a u d i oc r a s hc o u r s e tm
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NBCOT - OTR
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TABLE OF CONTENTS Exam Prep Audio Course for National Board for Certification in Occupational Therapy - Occupational Therapist Registered ........................ 1 Introduction: What is the National Board for Certification in Occupational Therapy .. 1 Course Content................................................................................................................. 1 Course Conventions ......................................................................................................... 3 Follow Along PDF Manual ............................................................................................... 4 Quizzes ............................................................................................................................. 4 The Key Takeaways .......................................................................................................... 6 Chapter One: The National Board for Certification in Occupational Therapy (NBCOT) ....................................................................................... 7 Who Are They? ................................................................................................................. 7 Mission Statement – Vision ............................................................................................. 7 What is Their Role?.......................................................................................................... 8 Exam Development ........................................................................................................ 10 Practice Analysis Studies ............................................................................................ 10 Practice Studies Analysis COTA and OTR .................................................................. 11 Exam Development and Construction ........................................................................... 11 Item Development ...................................................................................................... 12 Review ............................................................................................................................ 14 Quiz ................................................................................................................................ 16 The Key Takeaways .........................................................................................................17 Chapter Two – What Does it Take to be an Occupational Therapist? ......... 18
Characteristics................................................................................................................ 18 Skills ............................................................................................................................... 22 Lifestyle .......................................................................................................................... 23 Job Opportunities .......................................................................................................... 24 Pay scale ......................................................................................................................... 24 Education Opportunities ............................................................................................... 25 Review ............................................................................................................................ 26 Quiz ................................................................................................................................ 27 Takeaways ...................................................................................................................... 28 Chapter Three: Being an Occupational Therapist ...................................... 29 What do occupational therapists do? ............................................................................ 29 Where do they work? ..................................................................................................... 31 Responsibilities .............................................................................................................. 34 Specialties....................................................................................................................... 35 Review ............................................................................................................................ 37 Quiz ................................................................................................................................ 39 The Key Takeaways ........................................................................................................ 40 Chapter Four - Eligibility Requirements for Taking the Exam. .................. 41 Education in United States ............................................................................................ 41 Education abroad ........................................................................................................... 41 Purpose of the OTR and COTA Exams .......................................................................... 42 General Eligibility Standards ......................................................................................... 42 Character Review ........................................................................................................... 45 Early Determination Review.......................................................................................... 47
Review ............................................................................................................................ 47 Quiz ................................................................................................................................ 49 The Key Takeaways ........................................................................................................ 50 Chapter Five – Applying for the Exam ....................................................... 51 Application Process ........................................................................................................ 51 Eligibility Confirmation Notice ..................................................................................... 54 Authorization to Test Letter .......................................................................................... 55 Making a Name Change ................................................................................................. 57 Application Withdrawal and Refund for Personal or Medical Emergencies ................ 58 Fees................................................................................................................................. 59 Testing Accommodations .............................................................................................. 60 Review ............................................................................................................................ 60 Quiz ................................................................................................................................ 62 The Key Takeaways ........................................................................................................ 63 Chapter Six - Preparing for the Exam ........................................................ 64 Exam Blackout Period.................................................................................................... 64 What the Tests Looks Like ............................................................................................. 65 How to Prepare for a Multiple Choice Test ................................................................... 66 Exam Content Prep ........................................................................................................ 69 OTR Outline Domains ................................................................................................... 70 COTA Outline Domains ..................................................................................................71 Length of Preparation Time ........................................................................................... 72 Tools ............................................................................................................................... 73 Review ............................................................................................................................ 74
