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FAQs for Educators

Your questions answered

The questions in this section were compiled from the “This Quarter’s Question” in the quarterly Faculty Newsletter, which is distributed via email to all physical therapist (PT) and physical therapist assistant (PTA) faculty who request a copy.

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NPTE

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Why have a licensure exam?

Why do licensing boards require passing the NPTE for licensure? Why isn’t graduation from a CAPTE-accredited program sufficient?

There are a few points that need to be considered when answering this question.

  • The purpose of the NPTE is different from the purpose of PT or PTA programs. The programs’ primary purpose is to educate PTs and PTAs. The educational component provides a broad range of knowledge, education and skills, including a clinical component, so that PTs and PTAs understand the role of physical therapists and physical therapist assistants in providing healthcare to patients. Programs teach skills and knowledge that might not be used by entry-level practitioners, but will be used as individual becomes more experienced. The NPTE ‘s specific purpose is to protect the public by testing candidates on the minimum knowledge and education necessary for safe and competent entry-level work; it does not include a clinical component.
  • Programs can be subject to many different pressures – the pressure to graduate a certain number of students or to maintain a certain passing rate on the NPTE are two that come to mind. Development of the NPTE is subject to a different requirement – the Federation must be able to provide evidence to licensing boards that the NPTE is a valid and reliable tool for measuring entry-level competence of PTs and PTAs.
  • Even though all programs are accredited by CAPTE, there is a variation in programs. This includes coursework and grading standards. The NPTE provides licensing boards with one standard to which everyone is held accountable.
  • Completion of a broad educational program and passing a specific exam that measures entry-level competence provides licensing board members with the assurance that they are licensing or certifying competent entry-level practitioners who will be able to grow and mature in their profession.

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How can I prepare my students for fixed-date testing?

One point to remember is that the test itself has not changed. So all the strategies for preparing for the NPTE that you provide your students will still be as effective as ever.

Having said this, we should point out that we are finalizing the latest practice analysis, which will result in new test content outlines for both the PT and PTA NPTE. So test content will change somewhat for tests in 2013. But as always, we will post the new content outlines on our website ahead of time and notify you in the Faculty Newsletter.

Hard deadlines

The most important information you can convey to your students is that there are now hard deadlines for sitting for each test – deadlines for registering (PAYING) for the test and deadlines for submitting their applications to the state so the state can approve them prior to their deadline. Those deadlines are on FSBPT’s website.

If they miss the deadlines, they will be required to wait until the next scheduled test. They should not assume that exceptions will be made for them if they ask.

Can they test prior to graduation?

Another way to prepare your students is to communicate with your state licensing board to find out whether it allows students to take the NPTE prior to graduation. Some states allow this option if the school provides the proper paperwork.

Temporary licensure

Some states also allow students to practice during the period between graduation and the state receiving the results of their NPTE; others do not allow unlicensed personnel to practice for any reason. You may want to check with your licensing board to see if this is an option and what the procedures are for obtaining a temporary license.

Licensure reference guide

A quick overview of each state’s rules and regulations on taking the NPTE prior to graduation and temporary licensure can be found on our website under Top Resources. Look for “Taking the NPTE Prior to Graduation” under Initial Licensure and “Temporary Licensure” under Management of Licenses.

Always check with your state to ensure you have the latest information.

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Is the NPTE licensure testing program still accredited?

Yes, the Federation’s National Physical Therapy Examination (NPTE) program continues to hold Stage One accreditation from the Buros Institute for Assessment Consultation and Outreach (BIACO), a not-for-profit organization that provides independent evaluation of testing programs’ adherence to standards of quality essential for development and administration of fair, valid, and reliable tests.

As part of the Stage One review, the Federation submitted materials to BIACO describing the NPTE program’s organizational structure, test development and test administration procedures, psychometric methods and analyses, and policies and procedures for test security, scoring, score reporting, and record maintenance. BIACO auditors visited FSBPT to observe processes and interview key personnel.

Stage One accreditation confirms the Federation’s adherence to the BIACO Standards for Proprietary Testing Programs, which are based on testing industry standards and guidelines, including those developed by the American Educational Research Association, American Psychological Association, National Council on Measurement in Education, Association of Test Publishers, and International Test Commission.

