OT Exam Readiness Stage 2: Contemplation

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At some point between your academic work and fieldwork, you might decide to “change” your view about preparing for the exam. Some people might choose to start preparing earlier than others (and, it should be at your own speed – you are in charge!).    At this stage, whenever that happens for you, you decide that you should begin reviewing material, but aren’t sure where to start.   Once you start thinking about the change, you are officially in the CONTEMPLATION stage.

Here are some tips if you are in the CONTEMPLATION stage:

  1.  During academic work.

    Make sure that you are keeping your files organized.  As your program evolves, you should start consolidating and re-organizing your course notes and files into more focused sections.  For example, you might want to keep all your pediatric information together – information on medical conditions in peds, developmental milestones, psychiatric and social emotional stages and interventions,  pediatric assessments,  intervention ideas (which should include best practice guidelines and evidence about interventions), etc. could all go in one easy to access file.

  • You can organize your files in a few ways – I might make duplicates of assessment tools that will show up across the lifespan or across diagnosis groups – for example, the Allen Cognitive Level tool.  You might want to make extra copies of your files so that you have this tool in the adult psychosocial section of your notes and also with the geriatric section of your notes.  Sensory profile – same thing – probably a good idea to copy the sensory information as it pertains to children and then re-post the information that works with adult and geriatric populations there.
  • Another trick to staying organized with electronic files is by being strategic with your file names –  you want to have notes at your fingertips when you need them and studying by practice area is the way a lot of students will study.  For example, you might want to label all your Pediatric files with a Ped_xxx at the beginning of the file name.
  1. During fieldwork.

    First, realize that a good deal of learning has occurred in the academic portion of your program, but the NBCOT® exam will test the integration of your academic knowledge and your ability to apply this knowledge to real-world scenarios.   So, your fieldwork experiences will become your best friends as you decide what and how to study for the exam.   Here are some ideas for how to make your FW “work” for you:

  • Keep a record of new conditions that you see. Consider making a table of common conditions and finding “sample” cases to have in your mind while studying.  A table that lists the “classic” picture of the condition (information you can find in textbooks) and additional columns that allow you to compare the “classic” picture to your “sample” case (including setting and information about specific clients) will come in handy once you sit down to study.  It will also help you see the gaps in your FW learning – the conditions that you didn’t get exposure to are areas where you will need to devote more time to study once you are in the next stage.  Check out Conditions in Occupational Therapy by Atchinson and Dirette for a comprehensive overview of the most common conditions you should concern yourself with while studying for the exam.  The appendices in Pedretti, Willard and Spackman, or Trombly can give you some clues, too.


Condition Classic clinical picture Setting Client How does the client meet/differ from classic clinical picture?
     Cerebral palsy
     Autism spectrum
     Dev. delay
    Multiple sclerosis
  • Assessment tools.  There are a lot of them to know.  If you are still in FW, you can research assessment tools that would be appropriate in your practice area and ask your FW educator if you can practice on a client or two (if you haven’t done that already!). Put it in a chart.  Make some comments about who the assessment is appropriate for, what information it gives you, how to interpret the results and make clinical decisions about the results – ie did you use the results to detect change, make referrals, or something else?
  • Discharge planning.  Make a log of discharge decisions that were made at your FW sites too. This would include, why you discharged someone, what was their discharge status – if you discharged someone who didn’t meet all their goals, why were they discharged?  If you are working in a hospital or rehab setting, what types of clients were appropriate for home health vs. those who you discharged to a community service? Why were these decisions made?  Did you make outside referrals to anyone?  Why?  This will help develop your clinical reasoning skills by looking at patterns across clients and allow you to make more appropriate decisions in the future.
  1. Take a class to help you prepare.

    Since some of these involve some pre-planning, you might have to think about them in the CONTEMPLATION stage, but it it isn’t advisable to take any of these courses until you are in the next stage (Exam Readiness Stage 3:  Preparation).

  • If you want to take a class, here are some options:
    • TherapyEd goes all over the country and provides courses.  They are the main course prep product out there.  Many schools will have TherapyEd come to their campus to provide a course.  The instructors are experienced OTs and academics.
    • Exam prep in Costa Rica for a different kind of experience.  Good for those who want a more laid-back and personalized experience and who are wanting to take advantage of their last moments as a student and do some traveling. Trips are no larger than 6-7 OT students and you get personalized tutoring from an experienced educator (me).  You get pre-trip consultation, material while on-site in Costa Rica (at least 12 hours of study time), and follow-up until you take (and pass!) the exam.
    • PasstheOT offers an online exam prep course and offers tutoring services. They are newer than TherapyEd, but they get good reviews.
  • If you want to study on your own and can spare some extra cash on prep products here is a rundown:
    • AOTA has great pdf outlines available and practice exams that mimic the real-deal (I helped create content for this product – it IS the real deal!).
    • NBCOT exam prep – right from the source can’t be a wrong choice! They also have an app so you can study on the go (Pocket Prep).
    • TherapyEd has a book  that you can buy without taking their class ( it is extremely detailed – not everyone likes the format).
    • 45 Days and Counting – this one I really like – I think it does a nice job helping you plan your studying and gives you activities to do that facilitate your studying.
    • The OT Exam Review Guide by Caryn Johnson – this book has practice exams that are worth the price and effort.
    • OTquestions is another online product that has a lot of questions and the ability to take your studying on the road.
    • The other book that is not necessarily an exam prep product, but one that covers the ACOTE standards from top to bottom is the book OT Essentials for  Clinical Competence. This book is extremely comprehensive with a lot of activities that help you integrate your knowledge in all areas of practice.  The book is based on the ACOTE standards (which are the standards by which your program was developed and how the NBCOT domains were determined).
  • Other online tools
    • OT – REX – has helpful YouTube videos for students prepping for the board exam.

If you are beyond thinking about the exam, you might be ready to move to stage 3: PREPARATION.

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