Interventions are 38% of the OTR exam. Plan your four hours accordingly.

Domain 01 is 23% of the OTR exam. It covers acquiring information about the factors that influence occupational performance throughout the OT process: building an occupational profile, screening, selecting and administering standardised and non-standardised assessments, analysing performance skills and patterns, identifying client factors, and evaluating the contexts and environments in which occupations happen.

Domain 02 is 23% of the OTR exam. It covers turning evaluation data into conclusions about client needs and priorities: interpreting assessment results, identifying strengths and barriers to occupational performance, writing measurable client-centred goals, selecting a frame of reference and intervention approach, planning for discharge from the first session, and monitoring and modifying the plan over time.

Domain 03 is the largest domain at 38% of the OTR exam. It covers selecting and implementing interventions for a client-centred plan: occupations and activities, preparatory methods and tasks, education and training for clients and caregivers, advocacy, group interventions, adaptive equipment and assistive technology, orthotic fabrication and wearing schedules, environmental and home modification, and grading activities up or down in response to performance.

Domain 04 is 16% of the OTR exam. It covers managing professional activities of yourself and others: supervising occupational therapy assistants and aides, establishing service competence, documentation and reimbursement requirements, regulatory and ethical compliance, evidence-based practice, safety and infection control, incident reporting and quality improvement.

The OTR exam is 180 items in four hours and the COTA exam is 190 items in the same four hours. This works out the seconds per item for each, and tells you whether a practice attempt is ahead or behind at any point.