MY SCORE WENT FROM 444, 447, 476!

First Attempt

I just wanted to start off by saying that you can and will pass the NBCOT!  I’ll start off by giving a little info into my back story. First attempt score 444- I utilized AOTA prep, Therapy Ed, and the Johnson purple book. I read all the AOTA pdfs and made a million flashcards. I took so many exams from all three sources with what people would say were “good” scores. Basically, all I did was focus on content, which was not good. I seriously took hundreds of questions but my biggest mistake was that I would not read the rationales. I personally thought that the more I took, the better, which is true to an extent. What I really needed to do was understand what the question was asking.

Second Attempt

Second attempt score 447- I took 2 months off because I had a vacation planned. I honestly feel that was the best because it forced me to focus on other things instead of trying to take the exam again.

I think it’s important to let yourself heal so that you don’t try to jump back in too quickly.

I came back and studied for two and half weeks. I spent a lot of time reviewing material that I felt I was weak in or what I thought was just important to know in general. I reviewed OT Miri’s videos and took some more questions and scored “well.” I even took the practice NBCOT exam and passed with a 472. Again, I was lacking the ability to really answer the question because I was getting distracted by all the information given in the question. I also believe that even though the vacation was beneficial, I did not prepare myself enough to take exam again so freshly back from my break.

Third Attempt

Third attempt score 476- I took about a week and a half off from my second attempt to give myself time to recover. I took more questions again, but this time, the difference is that I deconstructed it to really determine what they were asking me. I also studied with friend and that helped me to understand things better because it allowed me to talk it out. I felt like my friend and I were able to come up with a more logical and concise rationale because sometimes the rationale given in the study guide was confusing and was very “textbook.” I reviewed topics and watched Miri videos that I was weak in but instead of focusing on memorization, I focused on understanding it. I also began to focus more heavily on the clinical simulations which I previously did not put much emphasis on. This time I also purchased Pass the OT and utilized their tutoring services, which I found extremely beneficial to make sure I was on the right track.

TIPS for MC Questions

For the multiple choice questions, I used an acronym I came up with: DOCK. D stands for diagnosis, O for OT process, C for context, and K for key words. I used this to determine all the important information given in the question and went from there. For selecting the answer choices, I came up with:  SCOPE. I asked myself was the answer choice SAFE, CLIENT CENTERED, OCCUPATION BASED, POSITIVE, EFFECTIVE/ETHICAL.


  • D — Diagnosis
  • O — OT Process
  • C — Context
  • K — Key Words


  • S — Safe
  • C — Client Centered
  • O — Occupational Based
  • P — Positive
  • E — Effective/Ethical

Tips for Clinical Simulation 

For the clinical simulations, I also made sure to not get distracted by the extraneous information and focused on answering what they were really asking me. Another tip is to be careful with clicking “YES”. I know some people believe that it’s a good strategy to click “YES” when you are unsure because no matter what you will get feedback to help you answer future questions. But honestly, for me, it made my confidence go down to see “negative” feedback. It’s also important to realize that some of the “neutral” feedback may sound “negative” so don’t let that throw you off.

Another tip when selecting assessments for your clinical simulations, is to select assessments that identify the problem at hand or what is specifically mentioned in the scenario. However, also select assessments that may not be mentioned specifically in the scenario but is associated or indicative of the diagnosis. For example: A patient is chronically ill, has multiple co morbidities and recently fell. You would select a balance test because of the recent fall BUT you should also probably select a depression or mental health assessment. Even though it’s not clearly stated that this person is feeling down or depressive, you can infer that people who are chronically sick probably feel down about being sick or not being able to function as they normally do.

Eat dark chocolate!

I read it is supposed to help with memory and reasoning. Whether it’s a placebo effect or not, at least it tastes good 🙂

For Repeat Test Takers

BE PATIENT with yourself, do not try to jump back in when you’re not ready, consider studying with a buddy to bounce ideas around and to see things in a new light, and be confident in the fact that you know what to expect since you have taken it before (and there’s nothing wrong with that!). I also told myself while studying for the third time that if I have to take the exam again, it’s ok. People mistook it for me not being confident, but that’s not true. I think it’s way for you to realize that this is just a test. Of course it’s important but I think when you tell yourself it’s ok and that retaking it again is not the end of the world, you don’t put extra pressure on yourself.

Count the Ways that You are Lucky

Counting the ways that you are lucky can take some of the edge and pressure off as well. The more pressure you take off yourself will result in you being more confident. I also looked up a list of top lawyers who had to retake their bar exams multiple times and they turned out just fine. For example, Michelle Obama, Hillary Clinton, and Franklin D. Roosevelt were all repeat test takers! I know that everyone’s circumstances are different and life happens but I found that counting the ways that I am lucky helped me to boost my confidence in myself.

I hope all of this was helpful to anyone reading! I want to thank Miri for providing this forum to all of us to help one another pass this test and to thank her for reaching out to me and giving me the words of encouragement when I needed them most.

Warm regards,