How Predictive Tools in Occupational Therapy Curriculum Design Improve NBCOT® Exam Outcomes
Preparing for the National Board for Certification in Occupational Therapy (NBCOT®) Occupational Therapist Registered (OTR®) exam can be an overwhelming experience for many students, given the broad scope of content covered and the difficulty of determining which topics to prioritize.
Many occupational therapy (OT) programs offer end-of-program practice exams and intensive review sessions that may benefit some, but at-risk students who are already struggling with the curriculum are unlikely to see the same results. Furthermore, attempting to squeeze in a vast amount of learning within a short period can increase anxiety and, in many cases, lead to burnout among any student.
For educators, these challenges present an equally difficult task. Designing an occupational therapy curriculum that balances clinical training, academic rigor, and NBCOT® exam readiness is complex under the best of circumstances. Add in limited classroom hours, faculty bandwidth, and the increasing demand for data-driven accountability, and it becomes clear why traditional curriculum design approaches are no longer enough.
In this blog, we will explore:
- The current OT curriculum design challenges for educators
- The importance of integrating predictive tools into the curriculum
- How TrueLearn helps programs strengthen NBCOT® outcomes
Addressing these challenges requires more than last-minute reviews—it calls for smarter, data-driven approaches that support both students and faculty throughout the entire curriculum. Recent NBCOT® data underscores this urgency: in 2024, only 68% of first-time new graduate OTR candidates passed on their first attempt, down from 73% in 2023.1
Current OT Curriculum Design Challenges Educators Face
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OT programs face increasing pressure to prepare students for both clinical practice and the NBCOT® exam. However, several obstacles make curriculum design more challenging today:
- Resource and workload constraints – Faculty often lack the time and bandwidth to create large pools of high-quality, board-style practice questions that align closely with the NBCOT® exam.
- Broad exam scope vs. limited classroom time – The NBCOT® exam covers a vast range of topics, leaving faculty with the difficult task of deciding which areas to emphasize and which to streamline.
- Delayed feedback on student performance – End-of-program reviews and practice tests provide insights too late, making it difficult to remediate struggling students before they sit for the NBCOT® exam.
These challenges not only affect students’ first-time NBCOT® pass rates but also place added strain on educators tasked with maintaining program success—underscoring the need for a more proactive approach. Rather than relying on end-of-program reviews, OT programs can strengthen outcomes by embedding predictive tools into the curriculum that deliver continuous, actionable insights.
The Importance of Integrating Predictive Tools in OT Curriculum
Predictive tools give educators visibility into how students are performing long before they sit for the NBCOT® exam. By tracking academic benchmarks, fieldwork performance, and assessment results across the program, faculty can spot at-risk students early and provide the right interventions at the right time. This proactive approach shifts the focus from end-of-program remediation to continuous, evidence-based support.
For example, research shows that overall academic performance, fieldwork scores, and practice assessments like the OTKE are strong indicators of how well students will perform on the NBCOT®.2 When educators can see these data points throughout the program, they’re able to recognize which students might need extra support sooner and provide targeted help before gaps become bigger problems. In many cases, this early insight can even prevent the need for intensive remediation later on.
Predictive tools also provide a continuous view of student progress rather than isolated snapshots at the end of the program. This makes it easier for faculty to track mastery, spot emerging challenges, and ensure students stay on pace. By addressing concerns earlier, programs can reduce attrition and keep more students on track to graduate and pass the NBCOT® exam on their first attempt.
The ability to engage students in precision learning is another critical benefit of predictive analytics. By aligning assessments with each student’s performance, faculty can guide students to focus more on their weaker areas while reinforcing strengths. This not only makes study time more efficient but also reduces anxiety and builds student confidence by showing clear progress over time.
The benefits extend beyond individual students. Predictive insights allow programs to evaluate curriculum effectiveness, make data-driven adjustments, and demonstrate outcomes more effectively during accreditation reviews. In short, predictive tools not only support student success but also strengthen program performance and reputation.
Implementing these strategies requires tools that are not only predictive but also practical to integrate into existing curricula. That’s where innovative, evidence-based platforms come in—helping educators apply these approaches consistently from day one.
How TrueLearn Supports OT Curricula
Meeting today’s curriculum design challenges requires more than traditional review sessions. TrueLearn, paired with Picmonic, delivers a powerful learning loop that integrates seamlessly into OT programs to strengthen teaching and exam readiness.
Comprehensive curriculum and board review
By leveraging the TrueLearn–Picmonic learning loop, students complete a comprehensive review of the material most likely to appear on the NBCOT® exam. TrueLearn OT SmartBank questions mirror board-style content, while Picmonic’s bite-sized, audiovisual mnemonics follow the three steps of the memory process and use spaced repetition to reinforce knowledge and combat the forgetting curve. Mock assessments in TrueLearn further simulate the testing environment, helping reduce exam anxiety and improve first-time pass potential.
Customized and precision learning
The learning loop adapts to each student’s performance, helping them focus on areas of weakness while reinforcing strengths. TrueLearn’s OT SmartBank results highlight knowledge gaps, allowing faculty to adjust lessons, provide remediation, and track progress over time. For students, this means study time is spent more efficiently and effectively, with earlier identification of challenges that might otherwise lead to remediation later.
Active and engaged students
TrueLearn and Picmonic also drive active learning by combining quizzes, videos, animations, and audiovisual mnemonics that cater to diverse learning styles. Students repeatedly engage with content in different ways—assessing with TrueLearn, reinforcing with Picmonic, and reassessing until mastery. This continuous cycle builds long-term retention and deeper understanding, preparing students for both clinical practice and the NBCOT® exam.
Together, TrueLearn and Picmonic provide programs with the tools to integrate board prep directly into the curriculum, support at-risk students, and improve NBCOT® outcomes—all while helping faculty strengthen curriculum design and meet accreditation standards.
As NBCOT® pass rates continue to decline, OT programs face mounting pressure to better prepare students while also reducing attrition and meeting accreditation standards. Relying solely on end-of-program reviews is no longer enough. By embedding a powerful learning loop into the curriculum from day one, educators can provide students with consistent, engaging, and evidence-based preparation that improves confidence, strengthens retention, and drives first-time exam success.
Learn how TrueLearn and Picmonic can help your institution drive optimal student outcomes.
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OTR® is a trademark of National Board for Certification in Occupational Therapy (NBCOT®). This content is not endorsed or approved by NBCOT®.
1 Certification activities. Nbcot.org. Accessed September 11, 2025. https://www.nbcot.org/certification-activities
2 Kurowski-Burt AL, Woods S, Daily SM, Lilly CL, Scaife B, Davis D. Predicting student success on the National Board for Certification in Occupational Therapy® examination. Am J Occup Ther. 2020;74(4):7404345020p1-7404345020p10. doi:10.5014/ajot.2020.037622