Steps to Ace the NBCOT Exam

Caroline Polk, MS, AOTA Digital Manager and AJOT Managing Editor

Taking the NBCOT exam is often a nerve-wracking experience for new OTs and OTAs. With systematic preparation, however, you can increase your confidence and the likelihood that you will pass the exam on the first attempt. Below are a few tips for preparing for the exam.

Learn Everything You Can About the Certification Exam

• Get a copy of the current NBCOT Certification Exam Handbook and learn about the exam format, content, and scoring. Review all the resources that NBCOT provides on its site.
• Be sure you understand the requirements and how to register for the exam.
• If you need an accommodation, leave plenty of time to pull together the paperwork.

• In a course exam, you know what the professor wants you to have learned. You have context on which to base your answer. The NBCOT exam presents questions without any frame of reference. You could have a question on older adults in long-term care immediately followed by a question on school-based occupational therapy.
• The exam is based on entry-level practice: what an entry-level OTR or COTA should know, as determined by NBCOT’s surveys of entry-level practitioners. The focus is on applying what you know to clinical situations, not simple recitation of facts.
• It’s a high-stakes exam! A lot depends on success!

Prepare to Study.

• Taking a practice test through AOTA’s NBCOT Exam Prep can help you determine what topic areas you need to focus on.

• NBCOT surveys OT and OTA programs every few years and determines the most commonly used texts. The exam questions are written with these sources in mind. Don’t worry if you don’t have those books, though; the test is based on what entry-level practitioners say they do in the course of their work, and it’s unlikely that the material hasn’t been covered in your program.
• Use AOTA’s Exam Prep Info Center Facebook group to ask other students about  the study materials and resources they are using through.

• How large should it be? Who should join?
• How will you work together, and how often? What are the members’ responsibilities?

• How do you learn best? Reading? Watching videos? You may need to spend some time converting some of your study materials into a format that works best for you.
• Making flashcards and creating outlines (putting material in your own words) can be useful.
• Remember that the exam is online, so it can help you to work with materials on the computer.

• The Certification Exam is based on the process and practice of occupational therapy, which NBCOT divides into 4 domains for OTRs and 3 for COTAs. Understanding the domain to which a question is oriented can help you figure out how to answer it.
• The exam is about the ability to gather information about a client’s occupational performance, formulate conclusions into a treatment plan, and select occupational therapy interventions. It also is about understanding standards of practice and ethics. It is not about regurgitating facts; it is about applying clinical reasoning.

Make a Study Plan.

• Many students begin to study in their last semester before graduation.
• Depending on when you want to test and how much review you need, 2 to 3 months of steady, consistent effort should be enough.

• Look at a calendar and set aside time each week for studying. You know what time of day is most productive for you, so try to schedule your study sessions during that time.
• Short, intense study sessions generally produce better results; you want to be able to remember what you studied. Several 30- to 45-minute sessions per week tend to work better than one or two long blocks of study time.
• Write down your study “appointments” in an actual calendar. If you have to break an appointment, reschedule it for within a week.
• Decide what you are going to do in each session. For example, people using AOTA’s Exam Prep sometimes take a short practice test on a specific topic, review topic outlines and other resources in areas that are weak, and then take another test on the same topic to see how their score changes.
• Take shorter practice tests so that you can absorb the information better. Practice tests that are 100 or 200 questions long will just tire you out. Remember, you don’t train for a marathon by running 26 miles every time you go for a run.

Be Prepared for the Day of the Exam.

• No matter how well you prepare for the exam, a few questions will cause you to scratch your head. You’ll look at all the answer options and still have no idea how to answer. Planning ahead for such cases can reduce anxiety.
• A simple approach is to always pick the same answer (e.g., D), then mark the question for review so you can come back to it if there is time. Unanswered questions are unscored; any answer, even a wild guess, is better than none. There is no penalty for wrong answers, so picking an answer gives you a chance to earn credit for a correct answer. This approach also saves time.

• Pull together everything you’ll need at the testing center—two forms of ID, your authorization to test letter, directions to the center, etc. Double check any instructions you have received.
• Eat a good dinner, and get a good night’s sleep. Trying to cram the night before will stress you out. Being well rested and able to think clearly is most important.
• Remember that many people before you have taken the test and passed. It is likely that you will, too. Be optimistic!

Learn more about AOTA’s NBCOT Exam Prep  and join the conversation about the exam on AOTA’s Exam Prep Info Center Facebook group

Caroline Polk is the digital manager for AOTA Press and managing editor of the American Journal of Occupational Therapy. She has worked with AOTA Press for a decade and has worked on allied health publications for most of her editorial career. Her current work focuses on converting AOTA Press publications to online platforms.