The National Occupational Therapy Certification Exam (NOTCE), formerly known as the Canadian Association of Occupational Therapists (CAOT) Exam, is the nationwide written test of OT knowledge of theory and applications here in Canada. Its prime purpose is to protect the public by assessing individuals who wish to practice occupational therapy (OT) all over the country. Second, since OT is a regulated health profession, all regulatory organizations require the NOTCE for full registration. It is held twice a year on the first Saturdays of July and November. Exam sites are available nationwide. You can choose which province you want to take the exam early in registration, although the specific location is not given until a few weeks before the exam date. As you go on reading this, we will delve on the resources you need to read, question formats and scoring method of the NOTCE. Essential web reads and stuff to browse and download are linked in the text.
The Blueprint, Profile and Essentials
In order for you to be successful in any exam, there are many things to know aside from the content of the exam. To be fully ready, one must know how the exam is written. You might remember from highschool or college days how teachers and professors have different formulations of their quizzes. Who gives out keywords? Who doesn't? Who likes essays and tables? Who likes identification or multiple choice type of questions? Some of those may seem minuscule to the content of the exam but it might surprise you to know that
how you organize the content of your review to a certain design may score you more points than just merely memorizing the books from page 1 to the glossary page.
To start off knowing the NOTCE, let me tell you, there is nothing quite like the
Resource Manual to let you have a peak at your Lady Victory. It has it all! The purpose of the exam, question formats, reference source and even sample exam questions. It's like our lovable Spacky - everything essential condensed in one. Now, the most important thing to take note of in this manual is the
BLUEPRINT. The blueprint is a graphic representation of the exam components and its framework. In a simpler angle, I'd like to think of it as a flower in a plant box.
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The Blueprint1
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It displays the dynamics of OT knowledge of the client, environment, occupation, practice process and the OT roles which we as therapists assume in the profession. The big center where the seeds are located compose of the examinee's knowledge of the CEO and OT process. This stands for sixty to seventy percent (60-70%) of the exam and can be found tabulated in more detail in figure 2.
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| The Matrix2 |
The colorful petals represent the six (6) major roles we assume in professional practice. These overlap at the center to show the dynamic unfolding of the roles centralized on the knowledge we know to enable our clients through the occupations they deem meaningful in their lives. This comprises of the thirty to forty percent (30-40%) of the exam. Lastly, the plant box nurtures the flower of knowledge and roles by supporting the practice with theories that we apply in clinics; vice versa, the applications evolve the theories we use through research.
Upon introduction to the blueprint, I'm sure more questions will surface in your mind - most especially, on the definition of each role in professional practice. This is where we turn to the
Profile of Occupational Therapists in Canada (a.k.a. the Profile) and the
Essential Competencies of Practice for Occupational Therapists in Canada (a.k.a. the Essentials). The
PROFILE provides the big picture of Canada's vision for its occupational therapists and is updated/revised every so often by the council.
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| Canada's vision for every OT - from competent to proficient and eventually to advanced practice3 |
The Profile briefly defines the competencies that OTs need to achieve in practice. These are the OT roles I have enlisted below: (1) expert in enabling occupation; (2) communicator; (3) collaborator; (4) practice manager; (5) change agent; (6) scholarly practitioner and (7) professional.
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| Figure in the Profile similar to the exam blueprint 4 |
There is a table after the image that delineates each component. Though this is just a very general description of each role. To further explain these
competencies, we will need to turn to the
ESSENTIALS. You'll be able to understand more about the profile more and what are the criteria that deem all practitioners "competent".
To put it simply, the essentials is the detailed qualities that make a "competent" OT.
Resources and Reads
So now that you are familiar with the manual, profile and essentials, we will be discovering important resources for your review. Although you might be with lots of OT resources, there are other references you might not be aware of just like the Profile and Essentials. The first place you look into for identifying potential review materials would be the Resource Manual. They are magnificently chronicled at the back of the manual.
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| The start of the reference list, perfectly written in APA format5 |
I marked all of the books I have then I browsed on the web to have information on the others. I checked the local library if they had any occupational therapy books. Sadly, they don't have much OT books there. I heard from a friend thought that I can access the University of British Columbia Library where they have a large collection of allied health professional books. If you can, borrow books to save money.
Here I list the resources that I have referenced from in my review:
1.
Enabling Occupation I and II - both books are definitely a necessity to read. You can buy it in the CAOT store or borrow it from a library that has it. Important to note the CPPF and the OPPM.
2.
Trial Occupational Therapy Exam Manual (TOTEM) and the Trial Occupational Therapy Exam (TOTE) - contains exam questions you can practice on. Check out CAOT website for more details.
3. Occupational Therapy for Physical Dysfunction (
Pedretti or
Trombly) - covering for the physical dysfunction knowledge.
4.
Willard and Spackman's Occupational Therapy - need I say more? It's your Yorozuya and it has it all.
