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OTR Exam Update Coming January 2024

We are committed to developing practice-relevant exams that meet high standards of accessibility. As part of this commitment, beginning in January 2024, the clinical simulation test (CST) items on the OTR exam will transition to scenario sets. This item type aligns with our accessibility initiatives and enables us to assess the same knowledge as CSTs but in a format that offers improved accessibility for testing accommodations.

Scenario sets are similar to CST items and include an opening scene followed by four related items. Each item in the set has six response options, three correct and three incorrect. Candidates will mark the three best choices.

The OTR exam will consist of 180 items. These items will be a mix of three- and four-option single-response multiple-choice items and six-option multi-select scenario sets. Candidates will still have 4 hours to complete the exam.

Sample scenario sets are available to review so candidates can become familiar with this item type. Practice tests will be updated and available from NBCOT by late summer 2023.

Sample scenario set 1
Sample scenario set 2

This update does not occur until 2024. All candidates who are taking the OTR exam before December 19, 2023, will see the current format of CST items and three- and four-option single-response multiple-choice items.

For more information, please visit the frequently asked questions page.