Tips for Current (and Future) Occupational Therapy Students: Passing the NBCOT Exam

I found out last Thursday that….I passed the NBCOT exam! I couldn’t help but cry tears of happiness and relief that this whole journey from applying for OT school to passing the national board for certification of occupational therapy exam was finally over! The amount of tears, stress, and anxiety I’ve endured since first starting OT school can hardly be described, but the realization that I’m done hasn’t fully sunk in yet. So I’d like to share with you some of the tips I found helpful in passing my exam. I know getting through OT school and fieldwork is tough enough and once you graduate and get to the point of limbo aka preparing for the boards, a little advice can go a long way. Keep in mind that what worked for me might not work for everyone, so take this advice with a grain of salt.

1. Pick your resources. As soon as I finished my last class, I immediately began to prepare for the NBCOT. For my program we were required to buy the TherapyEd book, which is the MUST HAVE study guide in my opinion, without the course it retails ($85) for the newest version. It goes over everything you need to know in detail and helps eliminate the need to study your textbooks, although you can always go back to these for reference on a topic you’re unfamiliar with, so I advise you not to sell your textbooks just yet. The TherapyEd book also comes with a CD with practice tests as an added bonus. I also purchased the AOTA exam prep, which I think was a good value as it has a ton of study questions and also study guides. The AOTA exam guides also go over some of the material that the therapyed books doesn’t cover, which is nice. There are other study materials available on Amazon and online like flashcards and study guides, but honestly buying too many can make studying complicated and the other materials just aren’t as up-to-date as the ones I mentioned.

2. Schedule your exam and create a study schedule. I recommend scheduling your exam ASAP to give you a study deadline and help keep the momentum going once you graduate. As of this posting, if you want your results as soon as possible I recommend scheduling your exam for a Monday because the exams are scored every Thursday and Monday is the deadline to take your exam and get the results that week (Taking the exam any other day will cause you to wait another week to get your results, which can be agonizing). I gave myself 8 weeks to study and I’d recommend giving yourself 6-8 weeks with a minimum of 4 weeks for at least 2-4 hours a day. This is what I did, that way I could still have time to relax, work, and enjoy my life. Some people spend all day studying after graduating, which you can do, but you will be more at risk for burn-out come exam time. Create a study calendar on google calendars or in an agenda book. I covered one topic or chapter a day to help organize my studying and minimize cramming (which is a big no-no). Chunking the information in small doses will go a long way in helping your remember the information and  I also recommend studying as soon as you graduate or finish your last class because the longer you wait the less motivated you’ll be to study and the more likely some of the material you’ve learned in class will leave your brain. I know your brain is probably fried from school but it is important to keep going. After all, once you pass you will be done forever and you will be an OTR or COTA. Studying weeks or months later will only be more difficult.

3. Take practice tests. If you buy the TherapyEd book it will come with 3 practice tests. I recommend taking one in the beginning of your studying to help gauge your current level and then one at midpoint and toward the end when you will be actually taking the test. If you’re an anxious test taker use these practice tests as an opportunity to mimic the real testing conditions. Set aside 4 hours of your time in a quiet area with no distractions (no phone or tv, because you won’t have these when you take the actual exam). Use ear plugs if needed, sit at a computer desk to help get you used to sitting there. I also used the AOTA exam prep and took smaller “quizzes” of 10-30 questions at a time to check my knowledge and progress when I got sick of reading. The AOTA exam prep is nice that it will give you a ranking of areas that you may need more practice in and areas you are stronger in so you can help guide your studying. I recommend answering some of these questions throughout your studying to give you an idea of what your strong and weak areas are. The AOTA exam prep also has a ton of clinical simulation questions which really helped me on the actual test. For the clinical simulation questions, my best advice is to pick only the answers that you know for sure are correct because you can either gain or lose points based on whether you choose a positive or negative response to the situation.

4. Essential topics to memorize or know very well. I guarantee you will have or be at risk for having questions with some of the following information, therefore I recommend you study this material and know this material very well: Ranchos Los Amigos scale, Glascow Coma Scale, types of reflexes, developmental milestones, SCI levels (especially know what motor function is available at each level), AOTA ethical standards (i.e. know what beneficence, non-maleficence, social justice, etc. are), types of groups for mental health. The medical conditions that you will normally see on the exam are pretty well covered in the study guides.

5. The night before the exam. Gather all the things you will need on exam day including a copy of your ATT letter, your 2 forms of ID, a print out of you appointment confirmation, etc. and have it ready to go so you’re not scrambling on exam day. Eat a healthy dinner and find way to relax (take a walk, read a good book, listen to some music, take a hot bath). Don’t worry about last minute studying, because at this point you know what you know and you’ll just stress yourself out more trying to cram more details.

6. Exam day. I recommend wearing something comfortable to the exam, because you will be sitting there for several hours. I just wore yoga pants, a comfortable shirt and a zip-up hoodie. Bring layers in case you get cold, but keep in mind if you need to take something off you’ll have to leave the room and put it in your locker, which will take away from your exam time. Try not to drink too much before the exam so you’re not running to the bathroom multiple times because again you will have to sign out and go through the scanning process each time you re-enter the exam room. Eat a good breakfast or lunch (depending on your start time), preferably something with protein to give you some energy. If you’re taking the OTR exam, you will take the clinical simulation questions first, I recommend spending no more than 15 minutes on each of the three scenarios to give yourself enough time to answer the 170 MC. Once you finish the clinical simulation questions you will be given a 10 minute tutorial on how to answer the MC (this doesn’t count against your exam time), I used this break to go to the bathroom and stretch, so feel free to do so if you don’t want to get up when the clock is actually ticking. For the MC, I spent 1 minute per question and gave my best answer and marked any questions I wanted to go back to. I had about 30 minutes left over at the end to review the questions I marked. I highly recommend doing the same because pacing yourself is important. Good luck in your studying and if you have any specific questions that I can clarify feel free to leave a comment on this post 🙂


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