Ophira Kopitnikoff, OTR/L Tara Troianello, OTR/L.

Success Strategies for Passing the

NBCOTOphira Kopitnikoff, OTR/L

Tara Troianello, OTR/L

• www.nbcot.org• You will create a username and password. Do not

create a duplicate account, you will be charged a fee.

• You will need a valid email address.• Payment is made by either Visa or MasterCard. Cost

of the exam is $480, plus an additional $40 to report your scores to each state you wish to be licensed in.

• You must complete the application in one sitting; you cannot exit the screen and login and start where you left off.

• Have your Student ID # ready.

APPLYING FOR THE EXAM

• You may apply either online, or send in a paper application.

• For paper applications: mail application and payment to

NBCOT, Inc.P.O. Box 64971Baltimore, MD 21264

• Go to www.nbcot.org and follow directions for online application.

• Application is valid for one year from the date of submission. ATT letters are valid for 90 days.

APPLICATION

• Applicants must submit:   - Official Final Transcript or Academic Credential

Verification Form (AVCF) This form states that all academic requirements have been fulfilled

 - Fieldwork Verification by the Academic Program Director (if applicable)

• Upon confirmation of eligibility to examine, the candidate will receive an Authorization to Test (ATT) Letter by e-mail or mail within 10-15 business days after all documentation is received

• The ATT Letter will include:Contact information for Prometric, and details on how to schedule, reschedule or cancel and exam

AFTER THE APPLICATION

Prometric cannot schedule an examination until the candidate has received the ATT Letter

A list of Prometric Test sites can be found online at www.prometric.com.

Candidates with an approved special accommodation(s) MUST call Prometric to schedule their examination.

SCHEDULING THE EXAM

The ATT letter is only valid for 3 months, after this time period applicants will have to reapply for another ATT letter

Scoring calendar: Scheduling the exam right before the scoring date will allow applicants to receive scores shortly after taking the exam

SCHEDULING THE EXAM

• “Practice Based Exam”: The exam tests the ability to make clinical decisions based on scenarios provided– TEST FORMAT:– 170 Multiple Choice Test (MCT) Items– 3 Clinical Simulation Test (CST) Items

• Tutorials are given before each section

• 450/600 is needed to pass the exam• DO NOT leave anything blank. Points

are rewarded for correct answers and there is no penalization for incorrect answers

THE NBCOT EXAM

• Some of the multiple choice questions stand alone, and some are grouped into a scenario that includes an introduction and is followed by several questions related to the same case.

• There are four answer options, with only one correct answer

• Spend about 1 minute on each MCT question• You may “mark” a question and return to it (it

is better to chose an answer even if the question is “marked” in case you do not have time to return

Multiple Choice Test (MCT) Items

• A practice situation called “opening scene” is presented which may include information related to practice settings, diagnoses, problem areas and occupational roles.

• Following the opening scene, there will be three to six sections with questions followed by potential decisions or actions that may be taken.

• There is probably more than one correct answer• After an action is selected, a feedback box will

appear which describes consequences of the action. After the feedback box appears, answers can not be changed

Clinical Simulation Test (CST) Items

Each action may be positive, negative, or neutral. Testers will not be provided with this information until the selection is made

Information from the feedback box should be used to make subsequent decisions

Clinical reasoning and critical thinking are needed in this section

Spend about 10-12 minutes on each CST item

Clinical Simulation Test (CST) Items

• The process of Occupational Therapy:• Referral, screening, evaluation, Intervention, re-

evaluation, discharge planning, clinical reasoning, documentation

• Professional Standards and Responsibilities:– Professional ethics, Ethical jurisdiction of OT, Practitioner

roles, supervisory guidelines, Health care system, Payment for OT services and reimbursement, federal legislation

• Human Development and Aging:– Pediatric development through geriatric. Includes:

Developmental theories, cognitive development, self care development, evaluation of developmental milestones, aging

EXAM TOPICS

• Musculoskeletal System Disorders– Hand, UE injuries, Arthritis, joint procedures, Burns,

Amputations, Burns, pain• Neurological System Disorders– CVA, TBI, SCI, CP, Movement Disorders, MS, SI Dysfunction,

Seizure Disorder • Cardiovascular & Pulmonary Disorders– CAD, PVD, COPD, Carcinomas, Pulmonary Edema

• Gastrointestinal, Endocrine & Immunological Disorders– Dysphagia, GERD, Cancer, Hepatitis, AIDS, Diabetes