Quiz ................................................................................................................................ 76 The Key Takeaways ........................................................................................................ 77 Chapter Seven – The Day of the Exam ....................................................... 78 Starting the Day ............................................................................................................. 78 Identification .................................................................................................................. 79 Test Sites ........................................................................................................................80 Exam Rules ....................................................................................................................80 Time................................................................................................................................ 82 The Tutorial.................................................................................................................... 83 Review ............................................................................................................................ 84 Quiz ................................................................................................................................ 86 The Key Takeaways ........................................................................................................ 87 Chapter Eight OTR Practices Occupational Therapist Registered .............. 88 Exam Content Outline ................................................................................................... 89 Domain One ................................................................................................................... 90 Tasks ........................................................................................................................... 90 Knowledge .................................................................................................................. 91 Domain Two ................................................................................................................... 92 Tasks ........................................................................................................................... 92 Knowledge .................................................................................................................. 92 Domain Three ................................................................................................................ 94 Tasks ........................................................................................................................... 94 Knowledge .................................................................................................................. 95 Domain Four .................................................................................................................. 97
Tasks ........................................................................................................................... 98 Knowledge .................................................................................................................. 98 Review ............................................................................................................................ 99 Quiz ...............................................................................................................................101 The Key Takeaways ...................................................................................................... 102 Chapter Nine COTA Practices .................................................................. 103 Domain One ................................................................................................................. 104 Tasks ......................................................................................................................... 104 Knowledge ................................................................................................................ 105 Domain Two ................................................................................................................. 106 Tasks ......................................................................................................................... 107 Knowledge ................................................................................................................ 107 Domain Three ...............................................................................................................110 Tasks .......................................................................................................................... 111 Knowledge ................................................................................................................. 111 Review ........................................................................................................................... 112 Quiz ............................................................................................................................... 114 The Key Takeaways ....................................................................................................... 115 Chapter Ten – Exam Topics Medical Content ........................................... 116 Some Basics an OTR and COTA Need to Know ........................................................... 117 Systems of the Body ...................................................................................................... 117 Potential Exam Topics .................................................................................................. 119 Types of Reflexes ........................................................................................................... 119 Developmental Milestones ........................................................................................... 121
AOTA Ethical Standards ............................................................................................... 121 The Glasco Coma Scale ................................................................................................ 123 The Ranchos Los Amigos Scale ................................................................................... 124 The SCI Levels .............................................................................................................. 126 GAF Scale ......................................................................................................................127 Review .......................................................................................................................... 128 Quiz .............................................................................................................................. 130 The Key Takeaways ....................................................................................................... 131 Chapter Eleven: After the Exam .............................................................. 132 Scoring Results............................................................................................................. 132 Certification.................................................................................................................. 132 License.......................................................................................................................... 134 Renewal ........................................................................................................................ 136 Review ...........................................................................................................................137 Quiz .............................................................................................................................. 139 The Key Takeaways ...................................................................................................... 140 Chapter Twelve: Conclusion ..................................................................... 141 Review ........................................................................................................................... 141 Practice Exam .............................................................................................................. 143 Promotional Material Introduction to NBCOT Exam Prep....................... 145
EXAM PREP AUDIO COURSE FOR NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY -
OCCUPATIONAL THERAPIST REGISTERED INTRODUCTION: WHAT IS THE NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY Welcome to your audio course on the National Board for Certification in Occupational Therapy exam preparation! From this point on, I will refer to the Board as NBCOT or, simply, the Board. I will call the Occupational Therapist Certification “OTR or COTA.” It depends on which actual exam you plan on taking, but more on that later. By the way, all of these designations are registered trademarks of NBCOT. I will guide you through the course. If you are listening, you may have just finished your occupational therapy training and want to become a licensed professional. Maybe you are thinking about your future and considering different career paths that interest you. Whatever the reason, we are glad you chose us at AudioLearn to guide you.
COURSE CONTENT First off, I want to provide you with a brief overview of the course. The material I present will cover the basic things you need to know to succeed on your boards your certification exam. You will pair up this information with what you learn or have learned in your studies. In this introductory chapter, I will tell you a little about NBCOT and OT certification. I will cover what the board is and what they do in depth in Chapters One and Two following this one.
