Preparing for the NBCOT® exam can be stressful. But, with the right tools and a study plan tailored to meet your unique needs, you can successfully pass the exam and excel. In this article, I will share my experience and study strategies that helped me pass the NBCOT® COTA® exam on my first attempt with a 3-week study plan.


3 weeks | 6 hours per day | 7 days per week

I only studied for 3 weeks and passed, so yes, it’s possible. But, I treated my study session as if it were my job and was committed to studying approximately 6 hours per session, 7 days a week. I also had a big support system. My husband and my kids knew how important it was for me to study and pass so they provided the space and support for me to really prioritize my study sessions. But everyone is different and what worked for me may not work for you. The most important thing in determining your timeline is to assess your own unique circumstances to establish a plan that works best for you.


  • AOTA’s NBCOT® Exam Prep
  • The Therapy Ed book (Green Book) + CD 
  • All of my notes from class and my books
  • OT Miri’s YouTube videos

I primarily used the AOTA’s NBCOT® Exam Prep for content review and practice exam questions, averaging around 90% on practice exams. I did one Therapy Ed practice exam a couple of days before the exam and got 58%. I cried and thought I was doomed, but I ended up passing the exam with plenty of room to spare.



I began my preparation by first doing a serious evaluation of my own baseline and depth of knowledge using the AOTA’s PDFs. From there, I made a study plan based on my weak areas. For example, I knew that I had a strong working knowledge of pediatrics, so instead of spending my time on what I already knew, I made a study plan focused on mental health and neurological disorders like ALS, MS, the Allen’s Cognitive Levels, Rancho Los Amigos Levels and the Spinal Cord Injuries. The way I tackled the material was to first read each section of the AOTA’s PDF (1-2 sections per day) and take an online simulated exam only on that section to test my knowledge. If I did poorly, I reviewed the material again. Once I had fully learned the material, I moved on to the next topic.


After a week of studying on my own, a few of my fellow cohort friends and I decided to form a study group. We were all highly motivated to pass our first attempt and we each had different strengths in our knowledge base. We met a total of four times and took full exams in silence. After each exam, we compared our answers and defended our own rationale to the group as to why we thought our answers were correct. Through the group process of articulating and analyzing all the correct and incorrect answer choices, we were able to develop the critical thinking skills necessary to choose the best answer choice.


In addition to building critical thinking skills, having a study group was beneficial because it allowed us to assign a topic to each member of the group, who would then teach that specific topic to the rest of the group. This not only helped to divide up the amount of content each of us would have to review on our own, it also helped us to learn and retain the material more effectively. To solidify what I had learned at each study session, I came home taught the material to either my daughter or my husband. Then, I took another AOTA’s NBCOT® Prep simulated exam before going to bed.


When going through the AOTA’s NBCOT® Prep simulated exam, be sure to include the 6-option questions and get plenty of practice answering those questions. With practice, it will get easier. You can usually eliminate 2 of the answer choices right off the bat based on whether or not the answer choice is appropriate for the diagnosis. The challenge will almost always come down to the remaining two answer choices. This is where your clinical reasoning takes place. You really need to look at the question to see what they are they asking and identify the actual question. From there, ask yourself if the answer choice is safe. What is the diagnosis? Are there precautions or contraindications I should be aware of with this diagnosis? If so, do any of those choices break those precautions? If so, eliminate it!  If not, keep it! Think safety first and always.

Other Considerations

  • Know the NBCOT score release dates — I am not the most patient person in the world, so waiting weeks for my results would have driven me crazy.  I checked the NBCOT® score release dates to make sure I took my exam 3 days PRIOR to the next release and even then, it the longest 3 days of my life. 
  • Visit the prometric center prior to testing day— I went to the prometric location the week before on the Monday so I could see what traffic was going to be like on the day I went. I didn’t want any surprises on test day.
  • Bring snacks — I brought a banana and water with me to drink on my self-imposed break at 100 questions. I was told to bring those by my fieldwork instructor because she brought those for her and they were good luck for her. I figured I needed all the help I could get
  • Wear comfortable clothes — I wore my favorite jeans, t-shirt and Birkenstocks. No socks- they did check my feet though, which was weird.

Final Words

Take a deep breath. Relax. Sounds like I am being blasé, but if you are reading this, you have already made the most important step forward in your journey — finishing school. You truly do know more than you think. Before you know it, you will be looking back on this day as a distant memory, giving advice to new grads that have the same fears that you once had and helping others reach their full potential.