Relationship of Clinical Performance Scores with NPTE Performance: A Systematic Literature Review and Meta-Analysis
Purpose: Clinical education is a significant part of physical therapy (PT) education. PT students must complete a minimum of 32 weeks of clinical education.1 It is presumed that upon graduation those PT students have reached entry-level competency in their clinical education, are able to successfully pass the National Physical Therapy Examination (NPTE), and then safely and successfully treat patients across the lifespan. Currently, the only comprehensive examination for PT graduates to gain licensure and practice in the U.S. is the NPTE. Passing the NPTE assumes that PT students’ academic and clinical competencies were achieved. Therefore, the NPTE serves as the PT professions “gatekeeper” for attaining licensure to treat patients across the lifespan. It is presumed that the NPTE validly and reliably assesses that the new graduates’ have met the required entry-level academic and clinical competencies. Our purpose was to determine the empirical relationships between PT students’ first and final clinical performance scores and their first-attempt score on the NPTE.Methods/Description: We conducted a systematic literature review with a random effects meta-analysis to determine the empirical relationships between PT students first and final clinical performance scores with their first-attempt score on the NPTE.2 Three studies were included in the clinical performance scores for the first clinical experience meta-analysis.3-5 Five studies were included in the clinical performance scores for the final clinical experience meta-analysis.3, 5-8Results/Outcomes: We found that the PT students clinical performance scores (first and final clinical experiences) had a small effect and non-significant relationship with first-attempt NPTE performance: (a) clinical performance scores (first clinical experience; = 0.04; 95%CI = -0.02-0.10), and (b) clinical performance scores (final clinical experience; = 0.07; 95%CI = -0.00-0.14).Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: Our results provide strong evidence that the NPTE is not adequately assessing PT students’ clinical learning and performance. The random effects meta-analyses provide precise and accurate measurement of each PT students clinical experiences (first and final) relationship with their first attempt score on the NPTE. Therefore, there is no guarantee PT students are meeting the required entry-level clinical competencies that ensure patient safety, suggesting a review of the current model for assessing PT students’ clinical learning and performance may be warranted. Failing to validly and reliably assess PT graduates’ clinical competencies could result in a PT graduate who can pass a multiple-choice examination, but has inconclusive clinical competencies.9 In pursuit of developing strategies to build resilience in academic and clinical environments, it is important to have an awareness of the empirical relationship between our measurement of students clinical learning and performance and their academic competency, as assessed by the NPTE.References: 1. Commission on Accreditation of Physical Therapy Education. Standards and required elements for accreditation of physical therapist education programs. (2015). Commission on Accreditation of Physical Therapy Education. http://www.capteonline.org/uploadedFiles/CAPTEorg/About1CAPTE/Resources/Accreditation1Handbook/CAPTE1PTStandardsEvidence.pdf. Accessed April 1, 2016. 2. Field, A. P. (2010). How to do a meta-analysis. British Journal of Mathematical and Statistical Psychology. doi: 10.1348/000711010X502733. 3. Dillon, L. S., & Tomaka, J. (2010). NPTE predictors in a Hispanic-serving institution’s physical therapist education program. Journal of Physical Therapy Education, 24(2), 14-18. 4. Fell, N., Mabey, R., Mohr, T., & Ingram, D. (2015). The preprofessional degree: Is it a predictor of success in physical therapy education programs? Journal of Physical Therapy Education, 29(3), 13-21. 5. Luedtke-Hoffmann, K., Dillon, L., Utsey, C., & Tomaka, J. (2012). Is there a relationship between performance during physical therapist clinical education and scores on the National Physical Therapy Examination (NPTE)? Journal of Physical Therapy Education, 26(2), 41-49. 6. Dreeben, O., (2003). An analysis of selected physical therapy clinical performances and success on the national licensing examination (Unpublished doctoral dissertation). Nova Southeastern University, Fort Lauderdale, Florida. 7. Kosmahl, E. (2005). Factors related to physical therapist license examination scores. Journal of Physical Therapy Education, 19(2), 52-56. 8. Vendrely, A. M., (2007). An investigation of the relationships among academic performance, clinical performance, critical thinking, and success on the physical therapy licensure examination. Journal of Allied Health, 36(2), e108-e123. 9. Federation of State Boards of Physical Therapy. Promoting safety and competence. (2015). Federation of State Boards of Physical Therapy; http://www.fsbpt.org/FreeResources/NPTECandidateHandbook/GeneralInformation.asp.