• Psychiatric and Cognitive Disorders– Consciousness, Cognitive Disorders, Psychotic Disorders, Mood

Disorders, Substance related disorders, Anxiety Disorders, Personality Disorders, Eating Disorders, PDD, ADHD

CLINICAL CONDITIONS

1. Biomechanical Approaches 2. Neurological Approaches3. Cognitive- Perceptual Approaches4. Psychosocial Approaches5. Evaluation and Intervention for

Performance Areas in Occupation6. Mastery of the Environment

EVALUATION AND INTERVENTION

1. Biomechanical Approaches – ROM, MMT, Endurance, Edema, Dexterity,

Sensation

2. Neurological Approaches– Evaluating motor control, limb and postural

control, Modified Ashworth scale (tone)

3. Cognitive- Perceptual Approaches– Cognition, perception, A-ONE, Rivermead,

LOTCA, Allen Cognitive Level Test

4. Psychosocial Approaches– MOHO, Occupational Adaptation, Role Acquisition

EVALUATION

1. Biomechanical Approaches – Increasing strength, endurance, balance, Scar

management, joint protection principles, splinting

2. Neurological Approaches– CIMT, motor learning principles, adaptation, SI

3. Cognitive- Perceptual Approaches– Remediation, Transfer of Training Approach,

Compensation, Dynamic Interaction Approach

4. Psychosocial Approaches–Managing problem behaviors, Intervention

groups, child abuse, elder abuse

INTERVENTION

5. Performance Areas of Occupation– Assessing ADLs, IADLs, Play/ Leisure, Work:

• KELS, MEDLS, Routine Task Inventory, Play History

– Intervention to increase independence in these areas

6. Mastery of the Environment– Home evaluation, wheelchair assessments,

Driver rehabilitation– Intervention to increase independence in these

areas

EVALUATION AND INTERVENTION

• Make a study schedule• Study in groups• TAKE PRACTICE EXAMS– This will help you get used to the format of the test– If the same types of questions keep coming up on practice

tests, they are important!– Write down and review the correct answers and their

explanations/ rationales even for the questions you answer correctly. There is always additional information in the explanations.

– Time yourself• The practice tests are generally harder than the actual

test. If you fail a practice test, DO NOT PANIC, use it as a guide to study topics you are having difficulty with

STUDY STRATEGIES

• Chose client centered actions• Read the question carefully before selecting a

response• Read through the questions and try to highlight

the three important pieces of information. (Usually extra details that are less important are thrown in).

• Eliminate all answers that are unsafe or unethical– once you do that you are usually left with 2 choices.

Study precautions and contraindications such as when you can or can not apply heat or when ranging is contraindicated

GENERAL STRATEGIES

• Eliminate obviously wrong answers• Do not “read into” questions• Do not think about treatment you saw with patients

in the clinic or in fieldwork to answer questions. Try and think of “best practice”

• Do not spend more than one minute on each question, if you do not know the answer, pick the best one and “mark” it. You can come back if you have time

• Only change an answer if you have a good reason (you missed an essential word)

• Avoid two answers that seem similar or are synonyms

TACKLING MULTIPLCE CHOICE

• Once you make a selection you can not deselect it

• Use the feedback provided as constructive feedback as you progress through the CST

• Do not select an option that “may” have a negative outcome, you will lose points. It is better to leave it blank

• Do not select more than three or four options. If you are sure about two, only select those two

TACKLING CLINICAL SIMULATION

• The NBCOT is looking for how something affects FUNCTION. The test is not about memorizing “levels” but about understanding how “levels effect function”. For example:– An individual scores a Level 3 on the Allen Cognitive Level test. At

this level a person can begin using his/ her hands to manipulate objects, has repetitive movements and requires tactile stimulation• Functional potential: self care activities such as brushing teeth

– An individual with a C6 SCI has elbow extension.• Functional potential: Independent depression transfers without use of

sliding board– An individual with a C8 SCI can tie his/her shoes– An individual recovering from a TBI is assessed to be at Level VII

of the Rancho Level of Cognitive Functioning Scale . At this level (automatic –appropriate) he can attend to highly familiar tasks in a distraction free environment but may need cues• Functional potential: Sequencing through morning ADL routine with a

visual chart

HOW FUNCTION IS AFFECTED

• The NBCOT does not expect students to memorize every single disorder, symptom or MET level, but the test focuses on practical application.

