Does anyone feel like the nbcot is rigged? Like it gives you questions based off on what you put for your fieldwork during registering for the exam? For example if you put peds and acute care, most of your questions would be mental health and hands.
I got a 427 on my first attempt but 465 on an NBCOT practice test. Results showed I was barely scoring for domain 3. I am someone who is able to narrow it down to 2 answers but struggles to pick the best answer from there. I am currently using aota, NBCOT, and therapyed. I’ve been entering tough questions into AI to help develop my clinical reasoning when breaking down these questions to learn why an answer is correct and others are incorrect. What else can I do to ramp up my score in this 1 domain holding me back?
Don't mind me, I am just writing this as a way to force myself to do some positive affirmation before I test on Monday.
I have put in consistent hard work for 8 weeks to study for this; I trust the process.
It may have started out rocky with practice questions, but I'm now consistently scoring 70-80% on them; I know enough to pass this exam.
Don't let intrusive thoughts fill my mind with self-doubt; I scored 470 and 475 on the NBCOT practice test and full practice exams and I should take this as an indicator that I have a good knowledge base.
My past failures up to this point don't define me, hard work and not giving up does.
Remember before going into this test that I have strengths like testing endurance and pacing.
All of it will have been worth it on October 15th.
I wanted to make this post since so many other people’s experiences helped me through this journey. It’s important to note that I received testing accommodations. I had 1 hour extended testing time and 30 minutes of stop-the-clock breaks.
My practice scores: I definitely was NOT someone who was consistently getting amazing practice scores.
· TherapyEd Exam B: 47%
· AOTA Full Practice Exam: 65%
· TherapyEd Exam C: 52%
· NBCOT Practice Test: 438 (1 week before exam)
· NBCOT Full Practice Exam: 463 (4 days before exam)
· Actual NBCOT: 460 PASS
The biggest things I learned:
I spent a lot of time translating practice percentages into whether I would pass the NBCOT. Practice scores were MUCH more useful when I stopped treating them like predictions and started treating them like information. I started asking, "What is this score telling me I need to work on?" and revised my study focus accordingly. During every practice exam, I wrote down a list of all the content/key terms presented in the questions that I needed more information on or did not know (many of which were conditions or different approaches), then reviewed the list the next day.
At first, I felt like I needed to relearn everything from OT school before I could be ready, but that wasn’t possible given the deadline for my exam. Eventually, I started letting my practice questions determine what I reviewed. A big thing I focused on was reading rationales and using ChatGPT for more explanation when the given rationale didn’t click in my brain. I am also notorious for second-guessing answers and changing from right to wrong at the last second, so I made sure I understood the rationales and didn’t change any answers from what I originally thought unless I had an evidence-based reason to.
Toward the end of my studies, I realized I knew more content than I thought. My bigger problem was figuring out what the question actually wanted. I started mentally breaking questions down into Diagnosis → deficit → occupational problem → goal → stage of intervention → precautions → what is the question actually asking me to do?
I paid attention to words like FIRST, NEXT, BEST, MOST appropriate, INITIAL, PRIORITY, SAFEST. Sometimes, multiple answers could technically help the client. The question is asking which answer is best at that specific point in the OT process. That distinction helped me tremendously.
My weaknesses changed throughout my studies. At one point, Domain 3 was clearly my problem area, so I focused heavily on it. Later, my NBCOT practice results showed that Domain 1 had become weaker, so I shifted again. I stopped giving every topic equal study time. I'm also a very visual learner, so comparison charts and condensed visuals helped me WAY more than rereading giant sections of a textbook.
TherapyEd: I used this for difficult questions, content gaps, and challenging my clinical reasoning. The scores sometimes absolutely destroyed my confidence, lol, so eventually I stopped using the percentage as a readiness indicator.
AOTA: I really liked this for practice questions and identifying domain-specific weaknesses. This resource is really good for providing more condition-based reviews. The questions felt more straightforward to me than TherapyEd.
NBCOT StudyPack: I saved this until closer to my exam, which I personally think was helpful. It gave me experience with NBCOT-style questions and showed me how my performance was changing as test day approached. The jump from 438 → 463 also showed me how much a single practice score can fluctuate. If I could go back and do anything different, I would've started using this resource way earlier than I did.
Two days before, I took a 50-question mixed-domain practice mini-test. I felt like I was doing terribly, but I actually did pretty well, scoring around 80%. That helped me realize I was going to register wrong answers more often than right ones, and I needed to stop focusing on that.
The day before the exam, I did a lot of mindfulness/stress-reduction practice and positive affirmations. I also packed all my snacks and extra water, planned my outfit for the next day, and then went to bed early.
On the day of the exam, I felt very calm. I made sure I felt confident going in and that I would do the best I could. The biggest thing to remember is that you prepared for this; you can't cram any more learning. The only thing you can do is keep your stress down so your brain works better. After the exam, I felt good, but definitely started to spiral as the week went on. I checked a couple of answers I remembered and found I got them right, except for one. I also only changed 1 answer during the exam because I genuinely had no idea, but some clinical reasoning ultimately led me to the right answer after checking.
My biggest takeaways:
· Don't use someone else's practice scores as your passing prediction.
· A bad practice test is data, not a verdict.
· Doing questions isn't enough—study your reasoning.
· Know why the wrong answers are wrong, not just why the correct answer is correct.
· If you're constantly changing correct answers, work on your decision-making process rather than assuming you need more content knowledge.
· Let your weaknesses determine what you study next.
· You do not need to know every single OT fact to pass this exam.
· Feeling uncertain after the NBCOT does NOT mean you failed.
I spent so much time worrying because my scores didn't look like some of the scores I saw people posting online. So if you're currently staring at a practice score that has you convinced you're doomed, take a minute before you spiral. Figure out why you missed what you missed, adjust your studying, and keep going.
Good luck to everyone studying. ❤️ You know more than you think.
I’m scheduled to take my 4th attempt on the 16th. I restructured my way of studying for this thing. Working with a tutor, and have been using the NBCOT study pack practice tests to break them up into 20 questions a day.
Then I read chapters in Pedretti’s textbook and the TMPOT study guide to reinforce my understanding on topics that I don’t really understand . Then I end my sessions with 10-15 minutes review of the OTPF. Also do some active recall on weak topics as well.
So far four weeks in, I’m understanding the questions a little better and plan to take the full 180 practice on Monday. Hopefully everything transfers over to the real thing. I’m in need of a win 🤞🏾