With experts Rosanne DiZazzo-Miller and Fredrick D. Pociask
Every few years the National Board for Certification in Occupational Therapy (NBCOT) publishes an executive summary of a Practice Analysis to ensure that Occupational Therapist Registered (OTR) exams cover content relevant to practicing therapists. In addition to any changes to the content of the OTR exam, they may also make changes to the percentage of the exam that is dedicated to each domain area. Beginning in 2019, the NBCOT board OTR exam will include these changes. The good news is our textbook, Preparing for the Occupational Therapy National Board Exam: 45 Days and Counting, included our own focus groups and interviews, including: students who passed the NBCOT exam on the first attempt, students who had to repeat the exam, and had currently practicing senior level occupational therapists to construct the majority of chapter content. Therefore, the content presented in the 45 Days textbook remains in very good alignment with the changes included in the 2018 executive summary. The free PDF of the 2018 ‘Practice Analysis of the Occupational Therapist Registered Executive Summary’ can be found here.
Summary of Changes/Additions:
- The practice settings represented as the primary practice setting for OT employment are the same, with the addition of 0.2% of therapists practicing in the community. Chapter 31, Community-based Practice, addresses this area of practice.
- Under Neurological disorders, 5.4% of therapists reported practicing with clients who have dysphagia. Chapter 26, Dysphagia, addresses this area of practice.
- Under Developmental disorders, 12% of therapists reported practicing with clients who have genetic disorders. Chapters 29 and 30 address pediatric conditions; however, specific to genetic disorders, it is important review the many different types of genetic disorders and understand clinical presentations, appropriate assessments and effective intervention strategies. This site outlines each of these in good detail.
- Under Cardiopulmonary disorders, 35.5% of therapists reported practicing with clients who have pneumonia. While pneumonia is not addressed as a specific condition, it is often times a secondary complication. Pneumonia is typically diagnosed through blood tests, chest x-ray or sputum test. There is both bacterial and viral forms of pneumonia and clients present with abnormal bubbling or crackling sounds in their lungs, which can be heard with a stethoscope. Clients with chronic conditions such as COPD and asthma as well as those with limited mobility are especially at risk for pneumonia. While medical staff prescribes the appropriate medications, therapists may help with training on deep breathing/coughing exercises to cleanse the lungs and training on how to use nebulizers. Most specific to OT is improving endurance and strength in order to resume function in ADLs while paying special attention energy conservation techniques.
- Under Psychosocial disorders, 1.3% of therapists reported practicing with clients who have eating disorders. Chapter 27, Mental Health Conditions addresses clinical presentation, assessments and interventions related eating disorders such as bulimia and anorexia nervosa.
- Under General Medical/Systemic disorders, 18.1% of therapists reported practicing with clients who had bariatric conditions; 1.9% practiced with clients who had organ transplantation and 14% reported practicing with clients who had trauma/polytrauma.
- Bariatric: In terms of bariatric care, AOTA provides a concise summary of OT’s role in rehabilitation that can be accessed here.
- Organ Transplantation: PM&R Knowledge Now provides an excellent article by Borras-Fernandez, Cruz, Castillo & Montes (2016). Of most interest to students preparing for the board exam is section 2 in the article that refers to rehabilitation management and treatments. The article can be accessed here.
- Trauma/Polytrauma: Another great resource by AOTA provides a concise summary of OT’s role in assessment and intervention related to polytrauma.
- Domain areas now have specific titles and each has changed slightly in percentage of the exam that is dedicated to each domain.
- Domain 1: Evaluation and Assessment is now 25% of the exam (an increase from 17%)
- Domain 2: Analysis and Interpretation is now 23% of the exam (a decrease from 28%)
- Domain 3: Intervention Management is now 37% of the exam (a decrease from 45%)
- Domain 4: Competency and Practice Management is now 15% of the exam (an increase from 10%).
It is our sincere hope that this message will help sort out any questions you may have on the 2019 version of the NBCOT exam and how Preparing for the Occupational Therapy National Board Exam: 45 Days & Counting addresses these changes and provides resources that will help you address these areas with your study plan.
Very best regards,
Rosanne & Fredrick
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