It’s scary and uncertain and a BIG DEAL. We don’t want to fail and have all that hard work go down the drain. It’s not what truly happens if we don’t pass on the first try but it does feel that way. I’ve been there.

Let’s break down the exam. It consists of 200 multiple choice questions and you have four hours to complete the test. There are fifty questions on each exam that do not count for scoring purposes. These questions are being evaluated to determine if the question meets criteria to be included on future examinations. The NPTE is graded on a scale ranging from 200 to 800 points but 600 is needed for a passing score. Don’t worry, if you do fail, you are allowed to take this exam three times in a 12-month period. But we are not going to worry about that until we have to!

The biggest success for you is taking the time to think about how YOU study best. This will be your golden ticket.

What is the best option to study for the NPTE-PTA exam?

There are plenty of study guides out there that include outlines, practice exams, apps, and more. Each will have pros and cons, so let’s dive into them so you can make an informed decision for yourself on which option(s) you want to choose.

Some more popular options are:

1. Scorebuilders by Giles
2. TherapyEd by O’Sullivan
3. NPTE PocketPrep -PT by FSBPT
4. Scorebuilders’ Content Master App
5. PEAT Exams

Scorebuilders

If you can only choose one book or are short on time, buy Scorebuilders. It’s reader friendly and easier to digest than O’Sullivan. It hits all of the high points. It’s colorful, full of diagrams, and has highlighted sections to help draw your attention to important topics. There are also practice questions within the book and it comes with 3 full-length practice tests. Some of these questions can be a bit easier than the actual exam, so we recommend that you still take the PEAT Exams to get a better feel for what actual questions will be.

Scorebuilders also has a wide variety of other tools you can use, including Basecamp, which is a gamified way to review where you climb the “mountains” that represent each of the main content areas that are on the exam. Online Advantage is another option that gives you access to additional practice tests if you need them to fill in your study calendar, depending on the length you are choosing. More on that below.

Scorebuilders also has some package deals that you can take advantage of if you do a group order with your class. They can be up to 25% off, so this is well worth organizing. The student organizer also gets free products.

TherapyEd

TherapyEd by O’Sullivan is much longer than Scorebuilders and can be difficult to process for more visual learners.There are less diagrams in this one and the book is in black and white. If you want to be truly comprehensive and have more time to study, this could still be a worthwhile investment to gain more complete knowledge. The 3 included practice tests tend to be much more difficult than the actual NPTE exam.

If you can buy both or have a longer study calendar and want to have more practice tests, start with Score builders then move to O’Sullivan. It might seem like a lot of money, but preparing well is priceless. It has been shown that the more times a candidate has the taken the NPTE, their likelihood of passing decreased substantially, that is not always the case. I didn’t pass on the first try and not even the second try. Keep your head up and stick with it. It all comes down to how you study, interpret, and retain the material.

NPTE Pocket Prep

With technology now a days, the NPTE pocket prep has a wonderful app from the FSBPT. This is a great option for quicker studying on the go. This gives you the opportunity to pull it up at any time throughout your day. If you are waiting in line for coffee or checking out, pull it up. It’s there for your convenience.

The advantage to this one is access to 600 more practice questions. These are not organized into exams, however. You can also choose to focus questions on only your weaker areas. This is a great option because it helps you work on test-taking strategies. This is also from the FSBPT, which is the organization that creates the actual exam.

Scorebuilder’s Content Master

This app has a combination of content review and access to 750 practice questions. The practice questions are designed to determine your mastery of content presented in the review sections. This app can be great for helping you to determine weaker content areas so you can more efficiently focus your time.

When should you start to study?

This depends on the type of person you are and how much time you have left before the exam. Are you someone who does well with crunching information all together at once or do you want to take time learning subject by subject. There are 4, 8, 12, and 16-week plans out there. There are people who study just a couple days a week and then there are others who study nonstop for 4 weeks. Truly, you want to stick to how you have studied before. If you are taking your test post graduation and depending on when your test is available, you should have a solid 2+ months to study.

If you choose a longer study calendar, you should take some days off from studying so you don’t burn out before test time.

Where should you focus most of your time studying?

