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Excellent Test Taking Tips

Most of the time, students have a difficult time breaking down the question to understand what the question is really asking. They often have difficulty choosing the correct answer after eliminating all but two choices.

When taking the test, make sure to read the question carefully and pay attention to key words, such as “most important, next, and initial.” Also, remember safety first, client centered, and occupation based. For the most part, you can easily eliminate two choices and decide between the other two answer choices, keeping in mind the tips above. Don’t get caught up in the details.

Below are 8 unique tips that could be quite useful to you.

Consider only the information that is in the question.

  • Do not read content into the question; simply apply what you know, in order to answer it
  • Read each question carefully. Ask yourself, “What is this question really about?”
  • What stage in the occupational therapy process are you in? (i.e., screening, evaluation, intervention, or discharge).
  • What is the practice setting? (i.e., acute, in-patient, outpatient, or home health).
  • What is the condition? (i.e., distal radius fracture, Parkinson’s, autism).
  • Identify the key words in the question stem (i.e., BEST response, INITIAL action, NEXT step).
  • Decide whether each option is correct or incorrect. Remember, for multiple choice, each response will be plausible, but only one choice will be correct.

Acronym to decipher any question (DASHBOARD):

DIAGNOSIS – diagnosis/diagnoses
Ask yourself: What can I expect based on the diagnosis/diagnoses?
E.g. TBI – you can expect both physical and cognitive difficulties (personality changes, loss of inhibition, depression, visual perceptual difficulties, mobility issues, difficulty with ADLs)
If there is more than one diagnosis/deficit, your answer should address all diagnoses/deficits.

AGE – age of the patient (baby vs. senior)
Ask yourself: What stage of life is the patient in?
This will help you decide on which approach you should use for this patient.
E.g. A child with CP has the possibility of making progress due to plasticity of the brain. Whereas, an adult with Alzheimer’s disease is not able to make progress in their functional and cognitive abilities.

SETTING – inpatient, outpatient, cardiac rehab unit, psych ward, schools etc…
Ask yourself: Where am I assessing/ treating the patient?
E.g. A patient in an inpatient unit would typically need acute intervention whereas, a patient in an outpatient setting would need long term rehabilitation.

HOW – what are your goals
Ask yourself: How can I help this patient?
E.g. Splinting to reduce spasticity, energy conservation techniques for a patient undergoing cardiac rehab …

BEST CLINICAL JUDGEMENT – using your clinical judgement will help you decide on the best type of intervention
Ask yourself: What is the best intervention for the patient in order to achieve your and their goals?

OT PROCESS – Consultation, screening, evaluation, goal setting, intervention, or discharge
Ask yourself: At what stage is this scenario taking place?
E.g. A screening is not an in depth evaluation, therefore using a standardized assessment is not indicated.

ACTIVE PARTICIPATION – intervention should always be client based.
Ask yourself: What meaningful intervention can I select to ensure that the patient actively participates in the therapy process.
E.g. If it has been identified that the patient enjoys a particular type of activity, then choosing the same type of activity as part of your intervention is likely to entice the patient to be actively involved in their treatment.

READ CAREFULLY – read question and all answer choices
Before answering a question, read through the question carefully – make sure you understand what is being described and what is being asked of you. Read each answer choice to understand what your choices are.

If you are asked for a recommendation then you need to only give a recommendation.

DESCRIPTIVE WORDS – take note of words such as best, most, next…
This is crucial in determining your answer.
E.g. if you are asked for the best, this usually indicates that more than one answer is correct and you need to select the BEST answer.

For all questions: Remember all interventions should be client centered and occupation based, and the patient should be kept safe at all times.

  • Technique to eliminate wasted time

If you are a visual and kinesthetic learner, you can mark your white board with several A, B,C,D’s in a vertical line. If you know that an answer choice is not correct, you can simply cross off that letter. You can also use this technique with your fingers. For example, A is your pointer finger, B is your middle finger, C is your ring finger, and D is your pinky. When you know that an answer choice is not the correct answer, flex the finger into your palm. This will eliminate wasted time and help you focus on the best two answer choices.

ABCD method for treatment goals and objectives.

  • A-audience- Who is it for (i.e., patient)
  • B-behavior- What are the goals and objectives
  • C-condition details
  • D-degree- time frame to have goals met

Formulate an answer before looking at the options.