5.
Quick References to Occupational Therapy - good for when you need to quickly refer to conditions
6.
Conditions in Occupational Therapy - much like the "Quick References" book, this is also a nice book in which they condensed all of the conditions.
7.
Group Dynamics in Occupational Therapy - best resource for knowledge on groups, from theory to application.
8.
Psychosocial Occupational Therapy: Frames of Reference for Intervention - greatest reference on theory in psychosocial practice.
9.
Kaplan and Sadock's Symptoms of Psychiatry - where all the psychological conditions can be found. The resource manual has listed the DSM-IV-TR but I find this easier to remember.
10.
Occupational Therapy for Children - the pediatrics Bible.
11.
Ethical and Legal Dilemmas in Occupational Therapy - this book is magnificent for knowing ethical practice with case scenarios.
12.
Introduction to Splinting - the foundation for splinting. The review questions every chapter is great for igniting your clinical reasoning skills concerning with this OT task. Case studies available as well.
13.
Cook and Hussey's Assistive Technologies - essentials on the types of assistive devices, assessment procedures. Another thing that is wonderful about this book is that it has a list of organizations in which these devices are available. I'm pretty sure that there was another book on assistive devices but I wasn't able to borrow it from the library. Everytime I went there, it's always borrowed.
14.
Measuring Occupational Performance - worried about your knowledge on assessments and performance measures? This is the ultimate book! It classifies them into categories and tabulates its information. This is a definite must-read for review.
15.
Guidelines on Controlled Acts and Delegation - list of controlled acts in the profession.
16.
Regulated Health Professions Act - it is most important to know certain legislation that concerns the practice.
17.
Canadian Health Act - yet another legislation we must be aware of.
18.
Health Professions Act - another legislation on the health care world. Pretty long but knowing it early on will help you in practice in the future. Especially when it comes to claiming your rights as a professional and to have an idea on how the regulatory body works.
19.
Accessible Housing by Design (ramps) - a question on accessibility might come out and knowing about the design acceptable is sufficient.
20.
Occupational Therapy Assessment Tools:An Annotated Index - again, another magnificent book on instruments used in practice.
21.
Functional Performance in Older Adults - knowledge on geriatrics practice.
22.
Conceptual Foundations of Occupational Therapy Practice - a great book that summates the most widely used body of theories in practice.
23.
Research in Occupational Therapy - best book to read about research in our field. In fact, it is very easily understood that you needn't look elsewhere. I'm pretty sure I browsed another book about research but I totally forgot that other one.
Additional resources:
1.
Occupational Therapy examination and practice preparation project for IEOTS (aka OTepp project)
A wonderful organization which helps you understand the health care system here in Canada. It is also, as I have described in my
previous post, a virtual
agora in which occupational therapists worldwide gathers and shares their knowledge. I learned a lot from the OTepp program and I have to say, I never would have imagined starting from elsewhere. Check out their website and see for yourself how magnificent the program is.
2.
CAOT's Occupational Therapy Exam Module (aka OTEM)
This used to be offered by OTepp but it was carried over to CAOT. It is an online discussion group which assists examinees in preparing for the exam. It has over 100+ questions in reserve to discuss with in order to mold the quick rationalizing during the actual exam.
3.
Orientation to the Canadian Health Care System, Culture and Context
They offer online courses for internationally educated health professionals (IEHPs) on the Canadian Health Care system.
For your basic sciences and medical-surgical review, I suggest that you stick to resources you feel comfortable with. After all, there can be lots I can suggest but it will be up to you and on how your reinforcement system works. I decided to stick wiht my old books Seeley, Snell, Guyton and Gilroy for I've used them quite a lot since college; thus, retrieval of information may be easier due to the repetitive factor.
Questions and Format
The way the examiner formulate the questions are quite unique. They present a case to you in such a way that you might be in front of the actual client. From there, they derive 2 to 5 questions. I suggest from here, you must have at least read the resource manual. If not, please do. It will be less confusing.
Now, here is the number 1 case and question example on the resource manual6:
Client: Mrs. C is a 66 year old woman.
Situation:
• She is recently divorced.
• She lives alone in a seniors’ apartment
• She has decreased functioning as a result of a degenerative neurological disorder
• She was getting home-making services in her apartment
• She was going to a geriatric day hospital to receive treatment related to physical problems
• Her physical problems include unstable gait, decreased balance, potential risks for falls,
decreased vision and general safety
• She has been admitted to an in-patient geriatric unit due to increasing depression
• On admission to the in-patient geriatric unit, she is withdrawn, irritable, expressed vague
suicidal ideation, and has stopped doing previous leisure activities
• Her previous leisure activities included music and sewing
• She has few close friends who are of the same age nearby
• She has one daughter who lives several hundred kilometers away
ITEM 1
What should the occupational therapist do FIRST to address Mrs. C’s depression?