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In Chapter Three, I will talk about what it takes to be an occupational therapist. What are desirable personality traits for an occupational therapist, and what kind of education and training will you need? I will also cover the Certified Occupational Therapy Assistant or COTA. Please note that when discussing the certified occupational therapist, the official title is Occupational Therapist Registered. I know it sounds a little funny, but I will use the official title. So, you will hear OTR to designate the therapist who is certified and COTA for an assistant. As you will discover a bit later, these are two similar positions and exams, but they are not the same thing. Chapter Four is where I cover the roles and responsibilities of occupational therapists and where they work. In Chapter Five, you will get an overview of what is on the exam this includes the validated domains, tasks, and knowledge of occupational therapy. In Chapter Six, I will tell you how to apply for the exam; in Chapter Seven, you will learn how to prepare for the test. Chapter Eight covers everything you need to do on test day as well as general information about taking multiple choice tests. The following few chapters outline the nitty gritty of what is on the exam. That is the actual content and what you should be studying. In Chapter Nine, I will discuss the COTA or Certified Occupational Therapy Assistant domains, tasks, and knowledge requirements for the exam. Chapter Ten covers the same information for the Occupational Therapist Registered or OTR. I will discuss the domains, tasks, and knowledge. Chapter Eleven is where I will cover what you do after the test and how to get your certification and license. Chapter Twelve closes out the course with a conclusion and a one hundred and seventy question practice final exam for OTR. Then there are two clinical simulation questions for OTR . Finally, there is an additional thirty question exam for the COTA.
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For the rest of this chapter, will discuss how the course will work and the chapter quizzes you can expect. I will also talk about your companion study guide that we like to call the Follow Along PDF Manual. So, if you are ready, let me get right into it.
COURSE CONVENTIONS Here, now, is a brief word about how to get the most from this course. Right off the bat, I want to give you some important information: As this course was in production, we were still under the effects of many changes cause by the Covid Nineteen Pandemic. The timelines I present to you in this audio course will be those for normal circumstances. So, when you are about to begin your registration process, understand this: lingering Covid restrictions may or may not have an effect on times and dates. Please look into this and plan accordingly. Now, back to the course conventions. I would strongly suggest that you listen to the audio lectures more than once. Listen at least twice, three times if you can. Throughout the chapters, I am likely to repeat some points more than once. These will be important points to remember as you prepare for your boards. There may be keywords or phrases that you will need to understand and remember. I will repeat those, and I will remind you of why I am doing so. This audio course offers you a great deal of material. You will soon understand why I have said you need to listen to the lectures more than once. You need to listen to the audio and follow along with the PDF manual whenever possible. This course is divided into several chapters; you heard me give a rundown of them a bit earlier. Many of these chapters are split into smaller sections. Each time I start a new section or chapter, I will give you its name. I will give you a short recap of the material I discussed and a ten question quiz near the end of each chapter. I will close out every chapter with a list of the most important things to remember from the chapter. In this course, I will refer to those key points as takeaways.
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FOLLOW ALONG PDF MANUAL Depending on where you are listening to my lectures, you can use the Follow Along PDF Manual. This is a staple of AudioLearn’s test preparation courses. Using this companion study guide is the ideal way to prepare for your exam. I know you might listen to lectures when in the car or while exercising. So, the study guide will not always be available to you or practical to use. But make a point to listen with the PDF manual on hand at least once through the entire course. You can print out the manual or enjoy the digital version. That’s up to you. The manual contains summaries of all the essential material I discuss in the lectures. It also includes links to supplemental material and content outlines for every exam level. The practice final exam in its entirety is also in the manual. Every test preparation course comes with a mock exam to help you measure your progress. Use your exam results to target future prep time. Focus on areas where you struggle.
QUIZZES The chapter quiz questions can be found in your Follow Along PDF Manual. There are answer keys so you can see how you did. I will also go over the questions and answers in the lectures. You can pause the audio, take a quiz, and find the correct answers using the answer key. You can also resume the audio and listen for the correct answers if that works for you. If you feel really confident, keep the audio running and take the quiz as I read it to you. A word of caution, though: your time to answer questions will be more limited with this method. You may have to keep pausing the audio to remember or revisit all the answer choices. Use the quizzes to learn about the question formats and how to correct your responses. If you plan to keep the audio running, listen carefully to the question and potential answers. I will read the question twice and then pause a bit for you to produce your answer. I will then give you the correct response. Even if you correct your quizzes from the answer keys in the manual, listen to the correct responses anyway. It is a wonderful way to review the course content.
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When you correct a quiz, make a note of the items that you struggled with. You can even make notes in your Follow Along PDF Manual. This will be essential information as you continue with your preparation. You will know where to focus your efforts.