After reading the question and highlighting the important information, try formulating an answer before looking at the options. If your answer is not in the options, try looking for an option that is most similar.  For example: If the question is about a patient in Acute Cardio Rehab and the question is asking what to do first and you come up with “check vital signs” but the closest answer choice says, “check orthostatic hypotension tolerance” then that is probably the answer.

Go with your gut instinct

The majority of the time the 1st answer choice that you think is correct, is correct.
Only change your answer if you are 90% sure that you chose the wrong one by accident

Spend no more than 1:30 per question.

It is better to focus on a particular question, than flagging it and coming back to review, toward the end of the exam. This can waste precious time.

What to write on your white board before the test starts,

write down on your white board any topics that you have memorized that you do not want to forget. You may want to list  Rancho Scales, Allen’s Cognitive Levels, pediatric development, etc.

THE ULTIMATE TEST TAKING TIPS

UNDERSTANDING THE QUESTION
LOOK AT EACH QUESTION AS A STORY.

Summarize what you are being asked in the core question.

 Use your own word to summarize the scenario/story.

Do not insert any additional information into the question.
– only use the information that is directly provided to you.
– don’t add to the story, don’t make things up, and don’t make assumptions.
 
Then: Make clear and concise decisions.
 
YES or NO to each answer choice. 
IMPORTANT  INFORMATION

 

 

 Type of Setting (acute, inpatient, outpatient, school, etc.)

Target Population (babies, adolescent, senior)

Diagnosis (new/acute, chronic, progressive, auto-immune, degenerative, mental health)

Presented Symptoms PROVIDED (fatigue, weakness, pain, hypersensitivity, decreased ROM.)

Patient/Caregiver Goals: patient-centered

Direct Quotes: be client-centered
WORKING OUT THE CORRECT ANSWER
TIME CONTEXT CLUES

Take note of the stage of the OT Process, and the stage of the patient’s diagnoses. I.e. Where you are in the OT Process of : Progressive Disease, Burn Stages/Phases, Splinting, etc.

 

 OT Process:
Evaluation/Intervention
Initial/First
Next
Regular/monthly/periodic
Last
At DischargeStages of Disease/Injuries
Recently Diagnosed
At the Beginning/At the start
Immediately Following
Progressive Diseases: 
Onset Of
Early Stage
Middle Stage
End Stage
Terminal StageSurgical Procedures
Pre or Post-Operative/Surgical/Prosthetic
Before/After/During Surgeries & Skin Grafts
KEY WORDS FOR SEVERITY OF SYMPTOMS

 
  • Minor
  • Mild
  • Significant
  • Substantial
  • Moderate
  • Severe
ALERT WORDS – “ODD MAN OUT” Look out for these words:

Except
Contraindicate
At Risk
Least Helpful
Least Restrictive Environment
Least likely to be effective….
ACTION OR ACTIVE WORDS:

Keep in mind: The patient is always an Active Participant in their Therapy Intervention.

 

 

  

The following verbs will give you an idea what therapeutic role you are meant to play, in the session:

Implement

Demonstrate

Train

Collaborate

Aid, Assist

Utilize

Facilitate

Mentor, Coach

Lead

Direct

Develop

Initiate, Introduce

Produce, Provide

Stimulate
WATCH OUT FOR THESE WORDS

Answer choices with these words are typically not the right answer choice because OT is not black and white.
  • Never
  • Only
  • Must
  • All
BEFORE MOVING TO THE NEXT QUESTION
ASK YOURSELF

Have you picked the absolute best/most appropriate answer choice that addresses the problem in the question?

There is no need to highlight “Best” or “Most” as you should always automatically look for the BEST OPTION.

 Is your answer choice:

  • SAFE?? –  Always Safety First
  • Ethical?
  • Client is an ACTIVE PARTICIPANT?
  • Client/Family Centered?
SCOPE

Use this CHECKLIST

 

 

 S– Safety – Always Safety First – make sure your answer choice SAFE

C– Client Centered – The patient/family is an ACTIVE PARTICIPANT

O-Occupation Based

P– Positive, doing good, beneficial, growth/progress

E– Ethical?

 
2 ANSWERS VERY SIMILAR

Answers that are basically the same but have different wording

 .

Eliminate BOTH right away.