In the letter conferring accreditation, BIACO auditors noted that the NPTE testing program meets or exceeds all appropriate testing standards. Highlighted for particular recognition was the Federation’s emphasis on test security in all phases of test development and administration, in support of the Federation’s mission to protect the public from the practice of physical therapy by unqualified persons.

The Federation welcomes external review as an essential step in maintaining a high-quality testing program and providing assurance to the public, the Federation’s member licensing boards, and test candidates that the NPTE is a fair, valid, and reliable test.

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Why not use “free” NPTE practice questions found on the Internet?

Students need to be very, very cautious when finding "free" sample questions on the internet or in chat rooms.

One reason to avoid using, soliciting or disseminating such materials is theft of copyrighted materials. Just because a website offers test questions as a sample doesn't mean that the questions aren't copyrighted. These questions are most often test questions stolen from a combination of legitimate test preparation courses, FSBPT's Practice Exam and Assessment Tool (PEAT) and the NPTE itself. Each copyright owner has the right to pursue legal action (including monetary damages) for copyright violation. FSBPT has, more than once, pursued legal action against individuals and companies that used copyrighted questions from PEAT or the NPTE.

In the event that the test questions are not stolen property, important questions should be asked about their quality. Writing effective test questions is extremely time consuming and requires considerable skill. Using poorly written test questions as preparation strategy may be detrimental to students' ultimate success.

A more important reason to avoid such materials is the risk of (1) being denied the opportunity to take the NPTE or (2) having a NPTE passing score invalidated because many of the questions had been compromised. Obviously, this second option is only relevant for NPTE items that were memorized and shared with individuals who had not yet taken the NPTE (recalled questions).

In the past we have found questions advertised as "samples" to be authentic NPTE questions. Before taking the NPTE, examinees sign a contractual agreement acknowledging the Federation’s right to invalidate a test score because of an unfair advantage (such as using recalled NPTE questions to prepare), even if the examinee was unaware the questions used as preparation were recalled from the NPTE. Such an event would be devastating.

In sum, many reasons exist for avoiding the use of sample test questions from chat rooms or the Internet. We highly encourage candidates to review the NPTE content outline,which can be found by going to “Free Resources/ “NPTE Development.”

The content outline provides detailed information about what content will be on the exam, and in what proportion. In addition, candidates might want to attend a legitimate test preparation course, purchase a copy of PEAT or participate in group study opportunities with classmates or others preparing for the NPTE.

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Why are examinees limited to taking the NPTE three times in a twelve-month period?

Our current test administration policy was implemented in 2005 in response to recommendations from an external commission convened in 2003 to review FSBPT’s test development and administration procedures. The commission recommended that FSBPT limit the total number of attempts to three to address test security and score validity concerns.

The policy addresses test security by controlling item exposure – controlling the total number of candidates who see the live test questions in a given test administration period. The commission cited item exposure, the availability of the Internet for sharing test experience information and the use of websites for test preparation activities as three factors which, in combination, made restricting the number of attempts a serious security need.

FSBPT combined this test administration policy with a specific plan to assemble test forms so that candidates taking the NPTE would not see the same question more than one time. By combining the two strategies, FSBPT can increase the assurance that a candidate’s test score is a reasonable representation of his or her underlying knowledge rather than access to live test content prior to the administration. Increasing score validity benefits candidates, jurisdictions and employers.

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NPTE development

I have heard that the questions on the NPTE take a long time to develop and validate. Since the profession of physical therapy is rapidly changing and is becoming much more evidence based, how do you assure that the questions on the exam are current?

It is critical that a high stakes licensing examination covers current practice. While it is a challenge to maintain this currency, the item writers and exam committees work very hard to assure the exam reflects current practice. Currency is maintained via the following steps:

  • The exam blueprint or content outline is revised at a minimum of every five years. The exam blueprint determines the content of the exam and assures that the content is relevant to current practice.
  • Currency is stressed at item-writer workshops; item writers are required to reference questions to recognized authoritative texts that have been published within the past five years.
  • Items are not used where there may be conflicting references or viewpoints in the literature
  • An item goes through committee review multiple times and each time, it is reviewed for currency.
  • The item goes through a final review for currency (among other things) prior to each and every time it is being released as an operational question.

