Identifying weakness in study areas during preparation for the National Physical Therapy License Exam

This study aims to find the weaknesses from students’ perspective in NPTE preparation, including the challenges posed by the pandemic.

An online survey was circulated to 2373 physical therapy students preparing for their NPTE, from Fall 2017 to Spring 2022. This form aimed to collect information about the content weaknesses in body systems (musculoskeletal, neuromuscular, cardiopulmonary, others) and content areas (physical therapy examination, foundational evaluation, differential diagnosis, prognosis, interventions, non-system domains). To assess the impact of the COVID-19 pandemic, students were categorized into pre-pandemic (Fall 2017 to Spring 2020) and pandemic cohorts (Summer 2020 to Spring 2022). The collected data was then analyzed, with descriptive statistics used to interpret the results.

Our study shows that 27% students faced challenges with cardiopulmonary concepts, followed by 25% in neuromuscular and 24% in both musculoskeletal and other systems. In the pandemic cohort, difficulty with cardiopulmonary concepts increased from 24% to 28%, and for other systems, it rose from 24% to 25%. Conversely, understanding of musculoskeletal concepts improved from 27% to 23%, while neuromuscular concepts remained unchanged at 25%. Regarding content areas, 32% of students reported difficulty in understanding foundations for evaluation, differential diagnosis, and prognosis; followed by 25% for physical therapy examination, 24% for interventions and lastly 20% for non-systems understanding. In the pandemic cohort, difficulty with foundations for evaluation, differential diagnosis, and prognosis increased from 30% to 32%, and for non-systems understanding, it rose from 19% to 20%. Understanding of physical therapy examination remained stable at 25%, while difficulty with interventions decreased from 26% to 23%.

Our findings suggest the students face challenges during their NPTE preparation in cardiopulmonary concepts and foundational topics mainly evaluation, differential diagnosis, and prognosis.

Our study shows the need for change in teaching methods with more focus on more tailor-made approaches and strategies to improve the content delivery in the topics considered weak by the majority of students. Further studies can also be done to compare the need for change in curriculum to bridge the change in NPTE exam formats.