National Occupational Therapy Certification Examination — Information & Free Practice

About National Occupational Therapy Certification Examination

National Occupational Therapy Certification Examination · CA

Key exam facts

Provider

The Canadian Association of Occupational Therapists (CAOT) administers the NOTCE. Its Certification Examination Committee (CEC) develops and regularly monitors the exam; examination policy involves CEC, the Exam Oversight Committee and the CAOT Board. Testing/proctoring suppliers deliver services rather than own the exam.

Format

Case-based multiple-choice examination with four possible answers and one best answer, delivered at in-person computer-based testing centres or by live remote proctoring online. English and French are offered.

Exam questions

Total questions: 200.

Time limit

Two hours of answering time per part (four hours total), excluding the scheduled break between parts. The in-person manual permits a break of up to 45 minutes between parts; timed washroom breaks continue to use examination time. Approved testing accommodations may modify arrangements.

Passing score

Passing scaled score: 290, on a scale ranging from 100 to 450. Correct responses earn one mark and incorrect responses zero; the required raw score varies slightly by sitting (near 70%) under criterion referencing, rather than a fixed 70% guarantee or bell curve.

Exam fee

Registration: CAD $755 plus applicable taxes, subject to change with administration costs. Ontario's regulator states $755 plus HST. Separate optional services: manual re-score $75 plus taxes; appeal $50 plus taxes; reconsideration free.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

• OT Expertise — Official range: 20–25% (Practice allocation: 22.96%)

  • Establish trusted professional relationships with clients
  • Co-create with clients a shared understanding of scope of services, expectations, and priorities.
  • Use a mutually respectful approach to determine the nature of the services to be delivered.
  • Respond to requests for service promptly and clearly.
  • Support clients to make informed decisions, discussing risks, benefits, and consequences.
  • Use occupational analysis throughout practice
  • Keep clients’ occupations at the centre of practice.
  • Facilitate clients’ use of their strengths and resources to sustain occupational participation.
  • Address the strengths and barriers in systems such as health care that could affect occupational participation.
  • Apply knowledge, evidence, and critical thinking from social, behavioural, biological, and occupational sciences to analyze occupational participation.
  • Share rationale for decisions.
  • Determine clients’ needs and goals for occupational therapy services
  • Respond to the context that influences the client’s request for occupational therapy service.
  • Develop a shared understanding of the client’s occupational challenges and goals.
  • Decide whether occupational therapy services are appropriate at this time.
  • Evaluate risks with the client and others.
  • Periodically review the client’s expectations with them.
  • Assess occupational participation
  • Agree on the assessment approach.
  • Select assessment tools and methods that fit the approach.
  • Take into account the impact of the client’s context on the assessment process and outcome.
  • Incorporate the client’s perspectives and opportunities throughout the assessment process.
  • Analyze the assessment results in context.
  • Communicate assessment findings clearly.
  • Develop plans with clients to facilitate occupational participation
  • Agree on the service delivery approach.
  • Determine intervention, timelines, outcomes, resources, contingency plans, and responsibilities.
  • Anticipate and address implementation difficulties.
  • Implement the occupational therapy plan
  • Support clients in accessing and using the resources to implement their plans.
  • Confirm shared understandings and progress of the plan.
  • Evaluate the results with the client and others involved in the plan.
  • Adjust occupational therapy services based on the evaluation.
  • Plan for concluding services, ongoing services, or a transition to other services.
  • Manage the assignment of services to assistants and others
  • Identify practice situations where clients may benefit from services assigned to assistants or others.
  • Assign services only to assistants and others who are competent to deliver the services.
  • Monitor the safety and effectiveness of assignments through supervision, mentoring, teaching, and coaching.
  • Follow the regulatory guidance for assigning and supervising services.

• Communication and Collaboration — Official range: 19–21% (Practice allocation: 20.41%)

  • Communicate in a respectful and effective manner
  • Organize thoughts, prepare content, and present professional views clearly.
  • Foster the exchange of information to develop mutual understanding.
  • Employ communication approaches and technologies suited to the context and client needs.
  • Adjust to power imbalances that affect relationships and communication.
  • Maintain professional documentation
  • Maintain clear, accurate, and timely records.
  • Maintain confidentiality, security, and data integrity in the sharing, transmission, storage, and management of information.
  • Use electronic and digital technologies responsibly.
  • Collaborate with clients, professionals, and others
  • Partner with clients in decision-making. Advocate for them when appropriate.
  • Share information about the occupational therapist’s role and knowledge.
  • Identify practice situations that would benefit from collaborative care.
  • Negotiate shared and overlapping roles and responsibilities.
  • Maintain mutually supportive working relationships.
  • Participate actively and respectfully in collaborative decision-making.
  • Participate in team evaluation and improvement initiatives.
  • Support evidence-informed team decision making.
  • Recognize and address real or potential conflict in a fair, respectful, supportive, and timely manner.

