How Doctor of Physical Therapy Students Overcome Academic Challenges to Achieve First-Attempt Success on the National Physical Therapy Examination: A Mixed Methods Study

Abstract

The purpose of this mixed methods study was to identify Doctor of Physical Therapy (DPT) students with markers of potential challenges on the National Physical Therapy Examination (NPTE) and evaluate their outcomes. The qualitative arm, framed by social cognitive theory, identified strategies students used to achieve first-attempt success. Of the 143 students from one DPT program who had markers of potential NPTE challenges, 79% overcame challenges to achieve success, revealing a weaker association between undergraduate grade point average (GPA) and NPTE performance. Year one program GPA and written exam performance while in the program were stronger predictors of NPTE performance. Qualitative analysis of interviews with 19 graduates revealed three themes: (1) Critical resources build confidence for a unique standardized test; (2) Peers support, teach, and hold each other accountable; and (3) Self-care is vital as emotions run high. Participants described needing to change their approaches to learning between undergraduate and DPT education. Critical resources for achieving first-attempt success included contextualizing knowledge in the clinical setting, NPTE preparatory courses, and frequent self-assessment, which facilitated retrieval practice and revealed knowledge deficits. Little is known about graduates who did not achieve first-attempt success but were ultimately successful, warranting further research.