Most have said focus on the big 3 –“Musculoskeletal, Neuro and Cardiopulmonary”. When you get your review book there will be a chart in there of percents of how much that section is on your test. Use that knowledge to help guide you with your studying.

Knowing how YOU study best and RETAIN the information is the important part. There is no one size fits all especially when it comes to a test as complex as the NPTE. Study the way you have in the past for exams and practicals. You have gotten through an accelerated program using those methods, so don’t change it now.

Use flashcards, the mobile apps, writing out the information, record yourself explaining and hit playback are great ways to begin. The biggest thing through all of this is finding and keeping with studying habits that have worked for you in the past. Just because its a beast of a test, doesn’t mean you have to change what has worked for you when it comes to studying.

Create yourself a study guide and schedule so that you’re not wondering what to study every day. Do not get overly ambitious, especially if you are starting to study early, because you don’t want to burn out. Give yourself time to absorb the information.

If you are hard at focusing and being diligent with studying, use the Pomodoro method. This is a method where you do 25 mins of studying, 5 min break doing something COMPLETELY unrelated (aka – no reviewing info in your head on break). Its more true to your brain’s cycle of focus and attention which will lead to more productive studying.

Think about this. A unique way to help you fully understand the information you are learning is to talk to others about what you are learning. Explain stuff to them even if you are not totally clear on it and have to double check your information, it will give you accurate idea of what you actually do or don’t know on that topic. Giving the chance for people to ask you questions about it will help you think deeper and understand the information at hand.

When should I take a practice exam?

Take your first practice test through Scorebuilders as this will help determine areas of strength and weaknesses which will help you plan your study schedule.

Once you have learned of your strengths with a test, study them 1-2x a week to keep them fresh. Study your weaker areas 2-3x a week.

Use the other test resources available (Scorebuilders, Therapy Ed, Online Advantage) to fill in your study calendar. We recommend taking one test per week if you are doing an 8 week plan and one every 2 weeks if you are doing a longer plan.

.What’s nice about the PEAT is its made by the FSBPT, who are the makers of the NPTE, so the practice tests and retired NPTE will be able to give you detailed score report. This is your golden ticket. Use that information for your studying and preparing for the real thing. When it comes to taking the PEAT, I would wait to take the first one 1 month from the test date. This means you will have studied the bulk of material by this time and worked on improving your weaker areas. This will give you a better idea of how you will perform on the actual exam. Take the second PEAT 1-2 weeks prior to your exam to round out your schedule. This will allow any final prep on areas that you are still testing a bit weaker in.

A good rule of thumb is to do no to very little studying the day before and the day of your exam. This is to allow your brain to recover and make sure that you are as fresh as possible going into testing. All I did was a few simple practice questions in the days leading up to the exam.

How To Take A Practice Exam

When it comes to taking practice exams, treat the test like how the NPTE will be. Set yourself a timer, go to a secluded room, close the door, no food or drinks, do not let anything distract you and give yourself the one 15 min break when it appears. We want to be able to simulate the testing center so that will cut down on any anxiety. This helps your brain learn how the test will go and allow you to work on mental stamina and pacing. .. Once you take these tests, review your results. Review every question. I know that will be time consuming but take 1-2 days after your practice test to review the questions you got wrong and work on understanding why. This helps you to understand if it was a testing error or a content error. Meaning, did you not understand or interpret what the question was asking or is it just a knowledge deficit. This can tell you if you need to perform more content review or if you need to work on test-taking strategies. Effective, efficient preparation leads to improved results.

How do I take the test and know which answer is the correct one?

Well this is a tough one to answer. There are different versions of the test so what one person’s version might be completely different from another. But let’s talk about the answer to the questions. .. The correct answer is the one they want you to pick will always relate back to safety. They don’t care what intervention or crazy manual you do, they want to know you will do no harm and will keep your patients safe. Another answer will appear almost right but not quite the one you should choose. One answer will be wrong answer and will be one you can eliminate quickly. .. Take your time with questions. First, read it and then think about what you would expect the answer to be. Then, review the answer choices. Find the matching one. Sometimes people jump to the answers first and not read the question first causing some confusion. I would recommend reading the question, formulating what you think they are asking then review your choices. Don’t get overwhelmed but go with your gut. I can’t believe how many times on a practice exam I picked the answer with my gut reaction then changed it because I started to overthink the question. Trust yourself. You have prepared for this. Take a deep breath. You’ve got this!

