program and successfully attained a license to practice, whether they took the NPTE multiple times or not.
Learning styles changed at a higher rate for those who did not pass the NPTE on their first attempt (85.7%, n=6/7). According to a study looking at critical thinking in nursing students, a Converging learning style, followed by Assimilating learning style have the strongest correlation to critical thinking scores (Gyeong & Myung, 2008). It is of interest that of the graduates that returned the Kolb survey, the change in the combined Converging and Assimilating learning styles went from 48.5% of the sample to 68.2% of the return sample. What is not known is when this learning style change occurred. This shift in learning style refutes the declaration that in higher education, learning styles are relatively stable (Richardson, 2011).