• Culture, Equity, and Justice — Official range: 20–25% (Practice allocation: 22.96%)

  • Promote equity in practice
  • Identify the ongoing effects of colonization and settlement on occupational opportunities and services for Indigenous Peoples.
  • Analyze the effects of systemic and historical factors on people, groups, and their occupational possibilities.
  • Challenge biases and social structures that privilege or marginalize people and communities.
  • Respond to the social, structural, political, and ecological determinants of health, well-being, and occupational opportunities.
  • Work to reduce the effects of the unequal distribution of power and resources on the delivery of occupational therapy services.
  • Support the factors that promote health, well-being, and occupations.
  • Promote anti-oppressive behaviour and culturally safer, inclusive relationships
  • Contribute to a practice environment that is culturally safer, anti-racist, anti-ableist, and inclusive.
  • Practise self-awareness to minimize personal bias and inequitable behaviour based on social position and power.
  • Demonstrate respect and humility when engaging with clients and integrate their understanding of health, well-being, healing, and occupation into the service plan.
  • Seek out resources to help develop culturally safer and inclusive approaches.
  • Collaborate with local partners, such as interpreters and leaders.
  • Contribute to equitable access to occupational participation and occupational therapy
  • Raise clients’ awareness of the role of and the right to occupation.
  • Facilitate clients’ participation in occupations supporting health and well-being.
  • Assist with access to support networks and resources.
  • Navigate systemic barriers to support clients and self.
  • Engage in critical dialogue on social injustices and inequitable opportunities for occupations.
  • Advocate for environments and policies that support sustainable occupational participation.
  • Raise awareness of limitations and bias in data, information, and systems.

• Excellence in Practice — Official range: 11–14% (Practice allocation: 12.76%)

  • Engage in ongoing learning and professional development
  • Develop professional development plans.
  • Engage in professional development activities to improve practice and ensure continuing competence.
  • Enhance knowledge, skills, behaviour, and attitudes.
  • Ensure that skills are adequate to meet practice needs.
  • Improve practice through self-assessment and reflection
  • Self-evaluate using performance and quality indicators.
  • Learn from varied sources of information and feedback.
  • Provide useful feedback to others.
  • Manage work resources and demands effectively.
  • Be mindful of occupational balance and well-being.
  • Monitor developments in practice
  • Stay aware of political, social, economic, environmental, and technological effects on occupational therapy practice.
  • Keep up to date with research, guidelines, protocols, and practices.
  • Appraise evidence related to knowledge and skills for practice.
  • Integrate relevant evidence into practice.
  • Consider the social, economic, and ecological costs of care.

• Professional Responsibility — Official range: 13–15% (Practice allocation: 14.29%)

  • Meet legislative and regulatory requirements
  • Respect the laws, codes of ethics, rules and regulations that govern occupational therapy.
  • Work within personal scope of practice and area of expertise.
  • Obtain and maintain informed consent in a way that is appropriate for the practice context.
  • Protect client privacy and confidentiality.
  • Respond to ethical dilemmas based on ethical frameworks and client values.
  • Take action to address real or potential conflicts of interest.
  • Be accountable for all decisions and actions made in the course of practice.
  • When observed, respond to and report unprofessional, unethical, or oppressive behaviour, as required.
  • Respect professional boundaries.
  • Demonstrate a commitment to minimizing risk
  • Follow organizational policies and procedures and take action if they are in conflict with professional standards, client values, protocols, or evidence.
  • Respect clients’ occupational rights and choices while minimizing risks.
  • Take preventive measures to reduce risks to self, clients, and the public.

• Engagement with the Profession — Official range: 5–8% (Practice allocation: 6.63%)

  • Contribute to the learning of occupational therapists and others
  • Contribute to entry-to-practice education, such as fieldwork placements.
  • Facilitate continuing professional development activities.
  • Act as a mentor or coach.
  • Show leadership in the workplace
  • Support assistants, students, support staff, volunteers, and other team members.
  • Influence colleagues to progress towards workplace values, vision, and goals.
  • Support improvement initiatives at work.
  • Serve as a role model.
  • Act responsibly when there are environmental or social impacts to their own behaviour or advice, or that of the team.
  • Contribute to the development of occupational therapy
  • Help build the occupational therapy body of knowledge.
  • Contribute to research in occupational therapy and occupational science, innovative practices, and emerging roles.
  • Participate in quality improvement initiatives, as well as data collection and analysis.
  • Collaborate in research with individuals, communities, and people from other disciplines.
  • Show leadership in the profession throughout career
  • Promote the value of occupation and occupational therapy in the wider community.
  • Advocate for an alignment between occupational therapy standards and processes, organizational policies, social justice, and emerging best practices.
  • Take part in professional and community activities such as volunteering for events and committees.
  • Influence the profession and its contribution to society.

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

Official sources and references

• NOTCE Resource Manual

  p. 6, Examination Blueprint

• NOTCE Resource Manual

  p. 6, Table 1

• Competencies for Occupational Therapists in Canada

  p. 9, Navigating the competencies

• NOTCE Annual Report 2025

  p. 1, Highlights

• NOTCE Resource Manual

  p. 5, Format

• NOTCE Resource Manual

  p. 7, Scoring & Pass Mark

Confirm current exam arrangements with the exam provider.