Take a deep breath.

Don’t panic.

If you’re reading this, you may have just received the stressful news that you didn’t pass the NBCOT.

After weeks and weeks of studying and stressing, you’re feeling super de-motivated and hopeless. These feelings are 100% normal and you should expect to feel crappy about it for a few days.

It’s Not The Worst Thing That Could Happen

I can assure you that even though you failed one, two, even four times, you will pass the NBCOT and you will become an awesome occupational therapist.

“That’s easy for you to say. If I failed before, I’m probably NEVER going to pass!”

You may be thinking this right now. But keep in mind that at this point in time, your increased stress levels are contributing abnormally to your negative feelings.

Once you get over the discouragement in a few days, you’ll be ready to get back to planning for the next test and yes…studying.

To help you bounce back, I’ve compiled a list of the best strategies from people on AOTA’s Facebook Group about on how they managed after failing multiple times. The Facebook group is called AOTA’s NBCOT Exam Prep Info CenterYou’ll also find some of my favorite study tips that helped me pass.

If you aren’t already in the Facebook Group, stop what you’re doing and join ASAP! Members share study strategies and encouragement after they’ve failed the exam. You’ll see that everyone goes on to pass it. I learned so much from that group while studying and definitely took in more advice than I could ever imagine.

14 Tips From Successful NBCOT Test Takers

These are my favorite tips from NBCOT test takers.
  1. “If you ran out of time on the exam, time yourself on every practice quiz to get in the habit of reading and processing information quickly.”
  2. “Don’t change your answers! It’s very easy to second-guess yourself but your first answer is more likely the correct answer.”
  3. “If you’re almost out of time and have many questions left, just pick one letter (A, B, C, or D) and answer every question you have left with that same letter.”
  4. “Study one topic for one to several days, then review right before bed so the information sinks in overnight.”
  5. “Take study breaks! You don’t want to overwhelm yourself. Take weekends off.”
  6. “During the exam you should give yourself at least one bathroom break to decompress. Your brain needs a breather. The 10 minute tutorials are a great time to take your break since they don’t count against your time limit.”
  7. “During the exam, don’t overthink things. Just use the information given without making any inferences.”
  8. “Don’t think about fieldwork scenarios during the exam. NBCOT wants ‘perfect world’ answers.”
  9. “Take a million practice tests” (I second this!).”
  10. “Safety, safety, safety. Safety is always the answer, especially for the case scenarios. Always err on the side of caution.”
  11. “Make sure you always choose the answer that best involves the active participation of the patient/client, especially when you have the choice between two ‘correct’ answers.”
  12. “Remember the questions they’re asking are knowledge based, not clinical experience. Know the book answer and don’t try to interpret it too much.”
  13. “Take a small snack to eat during your break to replenish your body.”
  14. “Get a prescription beta blocker from your doctor, It did me wonders. Usually test anxiety is the problem.” (This one was interesting so I added it; make sure to discuss this with your doctor if you’re experiencing high levels of anxiety during the exam).

failed the nbcot

Top Recommended Study Aids

If you’re wondering if you may not have the “right” materials, I created a little list of the same resources that come up time and time again in the study group.

1. National Occupational Therapy Certification Exam: Review & Study Guide + AOTA’s NBCOT Exam Prep

The combination of these two resources is the most recommended strategy that I followed. The book is also known as the Therapy Ed book. This was my regimen:

  • Read the Therapy Ed book cover to cover once.
  • Take the 3 Therapy Ed exams and read through each rationale.
  • Read through each AOTA PDF’s one to two times (easier to do than Therapy Ed).
  • Take 30-50 question quizzes from AOTA’s Exam Prep daily for about five weeks.
2. Occupational Therapy Examination Review Guide

Also known as the “Purple Book.” This is another highly recommended resource from other test takers. There is a COTA version of this book as well.

3. Pass the OT

People that have failed multiple times often recommend this tool for additional web courses and tutoring.

4. Quizlet

I always recommend getting your hands on these free pre-made flashcard quizzes to help supplement, especially with developmental milestones and splinting.

Manage Your Testing Anxiety

Many failures in testing can be attributed to anxiety.  Unfortunately, there isn’t an easy, quick fix for this.

What’s helpful to cope with this debilitating experience is to understand why your body inflicts this response on you.

Basically, your brain perceives the situation as a threat to your safety and survival. Because the environment is seen as a stress and a threat by your brain, it decides to try to help you by initiating the fight or flight response.

When this happens, your brain literally shuts off your neocortex – the part of the brain where deep thinking and reasoning happens. It sends all the blood and energy to your heart so you can be ready to fight – or run.

This is of course bad news since you need the deep-thinking part of your brain for recalling and analyzing information.

Just stay calm and remember that it’s normal to feel this way temporarily. It will pass in a few minutes – it always does – and you’ll be in much better shape to take the test.

failed the nbcot stay calm

Tips To Staying Calm:

  • Ignore your anxiety during the test, and try to focus on the questions.
  • Have confidence going into the examYou’ve been preparing for this. Remind yourself that you have this in the bag. Write your name on the board they give you followed by OTR/L or COTA. Tell yourself throughout that you will pass.
  • Breathe. Take slow, rhythmic, deep breaths while reminding yourself that you will pass.
  • Try natural supplements: If you don’t use prescription medications and want to try a more natural approach, I used GABA Calm lozenges during my thesis defense and found that they worked for me. Whether it was a placebo affect or not, it gave me a little more confidence about my anxiety. *Disclaimer: I am not trained in prescribing medication and recommend you always consult your doctor before using any supplements.

Don’t Wait Too Long Between Attempts

There are many circumstances that can lead to failing the exam. Some new grads take full time jobs after school which can lead to decreased study hours. Others have real world situations like family and kids that can take away from study time.

Whatever the case is, get back in the saddle when you know you can devote full time hours studying.

Do not wait too long after the test to start studying again!

Sometimes test takers do wait a solid six months to a year to get back to the exam. Understandably, you’ll feel very overwhelmed and de-motivated to study again after a failed attempt. I can totally understand.

If you can help it, though, do your best to re-take it sooner than later to retain all of the information you just studied.

Trust That You WILL Pass The NBCOT And Become An OT

While failing the NBCOT is a major downer, remember that you aren’t the first OT that’s been through this.

And you certainly won’t be the last.

Whether you pass the first or the fourth time has no bearing on how great you’ll be as a practitioner. Don’t let it drag you down.

You know you will be an OT one day no matter how many tries it takes.

Remember that YOU GOT THIS and that you WILL pass!

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  • Elsa Solomon November 2, 2017   Reply →

    Thank you for all the tips and encouragement.

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