 

 
BRAIN FART
JUST DON’T KNOW THE ANSWER Strategy:

  • Go with the answer choice with the most words or the longest response.
  • Recognize patterns in a question/answer: sometimes the correct answer choice reflects the same words to clue you in.
  • Every 30 Minutes: Rest your eyes. Close your eyes, take deep breaths, stretch for 30 seconds. MARATHON. This comes when you are pacing your timing, one minute per question AVERAGE, some will be shorter some slightly longer.
  • Respect each question as you encounter it.
  • DO NOT use the review button at all.
  • Carefully consider answer choice and be able to rationalize why YOUR answer is correct.
  • Pull out brain fart strategy and apply if you are taking too long.
  • Reduce anxiety and move on.
  • Do not dwell on questions you struggled with!!
  • Come to peace NOW that you will not know every single answer.
  • Answer and move on.
  • It’s over, you will never encounter it again.
  • Treat each question as an individual patient.
MUSCULOSKELETAL/HAND/SPLINT/CARDIO
Be especially careful to consider TIME CONTEXTUAL CLUES   

How many days/weeks since initial injury?

How many days/weeks since initial Cardiac Event?

How many days/weeks since initial burn?

Assessment/Intervention based on this info…

E.g: Fx in week 2 different than intervention you choose 8-9 weeks post Fx.
CLINICAL SIMULATIONS Realize that these are all like the case studies in school
PATTERNS

Sections are patterned to simulate the actual OT progress of treating a client

 

 Section A: Screening, Referral, Evaluation. Observations, assessments, ID client factors, symptoms, occupational profile, client’s current abilities.

Section B: Typically focused on interpretation of assessment results, making goals, responding to client/family concerns regarding evaluation findings, etc.

Section C: Focused on choosing most appropriate interventions based on findings made in Section B.

Section D: focused on patient education prior to discharge, discharge planning, recommending DME or other adaptive equipment
ALWAYS, ALWAYS, ALWAYS keep in mind any key words in the questions that offer information regarding TIME.

 

 

  

E.g:

  • # of weeks post-surgery
  • before/during/after
  • pre or post
  • week 2 or week 7
  • onset/early/stage/initial/last/etc.
 SUMMARIZE AND HIGHLIGHT  

Highlighting should be limited to 6 or 7 clusters of key words, mostly pertaining to the opening scenario.

Summarize the opening scenario USING YOUR HIGHLIGHTED KEY WORDS on your grid paper.

Summarize useful feedback after ‘yes’ answers.
Pick definite YES ANSWERS FIRST (they are going to give you feedback if that was the right choice).

If it’s NOT: feedback will be provided on how the client responded.

THEN: pick your no responses

Totally unsure? Can’t use the test taking strategy or educated guess? Pick YES…will give you feedback that will help you answer this section.
THE POINT SYSTEM

Keep in mind that when answering a question, no points are deducted for an incorrect answer.

 

  

Point-wise, answering incorrectly is the same as not answering, so always pick something (whatever your strategy is). It’s the difference of maybe earning a point vs. definitely not earning a point because you did not answer.

Don’t leave any questions unanswered.

For both single choice and multiple-choice questions – you earn credit for getting a question correct, and no credit if you get it wrong or don’t answer.

In terms of strategy, you can opt to choose “yes” because even if it’s incorrect, you get feedback that might help with answering subsequent questions.

To develop a strategy that works for you, practise answering some CST questions.

Some more tips to help you prepare for the exam.

Stay focused, talk it through step-by-step, use calming strategies, and remember to B-R-E-A-T-H-E

 

Use these Acronyms to help you answer questions

DOCK (use to dissect each question)     SCOPE (apply these to the answers)

Diagnosis                                                 Safe – Safety 1st

OT process                                              Client centered

Context                                                    Occupation based

Key Word                                                 Positive/Positioning – table top activities, transfers, splints

                                                                 Effective/ Ethical

                                             

NBCOT® Exam Guide

Test-taking strategies are about recognizing patterns within a specific question and its answer choices. These tips & tricks will help you “learn the language” of the NBCOT® exam in order to translate and decode exactly what it is that the question wants from you.