Other Considerations

When it comes to scheduling your test pick a date that doesn’t have anything else going on around it. We know the test is only given 3x a year. However, when it comes to choosing a date make sure you are fully confident with that date. I know someone who was planning a wedding, a honeymoon and the board exam all in the same month. They were so stressed out and she could’ve avoided that if she planned better. You don’t want extra distractions or additional stress around the test date. You want to set yourself up for success.

Another thing that helped me was a day or two before the test, I relaxed. I didn’t open the book, I watched my favorite movie, and got a good night’s sleep. I made sure to eat the night before and breakfast the morning of. Make sure you set yourself up for success even a few days prior to the test. I even had a dance party in my car before my test. I wore comfy clothes and was prepared. I got my mind right.

I know we all want to pass that test on the first try. It’s a lot of money, time spent, and added stress. But you have gotten yourself this far, don’t quit. Don’t let the fear and anxiety creep in. School has prepared you for this and you are taking every step to help you succeed to become a licensed Physical Therapist Assistant. If you have any questions or need to have someone listen for feedback, do not hesitate to reach out. I had people in my corner back then and we will do the same now for you.

Skilled Nursing Facility/ Assistive Living Facility

Let’s begin here. In a SNF & AFL we usually see significant improvements in our patients’ quality of life. Working in this setting can be rewarding but its often comes with hard work and downright frustrating with fluctuations in caseload. Some facilities are downright dreary and depressing while others might have more of a home-like feel. When it comes to working at a SNF & AFL, sometimes the company under reports the productivity requirements and the extent of your autonomy which is frustrating. I would make sure if you are looking to work in this setting, prepared yourself with questions to ask to get a clear idea of the work environment and job requirements before you say “Yes.”.

Here’s a great start:

1. How Many Therapists Will I Be Working With? What is the Ratio of PT/PTA?
2. What Is The Payer Mix with Medicare A vs Medicare B?
3. What Are Your Productivity Expectations? Is there Co-Treats and Group sessions?
4. Who gets involved with PDPM (Patient Driven Payment Module)?
5. Who Attends & is involved with your Care Conferences?
6. How Are Patient’s Scheduled? Is There A Trend Of When Patient’s Prefer Therapy?
7. What Would Be The Work Shift? Is There The Expectation Of Working Holidays And Weekends?
8. What Is There EMR System and Expectations For Progress Note/Discharge Notes?
9. What continued education or mentoring is given?

It’s important to review and know these answers prior to jumping in with both feet. You don’t want to sign a contract saying “Yes” if you don’t know the rules of the game. If there is any red flags for you or uncertainty, this setting might not be the one for you.

Acute Care

Acute Care is a setting where you have to determine the next step for your patients. Usually your patients are here for 2-7 days before you assist in the determination of which setting they should be transferred to for their rehab. Majority of patients in this setting have had a stroke, post operative care after a joint replacement, amputation, a trauma or infection, and even sometimes cancer. Each patient has a different diagnosis but the care is still the same, trying to maximize function and get them on the road to recovery with independent living if possible. Depending on the company and their services, the following questions are good starting points to discuss during your interview.

1. What is a typical caseload? What are their most common diagnoses of their patients?
2. What are the different units in the setting that are offered? What does the hospital have with certifications or specialties?
3. If you are applying for a PRN position, what is the specifics and expectations of the position? What is the pay rate?
4. What standards do they have for chart reviews?
5. How does the caseload distribution work? Will you be working with a specific therapist or patients each day?

Working in this setting can be challenging and a blessing. Majority of these patients are here for the short term before moving to their next destination. This means that you get a short amount of time to bond with your patients, the good and the bad. When I worked in acute, I liked the fact that after a joint replacement and recovery, I could help in the decision of where this patient would succeed in the next setting. Determining if a patient was safe to return home to receive home health, or they needed a long term rehab facility to help them get stronger, independent since they don’t have the support at home. It was rewarding to be part of their journey, even if it was for a little. If you like this aspect, this might be the place for your skills as a clinician.

