The National Board for Certification in Occupational Therapy, Inc. (NBCOT) offers the Certified Occupational Therapy Assistant (NBCOT-COTA) examination for certification purposes.
Before a candidate can take this test, he or she must have successfully completed an accredited academic program for occupational therapy, finished the necessary experience obligations, turned in an application and gotten the go-ahead from NBCOT for the test, provided documentation from a school registrar regarding the candidate’s eligibility and signed the code of conduct.
The criterion-referenced test is computer-based. At the beginning of the test, the candidate will have 15 minutes to finish a tutorial about taking this examination. This time is not counted towards the total time of 4 hours for the whole test. The exam has 200 multiple-choice questions in all. Of these, 30 questions are pre-trial questions and will be used on future exams. The rest of the questions will be totaled for the raw score. Candidates can flag questions as they go and return later to any questions for review or alteration. Candidates can go back and change answers as many times as they want, as long as time remains. If a candidate leaves a question unanswered, it will not count towards the score.
The test content is broken down as follows:
- Assess persons or people to find out what is required in terms of occupation-based intervention – 12%
- Build up intervention strategies that speak to the occupational requirements of a person or people – 22%
- Put into practice occupationally significant interventions with a person or people that support participation in pertinent environments – 50%
- Provide occupational therapy services that speak to the occupational performance requirements of groups of people – 9%
- Run, sort out and endorse occupational therapy services – 7%
The candidate’s raw score will be converted to a final scaled score which will be in the 300-600 range. The minimum passing score is 450. If the candidate passes, he or she will get the score, a certificate and a wallet card. If unsuccessful, the candidate must wait 45 days before taking the test again.
NBCOT Test Video Review
NBCOT-COTA Practice Test
1. Which of the following is an appropriate assessment for stereognosis?
A. Ask the client to look at items on a table, estimate distance, and pick up specific items
B. Ask the client to place items in specific positions by giving directional guidance
C. Cover the client’s eyes, and then ask him to identify objects by feel
D. Demonstrate and practice a route to a destination, and then ask the client to go to that place
2. A COTA is conducting a functional assessment of range of motion (ROM). Which of the following is NOT part of the functional assessment of ROM of the hip?
3. A client must wear a wrist-immobilization splint, but the splint tends to migrate as the client moves her fingers and elbow. Which of the following initial measures is indicated to reduce friction force and migration?
A. Change the size of the splint
B. Cover the skin with a stockinet or elastic tubular bandage (such as TubigripTM)
C. Increase the number of straps securing the splint
D. Tighten the straps securing the splint
4. A COTA working with a child with a learning disability and using an approach based on the model of human occupation (MOHO) would focus on:
A. Exploring sensory organization
B. Exploring person, occupation, and the environment
C. Exploring volition, habituation, and capacity for performance
D. Exploring process rather than skills
5. A COTA is helping to determine the best method to reduce panic attacks, based on best evidence. After posing the clinical question, which is the next step in evidence-based practice?
A. Conduct literature review and clinical assessments to gain evidence
B. Evaluate the validity of the evidence
C. Summarize and synthesize information
D. Monitor results
NBCOT COTA Practice Test Answers and Explanations
1. C: Assessment for stereognosis includes covering the client’s eyes and asking him to identify items using only the sense of touch. Clients should be able to identify an item within five seconds. The COTA should note the amount of time it takes the client to identify an item and whether or not he names the item properly. Items used for the assessment should be common items found within a client’s home, such as coins, cards, eyeglasses, eating utensil, keys, and pencils. During the intervention, the client first looks at and feels the object, and then he tries to identify it with his eyes covered.
2. D: Pronation is not part of the range of motion (ROM) of the hip. A functional assessment of ROM requires that the joint be manipulated through all possible movements:
- Hip: Flexion and extension, abduction and adduction, internal and external rotation.
- Knee: Flexion and extension.
- Shoulder: Flexion and extension, internal and external rotation, abduction and adduction, horizontal abduction and horizontal adduction.
- Elbow: Flexion and extension.
- Forearm: Pronation and supination.
- Wrist: Flexion and extension, radial and ulnar deviation.
- Foot/ankle: dorsiflexion and plantarflexion, inversion and eversion.
- Hand/fingers: Flexion (MCP, PIP, DIP), extension (MCP, PIP, DIP), abduction, and adduction (MCP).
- Thumb: Flexion and extension, opposition, abduction, and adduction.
3. B: Some migration is normal with movement because of the friction force between the skin and the splint. Often, covering the skin with a stockinet or elastic tubular bandage (such as TubigripTM) will be sufficient to reduce the friction force that results in movement (kinetic friction). Friction force relates to both the coefficient of fiction (depending on the material) and contact force (the degree of securing and tightening). The friction coefficient of a splint may be increased by lining the splint with foam or applying additional straps, which increases the force of the contact.
4. C: The model of human occupation (MOHO) explores a client’s volition, habituation, and capacity for performance. Volition relates to the child’s motivation to learn and the type of choices the child makes. Habituation reviews the productive and dysfunctional habits that the child has developed in relation to learning. Capacity for performance evaluates the child’s ability to learn based on mental and physical capabilities as well as sensory capabilities or impairment. Other models include:
- Canadian model of occupational performance: Explores aspects of the person, occupation, and the environment.
- Sensory integration model: Explores sensory organization.
- Occupational adaptation model: Explores the process rather than focusing on particular skills.
5. A: Evidence-based practice begins by (1) posing a question to which there is an answer, (2) conducting a review of literature and clinical assessments to gather evidence, (3) evaluating both the usefulness and validity of evidence derived from literature review and clinical assessments, (4) summarizing and synthesizing results, (5) communicating with all those involved, (6) utilizing findings to change practice, and (7) monitoring the results of the new practices to determine if they need to be modified in some way and evaluating overall effectiveness.
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