Predicting Success for Student Physical Therapists on the National Physical Therapy Examination: Systematic Review and Meta-Analysis

Background In physical therapist education, the National Physical Therapy Examination (NPTE) is the predominant measure of student success. Because the NPTE is a high-stakes examination, predicting NPTE performance is important for physical therapist students and programs. Purpose The purpose of this study was to determine the relationships between first-attempt NPTE performance and physical therapist applicant variables and physical therapist student variables. The 4 identified physical therapist applicant variables were undergraduate cumulative grade point average (GPA), undergraduate GPA for prerequisite courses, Graduate Record Examination verbal and quantitative subscale scores, and admission scores. The 4 identified physical therapist student variables were first- and third-year physical therapist student GPA, clinical performance scores (first and final clinical experiences), noncognitive student variables, and comprehensive examination scores. Data Sources A systematic search was performed with the databases PubMed and EBSCO (1966–2018). Study Selection Studies included in the review met the following criteria: the physical therapist education program offered an entry-level master’s or doctorate degree, pertinent data were available for each independent variable, the relationship between the independent variable and the NPTE was investigated, the NPTE was a continuous variable, the program was a US entry-level therapist education program, and the study was peer reviewed. Data Extraction Two independent reviewers completed data extraction and quality appraisal using the McMaster Appraisal Tool. Data Synthesis Random-effects meta-analyses using the Pearson product-moment correlation coefficient as the measure of effect size was used. Limitations Limitations of the review included a lack of homogeneity, high NPTE pass rates, modifications to the McMaster Appraisal Tool, small sample sizes, and publication bias. Conclusions No one physical therapist applicant variable should be used as an independent predictor of first-attempt NPTE performance. For physical therapist students, first- and third-year physical therapist student GPA had a strong relationship with first-attempt NPTE performance; clinical performance had a weak and nonsignificant relationship with first-attempt NPTE performance.