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THE KEY TAKEAWAYS Well, that wraps up the very first lecture. Because this chapter was just an introduction, there is no quiz. That is not to say that what I presented is not important. There are some essential points to remember from this introductory material. So, here are your ten takeaways: 1. I will refer to the National Board for Certification in Occupational Therapy as NBCOT. 2. The Occupational Therapist Certification will be referred to as OTC. 3. The Occupational Therapist who has their certification will be referred to as Occupational Therapist Registered OTR. 4. The Certified Occupational Therapy Assistant will be referred to as COTA. 5. The course content will cover the basic things you need to know to succeed on your boards. 6. You can print the Follow Along PDF Manual if you wish or use it in its digital form. 7. Listen to each of these lectures at least twice, more if you can. 8. Consult the Follow Along PDF Manual whenever you can. 9. The course is divided into chapters, and each chapter is divided into smaller sections. 10. There is a ten question quiz near the end of every chapter. Remember, the goal is to prepare you to take and pass the exam and get your license. Please take advantage of every resource we provide. So, with that said, thank you again for choosing us to guide you. Are you ready to get started? If so, come along as I begin chapter one. If you would like, take a break and continue when the time is better for you. Thanks for listening.
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CHAPTER ONE: THE NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY (NBCOT) Welcome to Chapter One of this audio course on preparing for the NBCOT certification exam! Again, I am your instructor for the course. In this chapter, I will talk about the who the NBCOT is and what they do. I will tell you about their mission statement, vision, and their statement of ethics. So, if you are ready, let’s start right in.
WHO ARE THEY? The NBCOT is a nonprofit organization charged with certifying occupational therapists and their assistants in the United States. It is the credentialling agency for the professionals in the field. The agency is responsible for the certification process from beginning to end. It develops, administers, and regularly reviews the process for certifying members of the profession. It sets the standards for the field and assures that members are current with the best available practices. Finally, the NBCOT develops and administers the certification exams both the COTA and OTR. To perform this service, the NBCOT works directly with the states to regulate, certify, and license occupational therapists. The agency informs the state regulators about required credentials, proper conduct, and regulations for licensing the profession. NBCOT has become the provider of the world’s standard for certifying occupational therapists.
MISSION STATEMENT – VISION According to the NBCOT this is a direct quote of their vision a link to the entire statement is found in your Follow Along PDF Manual on page six.
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“To be internationally recognized, by all relevant stakeholders, as the premier organization for certifying occupational therapy practitioners.” The agency is headquartered in Gaithersburg, Maryland and has about thirty to forty employees. It was founded in nineteen eighty six. Every state in the US requires an initial certification from NBCOT before they will grant a license to an occupational therapist. This is true as well in Puerto Rico, the District of Columbia, and Guam. Because they are associated with years of exemplary service by the NBCOT, certifications are accredited by the American National Standards Institute or ANSI. The Board also received an accreditation from the National Commission on Certifying Agencies or NCCA. A board of directors governs NBCOT ; this board is made up of professional Occupational Therapists Registered. Members of the public and Certified Occupational Therapy Assistants are also board members. This board provides the management and the strategic vision for the agency. Board members are nominated and elected by the OTR and COTA members. NBCOT maintains complete impartiality in their duties regarding the certification process. A link to their impartiality statement can be found on page six of the follow along PDF manual. In general, the statement acknowledges the importance of impartiality in the certification process. The procedures, policies, and structure of the organization itself are designed to handle any conflict of interest claims. They ensure that the process is objective for everyone.
WHAT IS THEIR ROLE? NBCOT is also responsible for maintaining a professional code of conduct and ethical behavior by occupational therapists. Their job is to promote these standards and ensure that they are maintained by every therapist. This code of conduct must be followed by every certified occupational therapist and any applicant for the exam. Professionals and “would be” occupational therapists must disclose any disciplinary action, as well as legal or criminal actions against them. The
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code requires that they do so within sixty days of the violation. To report such violations, notify the agency by email. NBCOT also produces and enforces the “Procedures for the Enforcement of the NBCOT Code of Conduct.” The Board has jurisdiction over and can sanction occupational therapists who are currently certified. This group includes those: •
who have applied for OTE-D- Office of Training and Development at the FDA or Food and Drug Administration.
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who have applied for certification;
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and who have applied for Early Determination Review or -E-D-R-.