  • At Discharge, Initial, First, Next, Last, At the start/beginning, Immediately following/after evaluation, recently diagnosed, before/during/after surgeries/skin grafts, PRE or POST operative/surgical/prosthetic, onset of, terminal stage, end stage, early stage, middle stage – These are all-time context clues related to where you are at in the OT process or stages of a progressive disorder, burn stages/phases, splinting protocols, fracture healing times, etc etc
  • Be careful of qualifier keywords that indicates “absolutes” – examples: like ALWAYS, NEVER – these typically are not the correct answer choice because OT is not black and white
  • Substantial, major, minor, significant, mild, moderate, severe –  keywords to ID the severity of symptoms
  • Look out for keywords that alert you that you’re looking for the “odd man out” in the answer choices: except, contraindication/contraindicated, precautions, at risk, least helpful/least restrictive environment/least likely to be effective, etc
  • Examples of Action/Active Words to look out for answer choices: implement, provide, demonstrate, train, collaborate, aid, assist, utilize, facilitate, mentor, coach, lead, direct, develop, initiate, produce, stimulate, introduce – these words clue you in that the client is an ACTIVE PARTICIPANT in their therapy intervention session.
  • Musculoskeletal/Hands/Splints/Cardiopulmonary questions: be especially careful to consider TIME CONTEXTUAL CLUES. How many days/weeks since the initial injury, cardiac event or burn? This is important because the evaluation assessment and/or intervention that you will choose will be based on this information. For example the most appropriate intervention of a fracture in week 2 is very different than the intervention you would choose with a healed fracture at 8-9 weeks.
  • Important information to always be highlighting and be aware of: Type of Setting (acute care, inpatient, outpatient, home health, skilled nursing facility,  community based center, psychiatric, school system etc),  Target population (infants/babies, adolescents, young adult, elderly adult), Type of condition/diagnosis (acute, chronic, progressive, degenerative, autoimmune, mental health/psychiatric, congenital, etc), presented symptoms provided (fatigue, weakness, pain, hypersensitivity, decreased ROM, etc),  client/family/caregiver goals and direct quotes ALWAYS should be highlighted and considered when choosing an answer choice to ensure you are being client-centered
  • Before moving on to the next question, you should use this checklist to ensure you have picked the absolute best/most appropriate answer choice that addresses the problem provided in the question:
    • SAFETY FIRST! Is your answer choice SAFE?
    • Ethical?
    • Client is an ACTIVE PARTICIPANT? (Look for your action words here)
    • Client/Family-centered?
  • If you ever get stuck and have no idea with a question on what the answer could be AKA “brain fart” episode or perhaps there’s a gap in knowledge of that question’s specific topic.. There are critical thinking/educated guess strategies you gotta pull out as back up in order to pick the best answer possible.
    • Go with the answer choice with the longest response or with the most words.
    • Recognize patterns within the question and answer choices – sometimes the correct answer choice reflects the same words to clue you in – or other times the answer choices will reflect “negative” wording except for one which is more positive.
  • You do NOT have to highlight MOST or BEST in the core questions — why? — because you are always looking for the most appropriate or best option with every question, so this is not important to be highlighted in these questions.
  • About every 30 multiple choice questions – GIVE YOUR EYES A BREAK – it’s already straining on your eyes to be staring at a computer screen for 4 hours, but you’re also stressing them even harder by having to ID important keywords and comprehend what you’re reading. Your eyes are definitely going to get fatigued at regular intervals which is going to cost you points if you’re not focused. So please, I urge you, to take this time to close your eyes, take a few deep breaths, stretch your arms out in your chair for about 30 seconds then get right back into the exam. Your eyes and brain will thank you.
    • This is also a perfect time to keep yourself on pace with your timing by glancing at your clock to ensure you’re progressing through the exam at a good pace – averaging about 1 minute per MC question. Remember: This is an AVERAGE – there will be questions you’ll likely breeze through in less than 1 minute and others that may take a little bit more time to read and pick the correct answer choice
  • Be sure to summarize what you are being asked in the core question and what is going on in your story in your own words. This will allow you to review your answer choices with a clear-cut problem of what you need to address by simply stating “Yes” or “No” that each choice does or does not address it.
    • Special Note: Do NOT insert any additional information into the question that is not directly provided to you.. AKA do not add to the story and make things up or make assumptions.  This is detrimental to your success in choosing and rationalizing the correct answer choice.
  • RESPECT EACH QUESTION WHEN YOU ENCOUNTER IT. Do NOT use the review button at all.  Take the time to carefully consider your answer choice and be able to rationalize why you believe YOUR answer is the correct answer and why the other choices are not.  Pull out those “brain fart”/educational guess strategies of your test-taking toolbox and apply them if you feel you are taking too long on the question to reduce your anxiety and move on. Do not dwell on questions that you feel you struggled with. Come to peace with it NOW that you are NOT going to know every single question on the exam. Pick an answer and move on mentally – it’s over – you’ll never encounter it again.
  • If two answers read like they’re basically saying the same thing but with different wording, then you can eliminate BOTH of them right away.

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