Stay Away from the Gray: Consequences of Cheating on the NPTE

by Mark Lane

We like to presume that knowledge of right and wrong underlies our society. We expect people to be ethical in their dealings, simply because it’s the right thing to do. But there is increasing evidence that this is not always the case. Unethical behavior on the part of high-ranking executives has brought corporations to their knees. And a recent New York Times article speaks of university surveys showing “not only that there is more cheating these days, but that students and teachers alike have become more accepting of some practices once considered out of bounds.” The same article cites a survey conducted by the Center for Academic Integrity, based at Duke University, which reports that 55 percent of students responding to a 2002 survey said that “it was not serious cheating to get questions and answers from a student who had previously taken a test.”¹

The Educational Testing Service (ETS) in Princeton, NJ, had to scramble this year to protect its Graduate Record Examination (GRE) in China, Taiwan and South Korea. When ETS saw test scores rising substantially in those countries, the company did some digging and found that memorized questions and answers had been posted on Websites by previous test takers. Recently, two Columbia University undergraduates were arrested on charges of carrying out a high-tech plot to cheat on the GRE using wireless microphones and digital cameras.²

In July 2002, the Federation of State Boards of Physical Therapy (FSBPT) discovered that “recalled” or memorized items from the National Physical Therapist Examination (NPTE) had been posted on an Internet site. That discovery of the posting of recall items and the actions the Federation has since taken to protect the examination have raised many interesting questions. This article will describe some of the issues and raise some further questions that both the Federation and licensing boards will need to consider. If there is good that has come from this episode of recalls posted on the Internet, perhaps it is that it has given us an opportunity to increase awareness.

What Is Right and What Is Wrong?

Since the Federation first sent out the initial news release announcing the recall postings, one question has been asked repeatedly: “When does sharing information on the examination constitute illegal or unethical behavior?” In other words, what constitutes cheating? We all know that students leaving an exam say things like, “That exam was really difficult!” or “There seemed to be a lot of pediatrics questions.” There is nothing wrong with making such general statements. But what about this question: “I am not sure if I got that question about the electrode placement for high voltage galvanic stimulation on the patient with muscle spasm of the rhomboid correct or not.” We know this type of “sharing” occurs and has occurred for years, but is it unethical? Does it violate Federal Copyright Law? Would candidates making such statements call into question their “moral character” and thus potentially call into question their qualifications for licensure?

As the Federation has investigated the postings, one thing has become clear. Personal definitions of right and wrong are often very specific to an individual and are often influenced by culture. It is evident that in some cultures, “right” is doing anything to help one’s fellow countrymen—and that may or may not mean helping them to pass an exam by sharing memorized items. “Wrong” would be refusing to provide this help. It is important to clarify the question of right and wrong so that candidates clearly understand that helping out a compatriot could impact the future licensure of both the giver and receiver of the recall items.

Unfortunately, life is not simply black and white. No matter how well such terms as “cheating” or “illicit sharing” are defined, there will always be gray areas, and there is a vast territory of gray between the black and white. So the question is, when does gray become a problem? The best advice to candidates for licensure is this: If there is any question at all that an action may not be right, stay out of the gray zone! It is not worth risking your career. The minute you get into the gray zone, back yourself out.

The following is the definition of illegal behavior in regard to the sharing of questions from the National Physical Therapy Licensing Examination:

The illicit sharing of memorized or recalled questions from the NPTE includes, but is not limited to, the following behavior:

1. the memorization or copying of any questions from any version of the NPTE;
2. the knowing, reckless or intentional provision, in written or verbal form, of any questions memorized or copied from any version of the NPTE to any other person through any means;
3. the knowing, reckless or intentional receipt, in written or verbal form, of any questions memorized or copied from any version of the NPTE to any other person through any means; and
4. the knowing, reckless or intentional solicitation or encouragement of another person to provide, in written or verbal form, any questions memorized or copied from any version of the NPTE from any other person through any means.

Based on this definition, the example above of a candidate describing a question falls into the category of “illicit sharing” of items.

It is critical for the Federation and its member boards to protect the integrity of the National Physical Therapy Examinations. While we tend to expect candidates to know right from wrong, it is clear that they may not—or that they may know and decide to cheat anyway. Sharing of memorized items from the NPTE is clearly wrong and we need to spread this message. The Federation has revised the Candidate Handbook, the application materials and the agreement that a candidate sees prior to beginning the exam. Licensing boards can help by reviewing materials they provide to candidates and the public and making sure the message is strong and clear.

Whose Job Is It Anyway?

Preventing unethical and illegal behavior is clearly everyone’s responsibility. Academic programs, the professional association, student organizations and individual students clearly have important roles to play. The focus of this article, however, is on the role of the Federation and its member boards.

Beyond making sure that candidates understand what is right and wrong, the Federation and its member boards need to review their respective roles in dealing with candidates who participate in sharing or receiving recall questions. From our brief experience, we know it is critical for these roles to be clarified, and it is equally critical for the Federation and its member boards to work together in these situations. While there have been some bumps along the road, our current experience working with member boards on this issue has been very positive and cooperative. We are now in the process of reviewing examination policies to clarify the Federation’s role and responsibilities. Member boards can help by reviewing their jurisdiction’s laws and rules dealing with this topic.

FSBPT’s Ethics and Legislation Committee has added language to the Model Practice Act: A Tool for Public Protection and Legislative Change (Third Edition, 2002)³ (MPA) making it clear that a state has the authority to take action against a candidate for licensure who participates in the sharing of NPTE questions. Louisiana is one of the few states that has developed excellent language designed to deal with this subject, and the Ethics and Legislation Committee used Louisiana’s language as a basis for the development of the MPA language:

3.03 Examination
If the board determines that an applicant or examinee has engaged, or has attempted to engage, in conduct that subverts or undermines the integrity of the examination process the board may disqualify the applicant from taking the examination. Examples of such conduct may include, without limitation, utilizing in any manner recalled or memorized examination questions from or with any person or entity, failing to comply with all test center security procedures, attempting to communicate with other examinees during the test, or copying and sharing examination questions or portions of questions. Any such violation shall be recorded in the official records of the board. Board action may include the following:

1. Disqualifying the applicant, permanently or for a specific period of time, from eligibility for the examination.
2. Disqualifying the applicant who has failed the examination from eligibility to retake the examination.
3. Disqualify the applicant, permanently or for a specific period of time, from eligibility for licensure.
4. Revoke, suspend or impose probationary conditions on any license [or certificate] issued to such applicant.

It is important to know that, in most states, once applicants have been approved to sit for the examination, they come under the regulatory authority of the state. The language above addresses cheating and the discipline that can result at every level of the examination process: not being able to take the examination; not being able to retake the exam after having failed; loss of eligibility to be licensed; and loss of a license. The language covers every scenario at every level of the test process. It prevents individuals who do not meet the licensing qualification of good moral character from receiving a license to practice physical therapy. The addition of this language to the Model Practice Act strengthens a practice act’s goal of protecting the public in the area of qualification for examination and licensure. Such strong statutory language makes clear that the board has the power to take disciplinary action in any area related to breaches in examination security.

¹Zernike, Kate. “With Student Cheating on the Rise, More Colleges Are Turning to Honor Codes.” New York Times, November 2, 2002.

²Gootman, Elissa. “Two Charged in Plot to Cheat on Entrance Exam.” New York Times, November 20, 2002.

³Available on the FSBPT Website at http://www.fsbpt.org.