• Do not focus on how to complete a transfer with a person who has a specific diagnosis. The questions test general knowledge. For example:– An OT practitioners is assisting an individual with Parkinson’s

Disorder in transferring from a W/C to mat. After locking the brakes the first cue would be:

A. “Stand up”B. “Scoot forward to the edge of the wheelchair”C. “Unfasten the wheelchair brakes”D. “Position the wheelchair so it directly faces the mat”

– Regardless of the diagnosis the answer would be “B”

PRACTICAL APPLICATION

• Be Familiar with – Allen Cognitive levels – TBI: Rancho Levels of Cognitive Functioning– Glascow Coma Scale– Reisburg’s Stages for Dementia– MET Levels– Child Developmental milestones

• Recent test questions have included issues relating to:– Feeding:, transition from g-tube, tonic bite reflex, dysphasia,videofluoroscopy– Transitional Employment Programs– Ergonomic design – OTR as consultant for establishing and developing community programs– Well-elderly– lymphedema management – Frames of references: such as Ecology of Human Occupation FOR and Person-

Environment-Occupation FOR

Topics

How I personally prepared for the exam…

What I used: ◦ TherapyEd National OT

Certification Exam, Review and Study Guide by Rita Fleming-Castaldy (2009)

◦ Lecture notes◦ General textbooks (e.g.

Pedretti’s Occupational Therapy, Willard and Spackman)

Specific Strategies

My timeline: Finished FWII 2 week break Made a 7 week study schedule, with 3-4 classmates

◦ If you prefer studying alone, like me, I would still recommend this as it forced me to keep to a schedule

◦ We assigned study categories to each week (based off the chapters in the exam review book)

◦ Each person studied on their own and we meet at the end of the week to go over any questions and do practice test questions

Took the 3 review book practice tests, with breaks, and then reviewed the answers and took notes based on Q&As I had trouble with

Scheduled 4 days for “full scale” practice tests ◦ Took tests in library cubicle without breaks to simulate actual test

environment◦ “Build up an endurance”

Specific Strategies

What worked best for me: Found I kept to my schedule more after I actually registered

◦ Register ASAP! Taking as many practices tests and/or reviewing

practice Q&As was the best way to prepare Focusing on my weaknesses

◦ Don’t waste time and energy making study guides or looking in depth into the subject areas you’re comfortable with – what you know is enough. So take the time to identify your strengths and weaknesses.

◦ E.g. I barely reviewed hand therapy or phys disabilities because those are my strengths. I made study guides for neuro and pediatrics and that helped

Reviewed (briefly) ALL my lecture notes and pulled out old study guides and review sheets - skimmed all lecture notes and only pulled out what seemed most important

Specific Strategies

NBCOT Competency Resources (online)◦ Self Assessment Tools ◦ Study Group Report Form ◦ Volunteer Services Guidelines and Log ◦ Journal and Textbook Reading Guidelines and Log

*NBCOT on FACEBOOK*◦ Good place to find study groups, ask questions,

get support, VENT, share study materials Review courses (TherapyEd Occupational

Therapy Certification Exam Preparation course) – pros and cons

Resources / Study Tools

“I made lots and lots of flash cards, rehearsed things verbally with roommates in college I had been studying with since freshman year, and found ways to make it fun and quiz each other.  Also just a suggestion to relax before the test is to do something fun and relaxing the night before and not freak out studying...if you don't know it by then you won't know it and it's better to go into the test relaxed than all stressed out.” – SB

Focus on ‘bigger concepts’ Study groups, flash cards, study guides/sheets Make a list of your weak topics to focus on PRACTICE EXAMS/QUESTIONS “I started off slow, several months before taking the test. I looked things over for

a half hour to hour a day and started building up. I made a plan and studied every subject four about 2-3 days then went back and reviewed it.” – AL

Take off the day before “I wrote down motivators on my study guides like my starting salary or my name

with OTR after it” – KL Don’t be discouraged by practice tests Questions are more application based than knowledge based

Tips from current OTR’s

Fleming- Castaldy, R.P. (2009). National Occupational Therapy Certification Exam Review & Study Guide. Evanston, IL: International Educational Resrouces (www.therapyed.com)

Johnson, C, Lorch, A. and DeAngelis, T. The Occupational Therapy Examination Review Guide, 3nd Edition. FA Davis

Publishing Company, 2006.

The NBCOT Certification Examination Handbook & Application (2011). Retrieved August 31, 2011, from the National

Board for Certification In Occupational Therapy websit: http://nbcot.org

References