The NBCOT develops and maintains the practice standards for OTR and COTA. These standards are the quality standard baseline for occupational therapy. I will talk about them in greater detail in a later chapter. The standards are what the organization expects from professionals in the OT field; they are used by many administrators to evaluate their occupational therapy professionals and to recommend development and discipline. In this regard NBCOT is responsible for maintaining a list of any disciplinary action they take. This is called the NBCOT Disciplinary Action Summary. NBCOT has authorization from the United States Citizenship and Immigration Services to grant Certificates for Health Care Workers. They can grant these certificates to occupational therapists entering the country to practice professionally. The credential is called a Visa Credential Verification Certificate, or VCVC. There is a five hundred dollar fee for this service. A VCVC must be renewed every five years, and the therapist must notify NBCOT if their immigration status changes. You should apply to renew your VCVC at least three months in advance. If you need a duplicate certificate, you can submit a VCVC Duplicate Certificate Request Form. This will cost one hundred dollars. If you live in the digital world and want a digital version of the paper certificates, NBCOT has them. These digital certificates are called badges, and you can put them on
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your digital sites and social media to display your credentials. You can earn digital badges when you: •
Pass the certification exam;
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Renew your certificate;
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Renew using a Practice Area of Emphasis;
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Become an NBCOT volunteer;
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Use the NBCOT program called Navigator to earn the maximum Competency Assessment Units.
The Navigator program is available through your “MyNBCOT” account.
EXAM DEVELOPMENT PRACTICE ANALYSIS STUDIES Perhaps the most important function of the NBCOT and the reason for this audio course is the development of the certification exam. Much like other professional organizations, NBCOT bases the COTA and OTR exams on a set of practice studies analysis results. These practice studies analysis results ensure that the content of the exam has a direct link to the best practices out in the field. The analysis sets out the domains, knowledge, and tasks required for an occupational therapist to become certified. These studies allow the NBCOT to evaluate the validity of the test and direct the Board when it must make changes to the exam. The content of the exam is fully guided by these studies which, again, validate the specifications of the test. The most recent revalidation was in twenty seventeen; it changed very little from the twenty twelve analysis. The study did, however, confirm that the domains, tasks, and knowledge statements would be clear and understandable to the candidates. It streamlined the outlines and eliminated redundancy. It also made sure the exam would reflect the actual practices in the field. This review did not change any of the knowledge required of the candidates.
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This latest review has been in effect since twenty nineteen and has dictated the standards for all exams given in that time period. Both the COTA and OTR have their own practice studies analysis, content outlines, and exams. I will discuss these content outlines in a later lecture. Each of the outlines sets out the domains, associated tasks, and knowledge statements that are covered on the exam. They also inform candidates as to how much of the exam is devoted to what areas; this is expressed as a percent.
PRACTICE STUDIES ANALYSIS COTA AND OTR The format that NBCOT uses for the practice studies analysis is the same for both COTA and OTR. They send out a practice data survey to a large number of entry level practitioners in the field. These practitioners are asked to evaluate the importance and frequency of each task and knowledge statement in their practice. They are also asked to recommend the percentage of the exam that should be dedicated to each domain area. Finally, this group of practitioners is asked to include on their reviews, any practices the survey did not cover. The results of all these surveys are compiled into the exam content outlines. The task statements in the OTR content outline were reorganized based on feedback from the practice studies analysis; the Board reduced the number of knowledge statements from sixty to fifty five. The results for the COTA content outline resulted in the same type of reorganization of task statements. For the COTA, knowledge statements were reduced from fifty seven to fifty two. NBCOT is required by external accreditation standards to conduct a practice studies analysis every five years. This ensures that the certification exams follow the current entry level standards for occupational therapists.
EXAM DEVELOPMENT AND CONSTRUCTION As NBCOT develops the certification exam, they follow the technical guidelines published by several of the nation’s oversight organizations. These include:
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Association of Test Publishers;
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Institute for Credentialing Excellence;
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American Educational Research Association;
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National Council on Measurement in Education;
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American Psychological Association.
