Does Fixed-Date Testing Disadvantage NPTE Candidates? 

With fixed date testing, NPTE candidates are testing closer to graduation and first-time test takers have maintained their pass rates. This article is by Lorin Mueller, Chief Research Officer, FSBPT

After the transition from continuous testing to fixed-date testing, some stakeholders raised concerns that the selection of NPTE testing dates might disadvantage candidates: rather than testing as soon as they want after graduation, some candidates had to wait weeks to take the NPTE by virtue of when they graduated. FSBPT investigated whether fixed-date testing had a negative impact and determined that in the early years of fixed-date testing, (a) candidates actually tested closer to graduation than under continuous testing, and (b) pass rates were high for candidates who tested either before graduation or on the first administration after graduation.

Changes Since 2011

Since 2011, there have been many changes to the NPTE testing program. Some of the changes have resulted from listening to our stakeholder community's feedback, and other changes have resulted from external forces.

In response to community feedback, FSBPT has taken the following actions:

• Over time, we have settled on four testing windows, equally spaced throughout the year. Keeping these testing windows at roughly the same time each year allows schools to adjust their graduation timelines and curriculum requirements to facilitate taking the NPTE near graduation without significantly interfering with educational goals.
• We have made it easier for schools to allow well-prepared students to take the NPTE prior to graduation. Schools can validate graduation on their dashboard on FSBPT’s website well in advance of eligibility deadlines.
• FSBPT has engaged many member jurisdictions to allow FSBPT to process candidate eligibility almost instantaneously.
• We have changed the number of testing days from five (two in July and one all other dates) to eight (two days each quarter).
• We have worked with Prometric to increase the number of seats available to NPTE candidates in areas where we need them. This is an ongoing process, and FSBPT uses input from schools to refine seating needs by test center.
• We have implemented a six-attempt limit for the NPTE, which has incentivized candidates to take the NPTE more seriously from their first attempt, and pass rates have risen on subsequent attempts.
• We have improved NPTE test security.
• We have improved tools available to candidates to prepare for the NPTE, as well as remediation tools if candidates are unsuccessful on their first attempt.
  • In partnership with Prometric, we developed a Demo Exam that allows candidates to practice with the actual Prometric testing interface and see sample items prior to taking the NPTE.
  • We improved the Practice Exam and Assessment Tool (PEAT) by using retired NPTE forms and giving candidates an NPTE-scaled score that is highly predictive of how well candidates do when they take the NPTE.
  • We have improved Performance Feedback Reports (PFRs) for unsuccessful candidates and designed a system of informative reports for schools.
  • We have partnered with FifthTheory to provide free, anonymous access to the Test Mastery Mindset program, which helps NPTE candidates prepare for any standardized test based on weaknesses in their test preparation strategies.

Regarding changes driven by external factors, two main issues stand out. The first is the increasing demands on PTs and PTAs. This resulted in raising the NPTE cut score in 2013 and 2018 at both examination levels. The cut scores were not raised in 2023, given that many of the changes we saw in healthcare delivery had stabilized by 2020. However, in 2020, we experienced the COVID-19 pandemic. In the period following the pandemic shutdown, first-time pass rates dropped significantly. Many other professional credentialing programs experienced a similar drop in pass rates, and the reasons for this are often attributed to some combination of the inefficacy of remote education, decreased student motivation, lowered program admissions standards due to fewer applicants, and a decreased emphasis on testing in education.

Given all these changes, along with continued interest in pass rate trends among NPTE candidates, we decided to take another look at the potential impacts of fixed-date testing on NPTE candidates.

Comparing Pre-Fixed Date Testing to Now

PT Candidates

For PT candidates, the differences between the pre-fixed date era and the current data are small. From 2008 to 2010, the years prior to the transition to fixed-date testing, candidates, on average, waited about 66 days to take the NPTE for the first time. From 2023 to 2025, the number of days for the first attempt is 47 days after graduation, about 19 days sooner, on average.

For candidates who are unsuccessful on their first attempt and must take the NPTE-PT a second time, the difference is a little larger. Prior to fixed-date testing, candidates took their second attempt in about 143 days. Using the most recent data, candidates under fixed-date testing take 173 days. However, if we exclude candidates who skip a test date (test more than 120 days after graduation) between their first and second test date, it drops to 141 days. From 2023 to 2025, about 5% of candidates skip their first opportunity to take the NPTE after graduation, and 28% of candidates skip a testing date between their first attempt and second attempt. Including testing before graduation, about 76% of candidates tested within 90 days of graduation from 2008 to 2010, and 92% of candidates tested within 90 days of graduation from 2023 to 2025.

Prior to fixed-date testing, only about 5.5% of candidates tested prior to graduation, with a 93% pass rate. As previously mentioned, FSBPT has made it much easier for well-qualified candidates to test prior to graduation, and the numbers bear that out. From 2023 to 2025, 33% of candidates tested prior to graduation, a 600% increase, while maintaining a 93% pass rate. For candidates who test after graduation, pass rates were 87% prior to fixed-date testing, while pass rates for candidates testing after graduation are 82% for candidates who tested after graduation from 2023 to 2025. While there is some difference in pass rates for candidates who test after graduation in the most recent data, that may largely be due to a greater proportion of candidates who were not approved or chose not to test prior to graduation.

PTA Candidates

For PTA candidates, we see similar patterns for selecting testing dates. From 2008 to 2010, NPTE-PTA candidates took the NPTE an average of 92 days after graduation. From 2023 to 2025, NPTE-PTA candidates took the NPTE 54 days after graduation, 38 days sooner. For candidates who must retake the NPTE-PTA, candidates from 2008 to 2010 took their second attempt in 184 days, whereas candidates from 2023 to 2025 took their second attempt in 197 days. Excluding those who skipped a test date, candidates from 2023 to 2025 took their second attempt in 194 days. For PTA candidates, about 8% skip an available test date after graduating (defined as testing more than 120 days after graduation), and 34% skip an available test date between their first and second attempt. From 2008 to 2010, 63% of candidates tested within 90 days of graduation, whereas from 2023 to 2025, 90% of PTA candidates tested within 90 days of graduation.

For PTA candidates, we see the same general trend in terms of testing prior to graduation, although it is less pronounced. From 2008 to 2010, only about 3% of PTA candidates tested prior to graduation, with a 93% pass rate. From 2023-2025, about 14% of PTA candidates tested before graduation, with an 87% pass rate. For candidates testing after graduation, from 2008 to 2010 candidates passed at an 82% rate, whereas from 2023 to 2025, candidates passed at a 77% rate.

Summary

There is a perception among many that prior to fixed-date testing, NPTE candidates sat for the examination very soon after graduation and had much higher pass rates. These data stand in contrast to that assumption. Given the many changes FSBPT has made to the registration process and deadlines over the years, NPTE candidates are able to test closer to graduation, and a higher percentage opt to test before they graduate. Although candidates who test after graduation have a lower pass rate than those who test before graduation, much of this difference is likely due to a combination of schools not approving less-prepared candidates to test prior to graduation and students who feel less prepared opting to delay testing.

First-time pass rates are lower for the 2023–2025 time period than they were for the 2008–2010 time period. This change largely occurred in the years following the pandemic lockdown. The NPTE is not alone in seeing lower pass rates over the past few years, with many major testing programs seeing significant drops in their overall pass rate over the past few years. Researchers point to the lower efficacy of remote instruction experienced during the pandemic, as well as an ongoing de-emphasis on stakes-based testing through all levels of education.  

Table 1: Time from Graduation for First and Second NPTE Attempts

Table 2: NPTE First-Time Pass Rates by Time from Graduation