Home Health

Home Health is a different animal compared to other settings mentioned above but majority of clinicians enjoy it the most. This setting puts more on you as the clinician then the patient because this services are for homebound patients. Let’s dive into the pros and cons. This seems to be the area that people want to know about the good, the bad and the ugly.

Here are the the Pros:

1. Decreased frequency of patients no shows
2. Patient’s are homebound so they shouldn’t be driving or not home, more consistent visits and available for their session
3. You can see the patient’s home environment which is helpful for your treatments
4. Usually higher pay compared to other settings

Vs. The Cons:

1. Having the confidence with your treatments to be able to treat alone
2. Dealing with traffic and time management, cost of wear & tear on your car
3. You have to bring your equipment with you & carry it in/out of their homes
4. Being on top of your own schedule to not get behind
5. Working in not the best living environments or circumstances

With home health, you are bringing the service right to their doorstep without the hassle of the patient having to bum a ride, coordinate a pickup, gather all their equipment and AD’s to get out the door to their treatment. They have less excuses to come up with and that’s a good thing! It’s not perfect but it is an improvement compared to outpatient who has a high cancel and no show rate.

Additionally, it’s not a bad choice since the reimbursement for gas and pay per visit varies depending on the company. I would take the time to reflect on your goals, your comfort level and the requirements for this setting. If you feel it’s a good fit with everything that is discussed during your interview, this might be the setting for you!

The following questions are ones I would ask if not discussed:

1. What EMR system do they use and their expectations for documentation? Do you have to use your personal computer or is one provided?
2. What would be your area of coverage?
3. Is there mileage reimbursement? If so, whats the rate?
4. What is the productivity expectation?
5. What is the company’s average census?
6. What is the ratio of PT’s to PTAs?
7. Is the job being paid hourly or per visit?

When it comes to working in Home Health things to consider are you should have reliable transportation and a good driving record, as your responsibilities revolve entirely around travel. Flexibility is also an important aspect of the job, as you may be traveling at different times in order to accommodate your patients’ schedules. If you feel you can handle that, accept that job offer and Good Luck!

Outpatient

The dreaded outpatient setting that everyone has something to say negative about. It’s not always that way but yes you will feel more of a strain, stress and burnout in this setting if it’s not the right fit. Each outpatient clinic can be different with having a caseload that might be all vertigo, neurological disorders/diseases, peds or even straight orthopedic. There are a wide range of what we can provide in the outpatient setting but finding the one that speaks to you, that’s the key. I’ve worked mostly in outpatient most of my career but have switches specialties from working with a PT who was doing an orthopedic residency/ fellowship, to all neuro caseload with vertigo, parkinsons, stroke, MS etc to working with just kids. You can find your skills to be more fine tuned in outpatient compared to other settings. This setting gives you the opportunity to see a wide range of ages, diagnosis, people’s personalities and use a range of skills such as modalities, manuals and equipment. If you feel you want to have a well rounded skill set, working outpatient will be that very opportunity. You might have to take some time to find the right one fitting your needs but it is possible.

As for when it comes to interviewing there are easy steps to prepare yourself. Before the interview, I always look over the company website to familiar myself further. And check in with previous employee review on glassdoor to see how those in the past felt treated and if there were any red flags. This is your chance to ask the questions that you really want to know-it’s not lead me wrong yet! They seem to be impressed with the research and honesty.

Questions to ask:

1. What does a typical caseload look like? At what frequency are patients scheduled throughout day? Who is responsible for scheduling clients?
2. What types of pts would you be treating? Will you work specifically with one PT?
3. Which documentation system do they use and how do they schedule patients? Will there be time set aside for documentation?
4. What are the opportunities for learning new skills? How long have the current therapists worked here? What level of onboard training can you expect? Do they have a mentor for you in the clinic?
5. Do they cover any of your expenses with licensure renewal or CEU’s credits?
6. If they do not treat a specific group of people that you are trained in, would they be open to training the others staff to be able to treat these clientele? If yes, that’s wonderful because they are seeing your skills as potential revenue and creating more of a footprint in the community. It’s a win-win.
7. How is the staff formed? Do they have technicians, front office staff etc to help with everyday tasks?

