How FSBPT Develops Items

Questions (items) for the NPTE are written by physical therapists and physical therapist assistants representing a broad range of practice settings in all parts of the country.

Beginning item writers are trained by experienced staff and colleagues to produce high-quality, psychometrically sound multiple-choice test questions that cover the major areas of physical therapy practice reflected in the test content outlines.

The items are reviewed by an independent panel of content experts for suitability for inclusion in the examination item bank. Before being used as a scored item on the NPTE, newly written items are pretested as unscored items to gather statistical information. The pretested items that demonstrate good statistical characteristics then become eligible to appear on the scored portion of the NPTE in future years.

Role of Exam Committees

The involvement of a large, representative group of practicing physical therapists and physical therapist assistants and other professionals on examination committees at every stage of test development ensures that the NPTE is relevant to the current practice of physical therapy.

• Item writer coordinators are experienced item writers who provide the first level of review for newly written NPTE items. They work closely with item writers to ensure that their items meet the criteria to be eligible for inclusion on the NPTE.
• The examination development committee is responsible for reviewing new items sent from the item writer coordinators. The committee members check that item content is relevant for entry-level practice and determine whether items are appropriate for inclusion in the NPTE item bank.
  
  The examination development committee also determines which items are included on each examination based on the test content outline, which stipulates the content areas that must be covered and the number of questions to be included for each area. The committee members approve the final selection of items with the aim of ensuring that the examinations administered to candidates are valid and reliable.

Changes to the NPTE

FSBPT has been working diligently to continue to update and improve many aspects of the NPTE, from candidate registration to examination development and delivery. Some of these efforts have already been implemented, while others will take effect in 2024. Learn more by reading this article, "2022 NPTE Updates: Research, Innovation, and Practice Analysis Updates," and watching our recent webinar, "The When, How, and Why of the 2024 NPTE Redesign." We have included frequently asked questions below, and you can also review the new content outlines.

General Questions

How many questions will there be per section for the PT and PTA NPTE in 2024?
The NPTE-PT will have five sections of 45 questions each (total of 225 questions), with 45 pretest items scattered throughout the five sections. The NPTE-PTA will have four sections of 45 questions each (total of 180 questions), with 40 pretest items scattered throughout the four sections.  

Will the total number of (scored and pretest) items in each of the sections on the exam be equal in number?  
Yes, all sections will have the same number of scored items.

Will scenario questions have a standard format?   
We expect that the following set of headings will appear in the scenario box for most questions. However, additional headings will be included where appropriate, and some headings may be excluded to reduce reader burden.

• Setting
• Sex
• Age
• Presenting Problem/Current Condition 
• Medical History
• Other Information
• Physical Therapy Examination(s)
• Physical Therapy Plan of Care

When viewing a regular question (with or without a graphic), will the question expand to take up the entire screen? Yes. If you would like to see exactly how the questions will display, please access the NPTE demonstration examination. This should give you the look and feel of the exams administered at Prometric test centers.

How will medications be referred to on the NPTE? Will they be referred to by classification, generic name, or brand name? 
Some items on the exam refer to generic and brand names for specific medications; typically, these are commonly used medications. The examination development committees for the NPTE-PT and NPTE-PTA advise on whether a particular question should refer to a medication by class or by the specific medication’s generic/brand name. They make this decision on an item-by-item basis.

With respect to laboratory values, are the normal ranges provided alongside the patient’s values, as is common practice on reports found in the electronic medical record, or should my students be memorizing normal ranges for all lab values?
In general, we do not provide reference ranges for typical laboratory values on NPTE items. Items testing knowledge related to laboratory reference ranges are no different than other items on the NPTE in that they are focused on the impact on the physical therapy plan of care and the patient’s response.

Can image questions and/or video questions also be integrated into a scenario set?
Although we do not currently have any questions that use videos or images in scenario sets, it remains a possibility in the future.
 

NPTE-PT Test Content Outline

Can you expound upon what types of knowledge are associated with regenerative medicine for the musculoskeletal and neuromuscular systems?

Examples might include:

• Conditions benefiting from platelet rich plasma (PRP)/stem cell therapy
• Expected prognosis for patients receiving platelet rich plasma (PRP)/stem cell therapy within the context of physical therapy
• Appropriate physical therapy-related interventions/precautions/contraindications for individuals receiving platelet rich plasma (PRP)/stem cell therapy
• Clinical considerations and/or adverse effects and appropriate response that a practitioner must take for an individual receiving a particular regenerative medicine treatment

Can you provide further clarification regarding the content under “Taping for edema management”? What does this content include, except for lymphedema?
This content would include any entry-level clinically relevant knowledge on how to safely manage taping for any type of edema, regardless of its source (lymphedema, postoperative, etc.). In other words, this could include fabricating, applying, adjusting, or training the patient/client/caregiver in the use of taping for edema management and understanding complications on other body systems (such as the cardiovascular and pulmonary system) from the act of taping.

If a work activity meets the inclusion criteria, but the associated knowledge requirement does not, is the work activity not on the exam? What about the reverse scenario (e.g., mechanical repositioning for vestibular dysfunction for the NPTE-PTA)?
If a work activity meets the inclusion criteria, but the associated knowledge requirement does not, the work activity may be incorporated into an item. In this case, the content to be tested would be related to how the actual activity is performed, applied, used, etc. If a knowledge requirement meets the inclusion criteria, but the associated work activity does not, the knowledge may be incorporated into an item (e.g., performing and/or training patient/client/caregiver in iontophoresis is a PTA Work Activity Deemed Not Critical; however, it is important that the entry-level PTA candidate have a broad understanding of the indications, contraindications, and precautions of iontophoresis).

Is the number of neuro questions specifically related to neurodevelopmental training (NDT), Bobath, etc., being reduced? 
Yes, the PT Practice Analysis Task Force made a collective decision to reduce the number of items testing knowledge in interventions of the Neuromuscular and Nervous System from 15–17 to 13–16. They made this decision in part because some interventions, such as NDT and Bobath techniques, have been falling out of evidence-based practice. So, we are asking item writers not to write items that test the theory of NDT or Bobath, that use NDT or Bobath in the stem or as the key, or that ask how to perform interventions in a stepwise fashion (e.g., developmental sequence, proximal then distal). These concepts are considered outdated and not supported by recent research. Instead, we ask item writers to consider focusing on why the technique/procedure is used and what types of patients would benefit from the technique.

NPTE-PTA Test Content Outline

Can you clarify whether iontophoresis and intermittent pneumatic compression (IPC) are still included in the Content Outline, despite not being deemed Critical Work Activities, or if they will no longer be part of the test content?  Or are there just certain aspects of these modalities that graduates need to have knowledge of?
The PTA Practice Analysis Task Force believed that the entry-level PTA practitioner should understand the knowledge needed for iontophoresis and IPC (e.g., when to apply, indications for use, contraindications, precautions) but not necessarily how to apply, what parameters to use when applying, etc. So, the aspect that may be on the exam is the knowledge behind iontophoresis and IPC.