The purpose of this quantitative study was to compare the pre- and post-pandemic ultimate and first-time pass rates for physical therapist assistant (PTA) candidates taking the National Physical Therapy Exam (NPTE) during the COVID-19 era in the U.S. This study builds a framework for future qualitative studies to understand factors leading to any pass rate reduction. Theoretical frameworks of Kolb and Vygotskii are used to connect the research to prior literature. The research design used non-experimental, secondary research with a correlational approach and explanatory design. The change in exam scores were explored by comparing NPTE pass rates and mean scores from PTA programs in the United States for the pre-pandemic (test takers before 2020) and post-pandemic time (test takers after 2021). The identified decrease in exam performance was found on the Federation of State Boards of Physical Therapy (FSBPT) website. The study looked at PTA graduates taking the NPTE from accredited PTA programs across the United States, including 7040 in 2018, 6713 in 2019, 6724 in 2020, and 6460 in 2021. There were 374 accredited programs in 7040 in 2018, 6713 in 2019, 6724 in 2020, and 6460 in 2021. The secondary data taken from the Federation of State Boards of Physical Therapy (FSBPT) was disaggregated by mean scores through institutional categories (private vs. public). Results of this study found the cohorts of 2018-2020 scored statistically higher compared to 2021 (p < 0.001) on the NPTE, which was measured by the independent samples t test. Solutions and recommendations are offered based upon this study's findings. These findings may expand our knowledge about the NPTE examination, educational practices, and provide future direction for additional research such as future NPTE results and results from other allied-health programs. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]