Usually outpatient is wide variety of team members, you can be in a clinic only by yourself and a PT or it could be a whole team approach with a front office, techs, other PTAs and PTs. Each company has their own philosophy and you just have to find the right one to match yours.

Other Considerations

There are always more things to consider when taking a job in healthcare. Mentoring is one of them. No matter how many years you have been practicing, everyone can benefit from mentoring. I would ask specifics on things that you are looking for to achieve in your career and see if they have the skills to get you there.

The biggest challenge with all of these settings is the productivity standard and the ins/outs of the job. Further questions to consider to bring up during your interview esp once you get the call back.

1. How will they measure your success as a clinician? Do they base everything off of your productivity or your outcomes?
2. Are there annual reviews where you can reflect and be given the chance to grow depending on feedback? How/when are raises administered?
3. What opportunities for job growth will there be in your future at this company?
4. What safeguards are in place to ensure dignified care for your residents? What is the CNA/resident ratio? What happens to your hours if census is low?
5. What is this company doing to prevent burnout and decrease turnover? What is the turnover rate for the therapy dept? For the building as a whole?
6. What is the PTO accrual policy? What type of benefits do they give?

In my mind, you never want to walk into a job not having the whole truth. It leads to confusion and poor communication between clinicians and superiors. It might come off as nosy or straightforward but its your job, time, and will to perform the job on the line. You don’t want to be coming to work hating every minute and trying to avoid the feeling of burnout/resentment.

Ask about what their “ideal employee” looks like. If they describe someone who works well beyond their pay (extra hours, takes on responsibilities such as QA without a pay increase), run. This’ll show if they value someone who they can exploit rather than someone that is good with patients and patient care.

If your interviewer is surprised by the questions you ask, I would just say, “I’m here to learn more about the opportunity and make sure I have a clear idea of the job, expectations and benefits of working for X company.” There is nothing wrong with being honest and open. It’s your career, not theirs.

1. “Why Are You Hiring?”

There’s a difference between a company that’s experiencing growth and looking to add a clinician to keep up with its success, and a clinic that’s burned through its last couple clinicians. Things happen, yes, but knowing why a business is hiring can give insight into the health and trajectory of the business. This is huge to know for your future! It’s not being too up front but it is giving you insight on the position they are hiring for.

2. “What Mentorship Opportunities Will Be Available?”

Starting your first day on the job by getting thrown into patient care, can be a jarring experience. While on boarding can vary from company to company as well as setting, there’s no “right answer” for how a company plans to ramp up a new employee. Likewise, if there’s no plan, that may be a sign of the lack of planning you are likely to experience going forward. As a new grad or new to the setting, this is going to be the cause of headaches and even more frustration.

Companies that have a specific intentional mentorship program offer an indication that they prioritize and recognize the value of mentorship in their clinician’s success. They will mention this right off in the interview. If they have such a program, it will come with objectives, a scheduled curriculum, and resources for the mentee to bring and ask questions to their clinic mentor. Some companies have a mentorship program that has to be completed in 6 months to 1 year. In some companies, you are on your own. Every company is different, and you just have to keep searching until you strike gold.

If you desire a connection with a mentor, make sure the person in that role is someone you see yourself connecting with regularly. If you would rather focus on self-study, ask if they offer subscriptions to journals, continuing education in a web based program like medbridge, or if there is an allotted money amount for continuing education. Everyone learns and grows differently so making sure you ask these questions can show you are eager to grow!

3. “Will I Be Treating My Own Consistent Caseload? Will I Be Treating in a Consistent Location?” 

As a provider looking to grow your expertise, constantly seeing different patients and getting bounced around to different locations can limit your ability to see progress and create frustration for both you and your patients. You want stability and a routine. Learning what you can expect early on will help you determine if the business will provide the clinical experience you’re looking for. Depending on your setting, you may actually want some variety in locations but mention this if they bring it up. Matching expectations and desires is key to finding the right role for you. I was someone who always said yes and was willing to help out another location so it always came back to bite me that when there was a spot to be filled, they assumed I would fill it. It’s wise to set your expectations and wishes up front.

