A Year in Review From NBCOT CEO Angela Macauley

This year marked an important transition for me as I stepped into the CEO role, a responsibility I am deeply honored to hold after many years with NBCOT. What has always stood out, and continues to motivate everything I do, is the unwavering dedication of our OTR and COTA professionals. Even as demands grow and challenges evolve, you remain committed to high-quality care, lifelong learning, and the people and communities you serve.

That commitment is the foundation of our mission. It drives our work and shapes the initiatives we undertake to support confident and competent OT practice.

A Strong Year for Certification

This year, more than 218,000 OTR and COTA professionals chose to maintain their NBCOT certification. That decision reflects a commitment to excellence, accountability, and the people you serve.

Staying certified means upholding a national standard for competence and ethical practice. It means you value ongoing learning and want to provide the best for every client, family, and community you serve. It reinforces public trust in occupational therapy and strengthens the credibility of OT practice across the healthcare landscape. Your commitment protects the public, elevates OT practice, and inspires the work we do every day. You worked hard to earn your certification; promote it with pride.

Innovation That Supports Practice

We were proud to receive the 2025 Institute for Credentialing Excellence Innovator Award for myEBPtool. This recognition reflects our commitment to creating practical, evidence-informed tools that support better clinical reasoning and more effective care. New conditions for the tool will launch in 2026.

The NBCOT Navigator® platform expanded with three new COTA case simulations—Multiple Sclerosis, Duchenne Muscular Dystrophy, and Middle School Autism. Four new microcredentials have also been added—OTR Adult Mental Health, OTR Orthotics and Prosthetics, COTA School-Based Pediatrics, and COTA Pediatric Mental Health.

These tools verify ongoing competence and support certificants in staying current and confident in their practice.

Expanding National Awareness of Occupational Therapy

The Why Choose OT? campaign saw powerful growth this year, and with it, an increasing recognition of the life-changing work that OTR and COTA practitioners do every day. We expanded our resources, increased our national visibility—including a shoutout from Al Roker on the TODAY Show—and strengthened relationships with schools and communities across the country.

One of the most inspiring developments has been the widespread adoption of our Promote OT challenge. Schools in states across the nation are bringing OT into local classrooms, giving young people early exposure to a profession they may never have encountered otherwise. This early awareness will help build a stronger and more diverse future workforce.

At the 2025 HOSA International Leadership Conference, we awarded several Why Choose OT? scholarships, supporting students who are ready to make OT their future. We also celebrated the launch of HOSA’s first-ever OT Competitive Event, giving thousands of high school students a new and meaningful way to explore occupational therapy.

The work we have done reflects our commitment to strengthening the workforce pipeline, increasing recognition of what occupational therapy offers as a career choice, and making it a household name. We want every household to know what OT is, why it matters, and the meaningful difference OT practitioners make. And we are investing deeply to make that vision a reality.

Recognizing Excellence in the Profession

This year, we honored an inspiring group of OTR and COTA professionals through our Impact and Innovation Awards, as well as the new Excellence Award. Their contributions reflect the depth, diversity, and dedication found across OT practice. This year’s award winners demonstrated innovation that improves care, leadership rooted in service, and a commitment to supporting individuals and communities.

Recognizing this work is essential. These stories uplift our community, encourage others, and highlight the vital way certificants are making a difference every day. As the next award cycle approaches, we encourage you to consider nominating a colleague or yourself to help bring more of these powerful stories forward.

Public Protection Through Outreach and Collaboration

Our External and Regulatory Affairs team and NBCOT Ambassadors played a vital role this year by supporting students, collaborating with regulators and state boards, contributing to conferences, participating in Why Choose OT? events, and hosting the State Regulatory Leadership Forum. Their efforts strengthen public protection, deepen relationships, and broaden awareness of our mission. We appreciate the commitment they bring to every interaction.

Addressing Emerging Challenges

This year brought several challenges that required attention across the profession. The U.S. Department of Education’s federal student loan rule changes created uncertainty for OT students and for the future workforce. We have been actively engaged on this issue and have shared additional information outlining our perspective and ongoing actions.

We are also mindful of broader pressures facing the profession—burnout, reimbursement barriers, workforce shortages, faculty demands, changes in student readiness for practice, and the rapid rise of AI. These challenges are real, and they are evolving.

We are committed to working alongside others across the OT community, supporting the workforce pipeline, and reinforcing competence at every stage of practice. We remain open to conversations and collaborations that align with our mission and help strengthen the future of occupational therapy.

Powered by Volunteers and Leadership

Our organization is strengthened by the dedication of our subject matter experts, ambassadors, and board members. Their volunteer contributions shape our programs, support public protection, and uphold the high standards our certification represents. We are grateful for the commitment they bring to this work.

Building Momentum for 2026

We are entering 2026 with a strong slate of initiatives designed to support both current practitioners and the next generation of OTR and COTA professionals. You will see enhancements across our digital platforms, new tools within Navigator, expanded feelReady Workshops to include virtual options, continued growth in Why Choose OT? outreach, and increased engagement with HOSA and other youth organizations. We remain committed to working closely with AOTA, AOTF, and ACOTE wherever our missions align.

In 2025, we completed a comprehensive Continuing Competency Practice Analysis. Many of you participated in the survey, and we are grateful for your input. The executive summary and updated competency profiles for each certification will be released in early 2026. This work will guide future planning and development of tools within the Navigator platform. Your feedback directly shapes the resources we create to support and verify competent OT practice.

Together, these efforts reinforce our commitment to public protection and to supporting strong, evidence-informed care.

Looking Ahead

Thank you for the work you do every day and for the dedication you bring to the people and communities you serve. Your continued support of NBCOT and our mission strengthens everything we do.

On behalf of our board of directors and team, I wish you and your loved ones a wonderful holiday season and a bright, meaningful new year. If you would like to stay connected, you are welcome to follow me on LinkedIn for updates throughout the year.

Angela Macauley