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Linking admissions criteria to performance on NPTE

As a PTA program, we maintain very high admissions criteria for our students. However, with the increased pressure to admit diverse populations as well as the pressure to admit most anyone at the community college level, we are having a hard time justifying this standard. Have there been studies linking admission criteria to performance on the PTA exam?

Most of the studies looking at admission criteria and pass/fail performance on the NPTE have been focused on physical therapist programs. However, several researchers are beginning to look at this topic related to PTA programs. You may want to contact your colleagues to see what efforts are being conducted related to NPTE performance of PTA programs.

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Are NPTE questions getting harder?

I have heard that the NPTE questions have gotten harder over the last couple of years due to better item writer training. Is this true?

Many stakeholders have asked if more difficult questions are being included on the NPTE, which in turn has made the examination more difficult to pass. Individuals have speculated that as FSBPT improves the quality of items written for the NPTE, the reliability of these items improves, and it becomes more and more difficult for candidates to determine the correct answer through the powers of deduction and logic.

High quality items are more difficult to answer correctly for students who do not know the material. However, test questions on the NPTE are not becoming more difficult. The FSBPT monitors item- and form-level difficulty as a standard part of its psychometric procedures. Test forms are assembled to be as similar as possible with respect to content and difficulty. Forms administered from 2001 through 2005 vary slightly in average item difficulty but do not show a consistent trend toward increasing difficulty. It is important to note that even if the average item-level difficulty across forms had increased, this should not influence the pass rate because all test forms are equated so that a form with more difficult items will have a lower passing score than a form with easier items.

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Do NPTE items have more than one right answer?

I have been told that the exam is structured in such a way that there are two "right" answers, but that one is a better choice. Is the exam scored using a partial credit model to account for an individual who might select the less favorable of the correct choices? Or is it an all-or-none credit system?

There is only one correct answer for each question. The item writers and exam committees go through great lengths assuring that there is one correct answer and three incorrect answers. Each option must be backed up with a rationale and reference as to why it is either correct or incorrect. Beyond this, statistics are collected on the item that also helps support the one correct answer. There is no “partial credit” for an answer. It is either correct or incorrect.

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Recalled NPTE questions

A question from a student: As an exam candidate who just completed my examination, I recall several questions on the exam where I was not sure of the answer. Is it ok for me to discuss the questions with my instructor?

On the surface, it may seem natural for you to go to a faculty member to discuss specific questions on your licensing examination. You may want to be assured that you answered the item correctly. You may also be motivated to “learn from mistakes” and a discussion of the question could be a productive learning experience. This is particularly true if you find you have failed the exam. You certainly want to pass the next time! However, by doing this you are putting yourself and your instructor in jeopardy.

Every item on the exam is copyright protected. When a candidate takes the exam, the candidate agrees not to share any question or part of a question with anyone else. Good intentions do not nullify this agreement or the copyright protection of the exam. The bottom line is that it is illegal for a candidate to share a test question with an instructor or anyone else.

You might say: “Ok, so it is technically illegal, but what is the harm if I discuss the item with my instructor? I can trust her. She would not share the information. So, no harm no foul.” Basically, it is not for you to decide when you can break the law or when you can’t. The law is the law.

A parallel question from an instructor: Can I talk to my students about the NPTE after they have taken it?

Certainly general comments about the exam are not a violation of copyright law. However, if your students discuss specific items or specific characteristics of the exam with you, they are in violation of the confidentiality terms that they agree to when they take the exam. Included in these terms is not disclosing the content of examination items. Legal action could be taken against candidates who violate these terms including criminal prosecution. Ultimately the student may risk being able to ever obtain a license.

Educators may unwittingly cross the line by asking students questions about the exam or by listening to a student share a question from the exam. It is important that educators defend the integrity of the licensure process by making students and colleagues aware of these critical issues and reporting violations when they occur. You can also report any violations to security@fsbpt.org.

Educators can find accurate information regarding the exam in the “Educators” section of the website. More detailed information on the NPTE can be obtained by attending a NPTE Workshop for Faculty. Information on upcoming workshops can also be found in the “Educators” section.

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Enhancing NPTE test items

Currently, the NPTE contains questions that include graphics. Does the Federation have plans to add other testing technologies such as “hot spots” or video?