4. “What’s The Expected Caseload?”

Workload and support are important to overlay with your salary requirements. Find out early on what the expectations will be and figure that into discussions about compensation if and when the time comes. When I had to split my time between clinics I was granted mileage since the other clinic was double the distance from my house. Know what the expectations are of how many patients they want you to see everyday or weekly, how many units you need to bill, and what your expected work hours would be.

This is also a time to determine how the schedule works. Will you be expected to treat multiple patients at a time and perform group treatments? If you do see multiple patients, what is the protocol to ensure that ethical billing is occurring? It’s important to know all the details so everyone is on the same page.

5. “What EMR System Do You Use? 

Asking about documentation requirements and what type of EMR system they utilize can make a big difference in how your day flows. Using a fluid EMR software that allows you to keep up with documentation throughout the day and easy to navigate will be a huge stress reliever.

You want to ask about the expectation of do you get a lunch break and is expected that you document through lunch or stay late to finish documentation? If they answer these questions honestly then you knowing that expectation can help when considering if this job is the right fit. It can also be a selling point if you have utilized their documentation system before in a clinical or other position, because they will know that you do not need as much training on how to use it.

6. “What Unique Treatment Philosophies Do They Promote? 

Even if the clinic sees the population of patients you are most passionate about, be sure the overall treatment philosophy matches your interests and values. You want to find a place that is going to add fuel to your fire, not try to distinguish it. If you’re looking to pursue a specific certification, ask what kind of support will be offered for you to accomplish such a goal. They might give the support or they might not. Luckily when I moved clinics, the new clinic wasn’t seeing a population that I was skilled in treating but they gave me the opportunity to teach and train my coworkers so we all can serve that population. I felt valued and innovative that I could make such an impact and continue to grow the practice.

As a professional looking for a place to hone their skills and grow their career, it’s important to assess if your potential new employer makes an effort to stay current with the changes. Is the clinic dynamic and have cutting edge ideas? Or do they seem to always be implementing the newest Instagram fads but not actually caring about the patients?

Taking the time to reflect on this prior will you determine what your future holds if you work at this clinic. You don’t want to be bored but you also don’t want to be left behind in what’s coming soon.

8. “What Are Opportunities For Growth?”

Whether you want to accelerate your career and move up the chain or settle in and refine your skills for a few years, make sure those expectations are a match with what the company has to offer. Having options is always a good thing; however, mismatched expectations can lead to frustration and resentment down the line. I decided to leave my clinic after serving there for 5 years. I felt I reached my potential at that clinic and was ready to expand my knowledge, gain skills and take the leap into a brighter future. With that leap, I was able to help mentor new grad PT’s, market my clinic to local doctors and referral sources, build a vestibular/concussion program, become assistant manager and become a more proficient clinician myself. You never know when or where growth can happen, so keep your eyes open to possibilities. If this company has the tools for you, it might be worth taking the leap.

9. “Can You Talk To The Staff? Can You Shadow For A Few Hours To See The Clinic In Action?”

Asking about the ability to shadow gives you an opportunity to see how the clinic runs, operates, and ask questions to their staff and patients. If this is going to be your new work place, you want to see how the daily functions run.  Most people forget to ask if they can shadow in the clinic for a few hours but it’s extremely helpful to make sure if this is the right setting for you.

Questions I would ask the other staff during my shadowing:

1. Do they feel their contributions are valued?
2. Do they eat lunch together?
3. Do they ever have any team building or group functions?
4. How do they all work together?

At the end of your interview, the interviewer might ask if you have any questions, I would ask at least 2 questions. This kind of preparation will also help clear the air on anything you didn’t discuss.

Keep in mind that you got into, and made it through, your strict and fast paced program. Kudos to you!

Navigating the job interview process is the easy part! The questions you ask—not the salary or benefits offered—will be your best resource in deciding if you will really love this job. Think of it like this, with most of us spend 90,000 hours at work over a lifetime, it is essential to make sure you are going to be happy. The things that will lead to you loving your new job are the connections with your work, your teammates, and your patients, and a solid match between the goals of the business and the goals you have for yourself. If they don’t match, it’s probably best to keep looking.