Will You Pass?

OT Dude Academy’s Free NBCOT® Exam Prep Course Studying Mindset, Habits, and Routines Will You Pass?
  • Students must pass the National Board for Certification in Occupational Therapy®  (NBCOT®) exam to gain certification as a prerequisite for a license to practice as an occupational therapy practitioner.
  • What factors can predict NBCOT® exam success?
  • Various researchers have examined predictors of success on the certification exam including admission factors, in-program performance measures (e.g., GPA, fieldwork performance), and exam-specific methods (e.g., practice exams).1 2 
  • Predictive measures include demographics, college entrance examinations, GPA, and program benchmarks.
  • Results from one study found:3 
    • Most students (n=268, 85%) passed on their first attempt.
    • Differences for those who passed were based on overall GPA, ACT or SAT scores, and fieldwork scores.
    • Academic course grades, fieldwork performance, and standardized test scores may also affect performance on the NBCOT licensure exam.
    • Consider contributing factors such as clinical and critical reasoning, professional behaviors, test-taking strategies, organization, notetaking, communication with the instructor or preceptor, question-asking, and study methods.
  • A second study looked at preadmission, academic, and fieldwork factors of students (n=144) for passing the NBCOT® Exam.4 
    • Age, marital status, or ethnicity were not significant for passing the NBCOT® exam.
    • Males (41% fail rate) were found to be more likely to fail on their first attempt than females (15% fail rate). However, as in most OT programs, there is majority of students are females, so data was not evenly split in this study and had sampling bias.
    • Students who failed their first attempt had lower mean recommendation strength scores on letters of recommendation and lower writing sample scores.
    • Students who failed the exam were found to have lower MOT program GPAs.
    • Undergraduate GPA was no associated with passing the NBCOT® Exam.
    • Students who failed were more likely to have been placed on a modified academic program.
    • Final fieldwork scores were not significant, but self-reported evaluations were. Students who failed their first attempt often had higher self-evaluations than students who passed on their first attempt.
    • Is fieldwork performance an indicator of NBCOT® Exam success? The authors of this study believe they require different skills:
      • “Whereas examinations typically require the student to recall, analyze, and
        apply knowledge to answer paper-based test questions correctly, fieldwork experiences require that the student also demonstrate the ability to execute his or her knowledge and practice skills in real-life situations.
      • The fieldwork experience further requires that the student demonstrate many behaviorally oriented skills that are not addressed on certification examinations.

How I Interpret These Studies

  • If you did well in OT school and fieldwork, you have a very high chance of passing.
  • But, you still need to study, reflect, and practice for the NBCOT® exam, just like how you prepared for passing a course’s OT exam or a fieldwork placement.
  • Those who are organized will likely do well.
  • Those who critically think and ask questions when studying (either mentally or asking peers) will likely do well.
  • Those who manage their test anxiety will likely do well.
  • Being confident is a good thing, but perhaps being overly confident is not.
    • Reflect on your strengths and weaknesses.
    • Strengthen your weak areas such as certain topics you score poorly on or do not understand.

Causes of Failure

  1. Taking the test “cold”.
  2. Reviewing everything from OT school.
  3. Memorizing practice questions and answers.
  4. Cramming the night before.
  5. Letting test anxiety get to you.
  6. Not finishing the test.
  1. Avi-Itzhak T. (2015). Ability of the National Board for Certification in Occupational Therapy practice test to estimate the probability of first-time pass status on the national certification exam. American Journal of Occupational Therapy, 69(Suppl. 2), 6912185080 10.5014/ajot.2015.015024[↩]
  2. Novalis S. D., Cyranowski J. M., & Dolhi C. D. (2017). Passing the NBCOT examination: Preadmission, academic, and fieldwork factors. Open Journal of Occupational Therapy, 5(4) 10.15453/2168-6408.1341[↩]
  3. Kurowski-Burt, A. L., Woods, S., Daily, S. M., Lilly, C. L., Scaife, B., & Davis, D. (2020). Predicting student success on the National Board for Certification in Occupational Therapy® examination. American Journal of Occupational Therapy, 74(4), 7404345020p1-7404345020p10.[↩]
  4. Novalis, S. D., Cyranowski, J. M., & Dolhi, C. D. (2017). Passing the NBCOT examination: Preadmission, academic, and fieldwork factors. The Open Journal of Occupational Therapy, 5(4), 9.[↩]
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