The CST

OT Dude Academy’s Free NBCOT® Exam Prep Course NBCOT® Exam Format The CST

Each CST (OTR) item consists of three main components:1 

  1. Opening scene – This contains general background information about a practice-based situation that sets the scene for the CST item.
  2. Section headers – Following the opening scene, each CST item has four parts that each begin with a section header. These section headers contain information specific to the OT process addressed in the section. The candidate is asked a specific question based on this information.
  3. Response options and feedback – This includes a list of potential options the OTR may consider in response to the question posed in the section header. The list of options in the CST item consists of positive and negative options. Candidates must select either Yes or No for each option before proceeding to the next part of the CST item. Selecting Yes will cause a feedback box to appear to the right of the option. The feedback provides additional information related to the outcome selected but does not give information on whether or not the candidate’s response is correct. Feedback is not provided when No is selected.

Candidates receive credit for selecting the correct response options. Points are not deducted for selecting incorrect response options.

Candidates can navigate to previous screens within the CST item to review the information there, the selections made, and the feedback received in response to the selections; however, candidates cannot make changes to the responses. Candidates must complete the CST items in the order they are presented.

Please note that there is one exam tutorial presented before the exam that describes the CST and MC portions of the exam. The time allotted for the tutorial prior to beginning the exam is separate from the exam timer. Candidates can revisit the tutorial at any time during the exam; however, the exam timer will continue to run.

Links

OTR Exam Tutorial

Sample CST problems:

https://secure.nbcot.org/CSTDemo/?CSTID=1

https://secure.nbcot.org/CSTDemo/?CSTID=2

Tips for the Clinical Simulation Test (CST)

The following are tips I have read online, learned from my peers, or what I can remember from taking the CST portion myself.

  • Familiarize yourself with the CST format, screen/graphical interface, and the expected amount of time you will spend on the CST.
  • Practice CST questions with time management in mind.
  • Read the opening scene carefully, paying attention to every detail.
  • Apply your professional reasoning.
  • Try not to let fieldwork practice (which may involve some shortcuts or other practices and may not be “textbook) influence your answers.
  • Consider the OTPF domain and process as well as factors such as the setting, expected outcomes, and client-factors.
  • Remember which part of the domain you are in: screening, evaluation, intervention, discharge, etc. when choosing “YES” and “NO”.
  • Read all options carefully first before marking any “YES” or “NO” choices. (You cannot unmark choices because marking a choice may present you with new information.)
  • Eliminate obvious choices that are incorrect with “NO” and mark “YES” choices you know are correct.
  • Eliminate unsafe choices, ones with contraindications, or ones that are not appropriate according to your professional reasoning, e.g., takes too much time to administer.
  • For the remaining choices, use the feedback provided to guide your critical thinking.
  • Do not get discouraged if the feedback describes a negative situation, e.g., the patient falls during your therapy session – what matters most is selecting the total number of correct choices, not what happens step-by-step (unlike real-life).
  • Write down pertinent information you believe can be useful for the next phase of the CST, e.g., which assessments you administered.
  • Think big picture and top-down and don’t get bogged down in bottom-up thinking as each answer choice may address the client with a bottom-up perspective.
  • Choose choices that reflect generalist (entry-level) OT practice, not the specialist scope of practice.
  • Consider the client’s emotional response based on the particular stage of the OT process.
  • If working with a minor, consider and collaborate with the caregivers as well.
  • Try to think 1 step ahead in the OT process and what you will plan to do in the next stage. This can help you expect some choices and when they appear on the screen, you know they are correct because you expected them.
  • Just like with the MC, there is no “correct answer”, but many “best” answers.
  • Be careful of over-selecting choices just because they are there. Follow your intuition.
  • Keep track of your time for all the CSTs – you will want to leave enough time for the multiple-choice section.
  • Stay positive despite your perceived performance on the CST, you still have the MC portion to do well!
  1. NBCOT. (n.d.). Foundations of the NBCOT Certification Examinations. Retrieved from https://www.nbcot.org/en/Educators/Foundations[↩]
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