The Federation has been exploring other testing formats for some time. While we have the technical capabilities of utilizing these formats, we are not planning on adding these types of test questions in the immediate future. These types of questions create a host of additional issues and complexities. For example, a question that requires the examinee to review to a video clip of a gait pattern and determine the dysfunction may seem like the perfect question for a physical therapy licensing examination. However, before such a question can be used, several issues have to be addressed. How much time needs to be allowed for a question that requires the viewing of a video as compared to a standard multiple choice question? How many times should the candidate be allowed to re-run the video? Is the video clip clear enough that all candidates are able to see the action taking place clearly? How does one account for the psychometric differences between the video question and other questions?

Another reason we are waiting prior to implementing additional test question formats is to continue to allow our tests to remain stable for a period of time before implementing any significant test format changes.

In spite of these factors, we do believe there may be some advantages to utilizing different test formats at some point in the future and will continue to review the literature and address the questions mentioned above. Ultimately, it is critical to determine whether or not these additional test formats provide us with better information related to the competency of the entry-level physical therapist.

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I have noticed scores at my school are higher since the new 2013 content standards. Can you tell me more about the change?

FSBPT rescaled the NPTE in 2013 to coincide with the change in the content standards. FSBPT announced the change in the Fall 2012 FSBPT Forum . For specifics on the changes, and a score conversion table, view the 2012 to 2103 NPTE Score Conversion Table.

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Public pass rate reports

Please explain the timing and rationale for posting pass rates

When are pass rate data updated on FSBPT’s websites?

Pass rate data are updated quarterly on the following schedule:

  1. February 1
  2. May 1
  3. August 1
  4. November 1

When will the 2010-2012 ultimate pass rates be posted?

The 2010-2012 ultimate pass rates will be posted on May 1, 2014. The reason for this is that ultimate pass rates do not become stable until 15 months after graduation. This delay in reporting ensures that the Federation publishes stable data for all PT and PTA programs, including those with late graduation dates.

When will the 2013 pass rates (exam year, graduation year, rank order) be posted?

The 2013 pass rates will also be posted on May 1, 2014. This allows time for students of programs graduating late in the year to have taken the NPTE before the pass rates are posted.

When are exam year pass rates posted?

Exam years end on February 28th. Since updates are posted quarterly (see above), the first quarter the exam year pass rate can be published is May 1st.

Why do you post ultimate pass rates for individual programs and not first time pass rates on the public site?

The Board of Directors believe that first time pass rates can be misleading because there could be many factors that influence that short term indices whereas the ultimate pass rate would be more indicative of the school’s overall program.

School Reports

How do I order school reports?

Ask your program director or administrator to go to the Educators login to access the free reports or to purchase school reports.

How do I find out my school code and password in order to log on?

If you have not yet subscribed or don’t know/don’t remember your school code and password, please send an email to schoolreports@fsbpt.org.

What kind of reports do you offer?

We offer four types of reports. Before you order a report, it is a good idea to review the sample reports first. That way you can be sure you’re ordering the report that provides the information you really want. Go to “Educators Login” on www.fsbpt.org. Look to the right of the SCHOOL ADMINISTRATOR LOGIN box. You will find reports and links to sample reports.

  1. Basic Pass Rate Report (Free): Provides a report of the data provided to CAPTE relating to graduating class pass rates for the last three years. In addition, there is information about the mean NPTE scale score for each class, a confidence interval for the mean, and the mean and standard deviation for all students from CAPTE institutions. Pass rates are provided for candidates’ first attempts as well as their ultimate pass rate. The report also includes a roster for each graduation year.
  2. Graduate Performance Report ($95): Provides information on NPTE scores for each student in a graduating class for up to six NPTE attempts, including test dates, provided that they have authorized FSBPT to release their scores.
  3. Content Area Report ($95): Includes the average score for one graduating class broken out by content areas and body systems from the NPTE content outline. The report also includes confidence intervals for the mean scores, and the mean and standard deviations for students from CAPTE institutions. The report presents this information in tables and box plot graphics.
  4. Group PEAT Score Report ($Free with Group PEAT purchase): This report is essentially the same as the Content Area Report, but for PEAT rather than the NPTE. The report also contains a listing of candidates included in the report, and individual PEAT exams can still be reviewed through the school interface.

Can I pay with a purchase order?