1. Arrange a visit from her friends.
2. Challenge her with new activities.
3. Engage her in short term, familiar activities.
4. Suggest she attend the unit’s Friday evening social event.
ITEM 2
Mrs. C. tells the occupational therapist that she is upset that her decreased vision means that she is no
longer able to sew. Using a client-centred perspective, what should the therapist do FIRST?
1. Suggest other leisure activities using the Interest Check List
2. Explore low vision aids and techniques that could allow Mrs. C. to sew
3. Encourage Mrs. C. to join activities at her local Senior’s Center
4. Assist Mrs. C. to find a volunteer to help her do her leisure activities
ITEM 3
At discharge, the occupational therapist will recommend that Mrs. C. attend an activity at her local
Seniors’ Centre. Which activity would be MOST appropriate for the therapist to suggest?
1. Music enjoyment group.
2. Recreational dancing.
3. Playing cards.
4. Recreational swimming.
ITEM 4
Mrs. C. is often impulsive and is not following safety guidelines when walking with her walker. What
should the occupational therapist do?
1. Set up a behaviour modification program for Mrs. C.
2. Continue teaching walker use, providing only 1 to 2 step instructions.
3. Further assess Mrs. C’s comprehension and ability to remember information.
4. Encourage Mrs. C. to regain internal locus of control and take responsibility for her safety.
ITEM 5
The multidisciplinary term is not confident that Mrs. C. has the functional ability needed to return to
her apartment. Mrs. C. strongly states that she wishes to return to her apartment. What should the occupational therapist do?
1. Have a discussion with Mrs. C. about safety and her ability to manage at home.
2. Arrange for increased home care services.
3. Investigate the potential for repeated hospitalizations.
4. Provide legal documentation of Mrs. C.’s incompetence.
For rationale, you can refer to the
resource manual. If you change information on the following case such as this:
-Mrs. C's leisure activities include watching television and walking.
-Mrs. C has macular degeneration.
NOTE: This change in the sample number 1 of the resource manual is by NO MEANS AN OFFICIAL ONE. It is just formulated by me in a mere example of knowing the client and their occupation. Also, the answer and rationale I have provided is again not in the official document.
If a question surfaces on which activity would be MOST difficult for her? Which would you choose? Think first before you read ahead.
1.watching television
2. walking outside around their house
3. dogsitting
4. playing UNO
It might surprise you that it would be number 1 because in this activity central vision is vital. Since Mrs. C has macular degeneration thus we know that central vision is compromised. The other activities can be done with intact peripheral vision. See how each case can vary differently with just those alterations? It test how well you know the client in their environment and how it affects the occupations they deem meaningful in their lives. My best advice is to see it upon yourself that you view each case as if you are facing a client. When you move on to the next question, it means that you get to meet another client who may have similarities but they are most definitely not one in the same.
Items and Scoring
The exam for my batch was composed of two hundred (200) questions. I assume that it was two points if you get the answer correct and zero if you pick the wrong choice. That means overall, the exam would be a total of four hundred and in order to pass you need 70% - that is 290. Funny though, if you calculate the 70% from the 400 it would be 280. They added 2.5% to make it 72.5% so yeah, it's 290 points according to the
PROCEDURES MANUAL. Also some exceptions are made for certain questions. You see, every batch of exams, a different set of questions are pulled from a "bank" and some are "experimental". If the experimental questions are drawn from the bank, and a lot of the examinees have
varied answers rather than the expected one, the question gets reviewed and possibly thrown out of the count. That is probably why the waiting time for your exam results is a span of 6 to 8 weeks. A council still reviews it.
Although in the procedures manual, they indicate that they just put on the range of 290 - 450 (I'm not sure either why it's up until 450 instead of 400) if you passed, my results came in a very detailed breakdown of the components patterned to the blueprint. I noted that they have revised it in 2010 as indicated in the copyright page. Maybe they have yet to change it in the manual.
Of course this amateur collation of information is useful for those who are already registered to take the examination. Please do refer to my previous post -
The Unofficial Guide to CAOT Application for IEOTs for the procedures on applying for the NOTCE. And do check the CAOT website for updates of the resource manual and other official documents.
Footnotes:
1Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE) Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf
2Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE) Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf
3Canadian Association of Occupational Therapists. (2012). Profile of Occupational Therapy Practice in Canada. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/2012otprofile.pdf
4Canadian Association of Occupational Therapists. (2012). Profile of Occupational Therapy Practice in Canada. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/2012otprofile.pdf
5Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE) Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf
6Canadian Association of Occupational Therapists. (2006). National Occupational Therapy Certification Exam (NOTCE) Resource Manual. Ottawa, ON: CAOT Publication ACE. Retrieved from the website on January 11, 2014: http://www.caot.ca/pdfs/Exam/ExamResMan10.pdf
