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No, You Don't Have to Know Everything to Pass the NPTE

by Miye Fonseca PT DPT

I hear a lot of “I have to read everything just in case” when studying for the National Physical Therapy Exam (NPTE). This is the academic mentality of cramming a lot of information whether relevant or irrelevant. That last bit of information could be the tipping point on the passing score - however, the reality is the majority of what you are reading won’t help you for the upcoming NPTE.

WHAT?! How’s that possible?

The reality of the National Physical Therapy Exam

The reality is you don’t have to know everything in order to pass the NPTE. You do have to know your core foundations (Musculoskeletal, Neuromuscular, CardioPulmonary) and be strong in the content sections (Evaluation, Examination, Interventions) in order to pass the exam. The goal is to make sure your academic knowledge is at entry-level competency and also confirm that you are safe to treat a patient by understanding clinical applications of the information.

While you may feel you have to go deep into a subject, the majority of the time that’s not actually true. Yes, you will have to delve into certain topics, but for the most part, you need to understand concepts that can be applied generally to a group of topics.

Why you shouldn’t try to study everything

Creates unnecessary stress and anxiety

The fear of “use it or lose it” creates unnecessary stress and anxiety about having to remember everything. When having to thumb through page after page of various books and resources, your head can swirl with the abundance of information. Making sure you read every little detail “just in case” makes you feel overwhelmed. This only creates more stress because you are now aware that there is so much information out there to learn and know. It’s can become an endless cycle - buried in books, papers, journals, or watching YouTube videos. After all of this, it can be hard to feel that you have accomplished anything.

Hours are spent reading or studying information that is not essential for the exam. Unfortunately, the accomplishment you feel after checking off chapters read from a book is not one that will be measured for competency on the National Physical Therapy Exam. It just shows you are able to flip through books. Being asked to summarize what you just read is a different story.

I hear a lot of “I read for x hours and I still don’t know much about this topic", or “I spent the whole day studying this one topic and I still don’t know how things work.” The endless reading of mass amounts of information comes down to how well you can integrate it into choosing the best answers on the exam.

Reinforces memorization

Reading study guides and textbooks reinforces academic study habits of memorization and recall. For instance, it's easy to recall and recite every muscle origin, insertion, and action of the body. However, this is not very practical when it comes to applying information to the actual NPTE. Many students get tripped up because they equate memorization with learning and then become frustrated when they keep missing the same questions or have to re-study the information.

When students just focus on memorization, it is tough to see how the information is applied to what they would see in the clinic. The NPTE questions are more clinically integrated, so the students must learn to apply this knowledge. Thinking clinically forces you to identify the cause of an impairment based on signs and symptoms, movements, and assessments.

Easy to go off on tangents

When reading, it’s easy to go off on tangents. You start learning something else that you may not know about or feel you should know. One thing leads to another and what was supposed to be a quick read turns into hours on a topic that may not be relevant for the exam. That’s when you get the feeling of “I just spent all this time and I still don’t know or understand the material."

Frustration can set in when you have to go back and re-read the material even though you feel like you just studied it all. And then when reading again, your brain inadvertently wanders or turns off because you feel that you already know this information. Yet, you still miss the questions.

Leads to multiple resources

You may find that different sources cite and explain information differently. This can lead to fact-checking - you go on a mission to find out which source is right. And when one source is different from the others, it leads to looking up other sources or asking around. This ultimately wastes time and takes you away from actually studying the material.

You may have also heard that it's beneficial to read a variety of books and to cover certain chapters. This only adds to feeling stressed and overwhelmed. If you study multiple sources for every topic that you don't feel strong in, you will only add pressure to the entire study process. This can become a never ending cycle that results in unnecessary stress.

Here’s what to focus on instead

Quality vs quantity

Reading too much information can actually hinder your ability to do well on the National Physical Therapy Exam. Here’s the thing, your time is better spent focusing on the material from a content perspective and a test-taking point of view. Referring to and understanding large concepts saves time and allows for relating the information clinically.

Keep the big picture in mind

For the sake of time, you can’t study every single detail. It’s great to have a vast amount of knowledge, but it’s best to keep the big picture in mind. Your end goal is to treat patients, not write essays or ace multiple choice exams. So rather than studying everything, focus on the common conditions that would be presented to you and take a more clinical approach to the exam.

How this all relates to the clinic

Here’s how “having to know it all” interferes when treating patients in the clinic. We are all probably guilty of some of these as student therapists during our rotations.

Evaluation: asking too many follow up questions and not leaving enough time for the physical examination

After reviewing the medical chart and looking over the intake form, you begin the subjective portion of the evaluation. If you ask too many follow-up questions, you will have a difficult time painting the whole picture. This can draw out the interview part and leave little time for the rest of the session.

Examination: performing too many objective measures and special tests

Once the subjective portion is completed, we perform tons of objective measures and special tests because that’s what we were taught in school. In order to rule in or rule out, you go through a checklist, asking the patient to perform repeated movements that invoke pain. However, we put our blinders on and just go through the tests even though we can gather some measures from what the patient already mentioned in the subjective history.

Intervention: overdoing the interventions

After we have an idea of what we are treating, there can be a tendency to keep performing a treatment or multiple treatments. Performing too many interventions in one session can make you seem ineffective and/or inefficient.

Treatment time: going overtime

This is where an aide might knock on the door to let you know that your next patient is here. However, you want to keep going and attempt to perform more interventions to get this patient better. Any combination of taking too much time during the evaluation, examination, or intervention can cause you to go over the allotted appointment time.

Once your schedule gets off track with one patient, your entire day tends to run late. Also, if you are perceived as giving preferential treatment to one patient, you can’t have subsequent patients feel that you are short-changing them, so you tend to run over with them too. Therefore, it’s best to be efficient during your evaluation and treatments in order to avoid running overtime.

Study efficiently to pass the NPTE

While it seems good on paper to know everything for the NPTE, it is not the best way to go about studying. Realistically and practicality, you’ll want to focus on the important aspects that matter only for the National Physical Therapy Exam itself. You have the rest of your career to keep reading and learning to help you become a better clinician.

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