The online system has two payment options; credit card or invoice. If you pay by credit card, your reports are available to be run the same day. If you prefer to have your institution send a check, you can choose to pay by invoice. When you choose to pay by invoice, the last screen of the purchase process is the official invoice. The invoice can be printed and submitted to your accounts payable department so that a check can be issued and mailed to the Federation with the invoice. Please do not send a purchase order - use the invoice you printed at the time you ordered the report.

How often is the report data updated?

The Basic Pass Rate Report, Graduate Performance Report, and Content Area Report are run from a database that is updated eight times per year, after each NPTE exam date. Schools will be given an opportunity after each exam date to review and request changes to your student rosters before the data is finalized and new reports become available. It is very important to review your student rosters prior to the deadline so that any discrepancies can be resolved.

What is the “Manage My Students” listing? 

The Manage My Students tab shows rosters of all your students in your most recent five graduating classes. There are two views: real time and report. 

The real time view shows the most updated information we have in our system. If you request a change to your roster it will immediately be reflected in the real time list. 

The report view shows the students that would be included if you ran a report today. Because report data is only updated after each exam, if you make a correction to your student roster after the deadline, the correction would not be reflected in the report view until the next scheduled update. 

When does my report expire?

When you purchase and run a report, it will remain viewable for up to five years. Reports will also periodically update for a graduation year as new data becomes available. There is no need to purchase a new report if some of your students wait to take the NPTE.

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State practice acts

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We’d like to be able to see what our state’s practice act allows, such as whether it allows temporary licensure or direct access to physical therapy services. Does the Federation maintain that kind of regulatory information?

Yes, you can find all kinds of regulatory information in the jurisdiction licensure reference guide on the Federation’s public website. This guide compares some of the major similarities and differences among the jurisdictions’ practice acts. It may be used as a reference for educational programs, students, licensing boards, professional associations, and others. Information is listed in aggregate and by individual jurisdiction. To review the information, go to "Free Resources"/“Regulatory Resources”/“Licensure Reference Guide.”

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Continuing competence

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What is the Federation doing about continuing competence?

The Federation has committed to building a continuing competence initiative, which will develop resources, tools and a system for its physical therapy licensing boards and the licensees themselves.

Why a continuing competence initiative?

Patients have every right to assume that a health care provider’s license to practice is the government’s assurance of his or her current professional competence, and clinicians themselves would like assurance that those with whom they practice are current and fully competent.

Physical therapy licensing boards have acknowledged their responsibility in this area. They are eager to take on this aspect of public protection for the people living in their state. They want to ensure that the PTs and PTAs licensed to practice in their state continue to be competent throughout their career.

aPTitude®*

aPTitude® is the FSBPT’s continuing competence system. Licensee features include the following.

  • Allows licensees to search for and find CC offerings that meet their individual needs
  • Provides licensees with a single place to maintain their licensure information, completed CC/CE activities and stores documentation for those activities
  • Keeps licensees up-to-date with the latest information on their jurisdiction’s CC/CE requirements, renewal dates and approved activities
  • Reminds licensees when their license renewal date is near
  • Allows licensees to plan and track CC/CE activities to meet renewal requirements

The practice review tool

The practice review tool (PRT) is an initiative created by the FSBPT to allow PTs to compare their knowledge, skills and abilities to current entry-level practice. It is also an opportunity to review PT fundamentals.

Many licensees will choose to take the PRT because it is an objective measure of their current knowledge, skills and abilities and is therefore helpful to them in determining what kinds of professional development and continuing educations activities will be most beneficial. If licensees would like to receive continuing competence or continuing education credit towards licensure renewal for taking the PRT, they should review their states’ specific requirements for credit.

*aPTitude is registered in the U.S. Patent and Trademark Office

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Initial licensure requirements

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Where can we find information about initial licensure requirements?

FSBPT’s website offers two ways to find that information.

  • Go to the Licensure Reference Guide which offers a quick overview of requirements in the 50 states and the District of Columbia. There are a number of other topics in the Licensure Reference Guide that may be of interest as well.
  • Go to the Licensing Authorities page which links to each state’s physical therapy board website. You’ll find information about licensure requirements, the fees and the license application.

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FSBPT and APTA

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How are FSBPT and APTA different?

The Federation of State Boards of Physical Therapy and the American Physical Therapy Association each have unique missions, purposes, and roles to play in the physical therapy profession. The Federation is a membership organization of 53 jurisdiction physical therapy licensing authorities striving for excellence in its mission of public protection.

