Insights from the Research ‘Predicting Student Success on the NBCOT® Examination’: Passing Advice

Did you know there’s a published article that looked at students who took the NBCOT exam and what factors they had in common that made them pass? This article was published in 2020 in the American Journal of Occupational therapy and they looked whether characteristics of academic and professional behavior across cohorts could indicate the likelihood of student success in passing the National Board for Certification in Occupational Therapy® examination.

About the NBCOT Exam

Students must pass the OT board exam, also known as the NBCOT exam in order to get licensed and practice as occupational therapy practitioners. And taking this exam is an investment in your time, money, and effort. It can be an emotional rollercoaster as you stress over studying for the test and your stress date, all the while, your friends and peers post on social media that they have passed. There can be a lot of anxiety that can take a toll on your mental health.

Knowing the factors that predict whether you will pass the NBCOT can be quite insightful. This study looked at 315 Master’s of OT students among eight cohorts.


  • Demographics
  • College entrance exams
  • GPA
  • Course grades
  • Fieldwork grades
  • OT Knowledge exams
  • NBCOT Exam

The Good News

According to the research (n = 268), most students do pass on the NBCOT exam, about 85% of students pass on their first attempt. So those are pretty good odds. What were differences seen in students who did not pass? Factors such as GPA, ACT and SAT scores, and Level II fieldwork scores were strong predictors.

So does this mean that if you have a poor GPA and low Fieldwork score you will necessarily fail? No, there are many other variables at play here. There are some patterns of course, such as students who do very poorly in the program are likely to fail. But the majority of students (including you) do quite well in their OT program, while others fail repeatedly.

So what’s the key? Well, this research article did not study other variables such as study time, study materials, study habits, time management, and so on. There’s also test anxiety and critical thinking and thinking processes for exams. As the NBCOT tests you a specific way, such as the CST, it takes a special skill and understanding in order to do well.

The authors concluded that, “Case studies using this success score suggest that additional resources and targeted interventions could be allocated to help students at highest risk of not passing the licensure exam.”

My Insights

Having passed 2 major board exams (EMT and NBCOT) on my first try, here are some of my insights and advice – for what it’s worth. As a mentor and content creator who created resources to help students to pass on their first try, I will share some additional resources that may be helpful (and what student’s have said have been helpful) for them to pass on their first try.


First is getting into the right mindset. Studying for the NBCOT exam can be a lonely journey. Kind of like studying for a test in school, you may be on your own for a while, but study in groups at other times. But not everyone likes to study in groups. It comes with its own costs (e.g., gas), time commitment (meeting up), and there may be distractions as students may be studying another part or they may just be distracting (making small talk). Then there’s the jealousy and envy that may come with your peers passing and you not. But this journey really depends on you. Only you can pass, not your friend for you or your family members.

You have what it takes

I am willing to bet that you have what it takes as you have done will in your OT courses, your capstone project, and your fieldwork. Test taking is a skill and once you become familiar with what and how the NBCOT exam will test your knowledge, then you will ensure your success that much more. It’s like the DMV driver’s test. If you study the right material and know how they ask you questions, then it becomes a breeze. Many students who fail may be thinking they are doing well, but they may not be understanding their answering decisions such as by not reviewing the answer rationales (even ones they got correct on the practice exams).


Time is everything, from the time you have to take your exam, to how much time you study per day, to how you manage your time on the exam. If you become a master of your time, then you can use it to your advantage. The NBCOT is a 3 hour exam and while that may seem like a lot, it may not be if you do not watch your time carefully, e.g., taking too much time on the CST section.

The key is to practice timing with practice exams and to get a sense of how much time you take answering questions and how to be more efficient with your time. Once you get comfortable with your time management, when stress runs high during your real exam, you can be more confident that you are staying on track!

The Free NBCOT Exam Prep Course contains CSTs Simulations to practice your time management.

Factors You Can Control

The variables that the research article mentioned are things that you cannot change such as your grades and scores. However, there is a lot you can change and that is what you study and how you study. If there was a research study that looked at the top resources that students used, there would be a pattern that probably correlated with a high passing rate on their first try. But as with everything, there are exceptions. I see many posts from students on the AOTA Exam Prep Facebook group saying they used these same popular resources, yet they still failed on their first attempt. Or their second, and third.

While each individual student’s case is different, it all boils down to how they answer the questions and them picking the incorrect answer choices. This comes down to an understanding of what you are being asked and answering the question directly. One way to be more successful with this is to understand the material in the broad picture and not getting lost in the small details, to then to apply your critical thinking. The NBCOT exam is not about memorization, but critical thinking and the application of concepts that mimic how you will practice as an OT. Examples of processes to master include screening, evaluation, intervention planning, and professional behavior. This leads me to…

My Resource – Used by Thousands of Students

One of my goals is to help students, especially the OT community. As a content creator, I have created a comprehensive course to help you review for the NBCOT exam.

Yes, this is another resource, but it is among the many such as Therapy Ed, AOTA’s Exam Prep, and OT Miri to provide you with more tools to review for the NBCOT exam. What is different about my course is that similar to OT Miri’s resources, they are all free!

My course contains not only videos but also podcasts, audio quizzes, quizzes with different media such as video clips and matching, as well as practice CSTs. It is in beta but is constantly being improved based on feedback from students.

Screenshot from the course

Many students have provided positive feedback and reviews about my course and how it has helped them to pass.

So don’t miss out and enroll now.

While I can’t guarantee that you will pass on your first try, I can guarantee that you will have an engaging learning experience with this occupational therapy material. This can drastically increase your chances of passing and is one of the most underrated resources (according to other students’s feedback) to review for the NBCOT exam.

Good luck!

P.S. If my resources have helped you to pass, please mention OT Dude in the AOTA’s Board Exam Prep Facebook group, thanks! 🙂


  1. Kurowski-Burt AL, Woods S, Daily SM, Lilly CL, Scaife B, Davis D. Predicting Student Success on the National Board for Certification in Occupational Therapy® Examination. Am J Occup Ther. 2020 Jul/Aug;74(4):7404345020p1-7404345020p10. doi: 10.5014/ajot.2020.037622. PMID: 32602454; PMCID: PMC7325415.