Predictors of NBCOT Examination Pass Rates: The Role of GPA, GRE, and OTKE Scores in Occupational Therapy Education

Given the critical role of National Board for Certification in Occupational Therapy (NBCOT) certification in occupational therapy (OT) practice, this study examined predictors of NBCOT examination success to inform program improvement. Analyzing data from 59 Master of Science in Occupational Therapy (MSOT) graduates at a single institution over the course of three years (2020–2022), a retrospective design with logistic regression assessed undergraduate grade point average (GPA), prerequisite GPA, within-program GPA, Graduate Record Examination (GRE) scores, and pre- and post- Occupational Therapy Knowledge Examination (OTKE) scores as predictors of first-attempt NBCOT pass rates. Of 58 students with reported outcomes, 56% passed on the first attempt. OTKE pretest (OR=1.105, p=0.032) and posttest (OR=1.189, p=0.027) scores significantly predicted success, with each one-point increase raising pass odds by 10.5% and 18.9%, respectively. A typical female student with mean scores had a 62.2% pass probability, while maximum scores yielded 99.4%. GRE scores and GPAs showed no significant association. Despite a 100% aggregate pass rate, first-attempt rates declined from 81% (2020) to 38% (2022), possibly due to COVID-19 disruptions. These findings highlight the OTKE’s value in NBCOT preparation and question the GRE’s utility in admissions. Future research should investigate admission processes, test preparation strategies, qualitative admissions factors, and how OTKE integration can advance OT education by enhancing curricula and student readiness.