Per their website, the APTA is an individual membership professional organization representing more than 80,000 member physical therapists, physical therapist assistants, and students.

Unlike APTA, individual PTs and PTAs are not the primary members of the FSBPT. FSBPT members are the 53 jurisdiction licensing boards. Each jurisdiction sends a voting and alternate delegate to the annual Delegate Assembly which is held during the Federation’s annual meeting.

Whereas most physical therapist and physical therapist assistant licensing board members are also American Physical Therapy Association members, the typical APTA member has had little or no opportunity for interaction with the Federation outside of the National Physical Therapy Examination (NPTE). It is important that PTs and PTAs understand the unique roles of the APTA and FSBPT: where they may overlap and where they may diverge.

Historically, the NPTE has been the primary focus of FSBPT. Prior to 1986, however, the NPTE was developed by the APTA. Visionaries within the then APTA Section on Health Policy saw the potential for problems with the professional organization developing the entrance exam to the profession. What were some of these concerns? These visionaries identified that there was a potential for a lack of credibility of the examination process if developed by the professional organization. Additionally, the potential for conflict of interest was very real. In 1986, FSBPT was formed in response to these concerns.

In 1993, the transfer agreement between APTA and FSBPT brought the responsibility and ownership of the exam under the Federation. Under the agreement there are certain terms and obligations that must be met by FSBPT until 2014. Since the Federation took over the examination, it has worked hard to assure the defensibility of the NPTE and assure that it meets current standards for the development of a licensure exam. Today the NPTE has high credibility as a high stakes, secure examination which meets rigorous professional standards and earned external accreditation.

The NPTE, however, is not the only thing happening at the Federation. It is a dynamic organization developed to support the jurisdiction members and promote best practices in regulation. The FSBPT actively communicates and collaborates with the member jurisdictions and other stakeholders in the areas of discipline and ethics, legislation and professional standards, continuing competence, and standards for foreign educated physical therapists and physical therapist assistants.

APTA membership is completely voluntary for physical therapy professionals. Some PTs and PTAs go their entire career without APTA involvement. However, every licensed /certified PT or PTA has had to interact with a licensing board, usually during initial licensure and then upon each renewal. Licensing is mandated for physical therapists in all jurisdictions, and in most jurisdictions for physical therapist assistants.

Licensing boards must comply with the individual statutes and regulations in their jurisdictions. The Federation has no authority to mandate anything to its member licensing boards; all products and services developed are completely voluntary. They always have the option of opting in or opting out. APTA National also has its components which include the State Chapters and the Sections. These components are required to follow the same policies as set forth by the national organization, but the components remain independent organizations.

Just as individuals and APTA chapters look to APTA for resources, jurisdictions often come to FSBPT for resources and support when going through the process of updating the practice act or regulations or making scope of practice decisions. FSBPT tracks state and national legislation of interest to the physical therapy community and communicates that information to the jurisdictions.

Typically the legislative changes, introduction of bills, and lobbying are performed by APTA. The APTA has utilized the Federation’s Model Practice Act as the best practice for legislative language regarding physical therapy. Unlike the FSBPT, APTA also maintains a Political Action Committee, the PT-PAC which accepts monetary contributions to further the professional association’s goals.

Both APTA and FSBPT support that it is the responsibility of the individual PT and PTA to maintain competence throughout a lifetime of practice. Jurisdictions can only mandate a minimal competence level to protect the public from incompetent providers. FSBPT has developed a continuing competence program to meet the goal of ensuring minimal competence and safety. Professional development is beyond the purview of the licensing authorities but well within the scope of the professional association. Professional development is an ongoing process of assessment and planned actions that provide the opportunity for the acquisition and application of knowledge, skills, and abilities that meet or exceed contemporary performance standards.

It is completely appropriate and encouraged that state boards and state chapters interact and collaborate towards a common goal. State APTA chapters and state licensing boards have often found ways to work together. In some instances, state boards are legally prohibited from lobbying or initiating changes to the practice act. The boards find it necessary to engage the chapter for help in these matters and work together to promote the changes.

APTA and FSBPT both play vital, but different roles in the world of physical therapy. The organizations have different missions and therefore, different goals. Understanding that each organization represents a different point of view with a different primary focus, while fostering relationships and communication between them allows for a stronger PT profession.