How I Passed the NBCOT On My First Try (And you can too!)
This post was originally published on March 14, 2016 and updated on July 18, 2019.
Are you finished with OT school and looking for a solid study plan to help you pass the NBCOT on your first try? If so, this post was created just for you!
While I was studying, I personally loved reading other new OTs’ success stories in the NBCOT exam prep Facebook group as well reading up on what to do if I failed (more on that below). I absorbed so much information that I ended up using in my study plan, which is outlined in this article.
I want to note that I haven’t been paid to write about any of these resources; they were all resources I either learned about from school or from other test takers.
First Off, How Long Should You Study For?
I studied for approximately six weeks after I graduated, and put in about 3-4 hours a day, 6 days a week.
I only had one or two days in the beginning of studying where I put in a full 8 hour day like I thought I was supposed to. I quickly realized I couldn’t handle that much cramming after depleting my brain’s activity tolerance (is that even a thing?) during fieldwork and school.
Honestly, I think if you have a solid four weeks at least, you don’t need to do full days every day. It definitely doesn’t hurt to study for full days if you’ve got the motivation, though!
Based on my classmates’ experiences and my experience, 3-4 hours a day is generally sufficient if you’re retaining the information as you read it.
TLDR; these are the resources I had the most success with:
Luckily for me, my OT program required us to purchase the Therapy Ed NBCOT Study Guide for one of our last “wrap up” courses during our second to last semester.
I wasn’t always the best about buying ALL of the required textbooks (so expensive!), but I heard so many good things about this book and how it helped quite a few people pass the NBCOT on the first try. Even if it hadn’t been required, I very likely would have purchased it anyway, and now recommend it to any new test taker.
I did not take the optional test prep course due to financial constraints but my classmates that took it said it was really helpful learning good test-taking strategies. If you have severe test anxiety or require extra time during exams, it might not hurt to consider it.
Something to keep in mind is that the Therapy Ed guide is DENSE. So much detail = information overload at times, as it basically covers everything you learned in OT school, plus three practice tests with the same amount of questions as the actual exam (170 multiple choice plus three clinical simulations).
You may have already heard this, but the Therapy Ed tests are HARD. Harder than the actual exam. So, if you’re scoring in the 50’s and 60’s, don’t be alarmed, because almost everyone is scoring in the 60’s even right before test time.
Just a heads-up: reading this book can be a bear. It is SO, SO detailed and complex, so I would usually just read about 10 pages to maybe one chapter a day at the most.
I can say some major cognitive rest breaks are needed after digging into this book, but even so, it was the most helpful and information-packed resource that I’ve found.
AOTA’s Test Prep Online
The second resource – and my favorite study material – was AOTA’s Test Prep online practice tests plus PDF’s on all of the main topics (hands, pediatrics, work, neuro, burns, and so on).
These PDF’s were SO much easier and shorter to read than TherapyEd and complemented the additional multiple choice quizzes.
I would do at least 20 questions a day (but often 50), and surprisingly had fun trying to beat my overall average and previous scores that I think I definitely saw all 1,100-something quiz questions at least once.
The answers and rationales are always provided at the end of the test, too, so I found that a lot of times I memorized the answers without even trying.
The AOTA Course alone did not have the same amount of detail and thoroughness that Therapy Ed did, so I still recommend you purchase Therapy Ed, read it cover to cover once, and take the practice exams throughout your studying.
Quizlet’s NBCOT Flashcards
Third, I used Quizlet’s free NBCOT flashcards that other students made and shared publicly for memorizing things like Rancho Levels, Allen Cognitive Levels, etc. Using Quizlet helped me break up the monotony when I needed a break from TherapyEd or AOTA’s test prep.
One thing to keep in mind is that since these quizzes are made by students, there may be some inaccuracies with answers. I definitely wouldn’t recommend this as your sole study strategy (you’ll want a thorough resource), and do be on the lookout for incorrect flashcards.
Should You Study With a Group or Alone?
This all depends on what style has worked for you in the past.
I attempted group study sessions with my friends from my cohort, but we almost always just ended up talking about how stressed we were and switched to other non-exam topics.
I personally did better studying by myself because I was so distractible. You might do better with a group to keep you accountable, though!
When you’re not studying, please make sure to carve out some fun and relaxing time to spend with your friends, family, and significant other if you have one, because it definitely will help to keep you sane.
As far as working goes, I personally would NOT recommend getting a full-time OT job on a temporary license and thinking you’re going to have the time and energy to study every evening.
You are going to be absolutely exhausted from working as a new OT and you will have major pressure not to fail since failing = no more temporary license = no more job (yikes!)
I did babysit for two families approximately 15 hours a week and ALWAYS brought my study materials and laptop, as I was primed and ready to knock out as much as I could during the kids’ nap-time and bed-time. I think doing a bit of easy part-time work is much easier on you with way less stress of losing your license/job.
The Day of the Test
When it came time for test day, I did the recommended steps of going easy the day before on studying, going out for a nice dinner, and making absolute sure I went to bed early enough to get a good night’s sleep.
I made sure to dress warmly even though it was summer (because air conditioning).
I brought snacks and water and followed my school’s recommendation to get up after about an hour and stretch my legs/take a bathroom break.
One of my instructors strongly recommended back before I graduated that everyone needs to get up at least once during the test, and I wholeheartedly agree.
I also remember her mentioning NBCOT pass rates were higher when this was done (if I find a study on this I’ll be sure to link to it!)
One final step we were taught was to write our full names on the whiteboard they give you, followed by “OTR” before you start, as well as a motivational quote like “I will pass.”
So I took my rest break, ate a banana, and cruised along for the 3.5 hours (or however long it was) feeling pretty confident at first.
Then towards the end I started getting really stressed about not feeling like I knew any of the pediatric content (clearly I don’t do peds!).
So, like everyone else, I walked out feeling like I failed.
Feeling pretty bummed about the possibility of spending another month and another $500 retaking and retaking.
But guess what: I passed, with plenty of points to spare!
I’m confident if you use trusted resources and give yourself enough time, with a solid study strategy, you will do the same!
But What are the Current Passing Rates?
Because I love numbers, I wanted to add in some stats for you: According to NBCOT’s information page, 71% of test takers passed the NBCOT in 2018 (dropping from 74% in 2016, and 72% in 2017).
I don’t have solid information about why there is a drop in pass rates, but I do have anecdotal information from many students and new grads that I talk to about popular study strategies.
Unofficial NBCOT study videos on YouTube are becoming really popular, and many test takers are only using these YouTube videos for studying. PLEASE don’t do this!!!
You really need at least one professionally-made resource to use as well, since they are created to cover everything you need to know. YouTube videos are great to supplement your studying, but they really aren’t going to cover everything compared to a legitimate resource. Follow this link to see program performance data on the NBCOT certification examination by state and program level.
If You Still Don’t Pass:
If you don’t pass the first, second, even third time, it’s okay! Please don’t beat yourself up about it. Just keep at it and revamp your study strategy, try new materials, consider getting a tutor, and spend more time studying vs. working. For more tips on what to do, check out our guide on what to do if you’ve failed the NBCOT.
No matter how many times it takes, you will pass, and you will be an amazing OT or COTA!
And that wraps up our NBCOT study tips guide! These are my personal experiences of studying for the NBCOT. If you tried something totally different and it worked for you, please share in the comments below, as we can all use as many tips as we can to pass the NBCOT!
Happy studying and best of luck to you!