NBCOT’s test administration and development procedures also follow sections of the Uniform Guidelines for Certifying Agencies that are relevant to their certification. The Board is accredited with both the American National Standards Institute and the National Commission for Certifying Agencies. Both oversee NBCOT’s adherence to their specific standards for assessments like the practice analysis studies. Having met all required standards, NBCOTA- constructs both the COTA and OTR certification exams using both scored and non scored items. Once the studies are complete and the exam content outlines developed, NBCOT selects the areas for the exams from the outlines. The areas tested are in proportion to the percentages established for each area in the outlines. Each of the scored questions are then field tested and developed into the actual exam. Then, a group of subject matter experts reviews and validates the exam. This group’s primary task is to ensure that the exam matches the current practice in the field for entry level occupational therapists. Subject matter experts are also asked to develop any new domains, tasks, or knowledge statements that they feel are missing. Both the survey group and these subject matter experts are recruited according to the accreditation standards of the NCCA. These standards define the demographic makeup of the subject matter experts. The group must represent the actual breakdown of practitioners by ethnicity, practice experience, gender, and geographic region.
ITEM DEVELOPMENT As the group develops the exam one item at a time, there is a responsibility to ensure fairness. It is the job of NBCOT to make sure the exam is readable. They must ensure 12
that the terms used are universally understood and accurate. The final version of the exam must use neutral language. •
Other areas for assuring fairness in the test include:
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Tying the test items to published references used in occupational therapy;
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Eliminating any bias or stereotyping in the items;
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Testing all items in the field before including them on the exam;
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Making sure all items are coded to the exam content outline;
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Using subject matter experts who are active occupational therapy practitioners from both COTA and OTR;
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And subject matter experts are selected from diverse practice experiences, cultures, and geographic areas.
This same ethic of fairness runs through the entire exam and certification process. As the exam is developed and the process is administered, NBCOT ensures fairness by using standard procedures. These procedures are used to govern registration, accessibility, test proctor roles, and test security. Other ways that fairness is maintained include assuring confidentiality, scoring accuracy, and timely reporting of results. Just as fairness is considered essential, so is quality control. The importance of the exam being accurate to the current practice of therapy cannot be overstated. In dealing with the careers and career aspirations of many, NBCOT needs to be sure they get it right. Quality control is exercised over the entire process, from practice studies analysis to reporting your test results. Each exam produced by the agency must be characterized by validity of content, reliability, integrity, and fairness. Quality control assures that all versions of the exam have the same content. Every item on each version is validated by subject matter experts. In the end, the exam scoring uses a statistical process employed throughout the industry for professional testing. Once a passing standard is established, it cannot be changed. This standard is consistent over time no matter which version of exam is considered.
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As I previously mentioned, the NBCOT exam includes scored and non scored items. The non scored questions are field testing items. These items have performance data analyzed to determine their validity and reliability. The information obtained from non scored items helps determine how or if the items will appear on future versions of the exam. When taking the exam, the candidate cannot tell which items are scored and which are not. These unscored items are collected and reviewed with predetermined psychometric measures. When a field tested question meets the psychometric standards, it goes into the pool of items for future scored questions. If a question does not meet the metrics, it is reviewed, revised, and field tested again. To ensure both fairness and quality control, Item Response Theory methodology is used to analyze test items. Using this information when developing the exam questions helps the developers assure that they choose appropriate items. NBCOT uses these metrics to ensure the exams are reliable and valid from year to year. Using these metrics lets the agency provide performance feedback to the candidates quickly.
REVIEW Right now, let’s review what you have learned before I present your ten question quiz. The NBCOT is a nonprofit organization charged with certifying occupational therapists in the United States. The Board develops the standards for the field and assures that those standards are current with the best available practices. Finally, they develop and administer the certification exams for both the COTA and OTR. The procedures, policies, and structure of the organization itself are designed to handle any conflict of interest claims. They ensure that the testing process is objective for everyone. The NBCOT is responsible for the Practice Standards and Code of Conduct for occupational therapists. They also handle discipline through their Procedures for Enforcement.
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The most important function of the NBCOT and the reason for this audio course is the development of the certification exams. Results from the analysis set out the domains, knowledge, and tasks required for an occupational therapist to be certified. NBCOT is required by external accreditation standards to conduct practice analysis studies every five years. Each exam produced by the agency must be characterized by validity of content, reliability, integrity, and fairness. Scoring of the exams uses a statistical process employed throughout the industry for professional testing. The NBCOT exam includes scored and non scored items. The non scored questions are field testing items.
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To download the audio version of this course, please visit our website WWW.AudioLearn.com
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