Tools for CTR Exam Success

Vol. 17 •Issue 13 • Page 14
Registry Perspectives

Tools for CTR Exam Success

Make a plan, prepare well and you will be successful when taking the certified tumor registry exam.

Studying for the certified tumor registrar (CTR) exam and then taking the exam are important steps in your career. Being successful in obtaining the credential is also important for your own personal growth and sense of accomplishment.

When teaching the National Cancer Registrars Association (NCRA) CTR Exam Prep Workshop twice a year before each testing period, Carol Schultz, RHIT, CTR, and I offer a number of tips, suggestions and philosophies to the students. We consider this information as important as the exam content. Understanding how to study and prepare for the exam, as well as the approach to actually taking the exam, can mean the difference between success and failure. In preparing for the exam, students may often think they perform well at their job, so therefore can pass the exam. They neglect to prepare for the areas the test will cover that are not part of their daily routine, or take the time to refresh their memories on general information they once knew but is now a fuzzy memory. Another common challenge is that many exam candidates know the material but have difficulty in relating the test questions to their knowledge. There is an art to taking a test, in understanding how to read test questions and then connecting those questions to your knowledge base.

Studying for the Exam

Once a decision has been made to apply for the CTR exam, it is imperative to devise a plan to prepare. This preparation includes an assessment of your knowledge base and an honest evaluation of your strengths and weaknesses. This assessment cannot begin without a review of the topics that will be covered on the exam, which can be found on the NCRA Web site,, or the NCRA’s Council on Certification Web site,

A careful review of the CTR exam outline is essential to developing a study plan. There may be items on this list that were not expected, such as computer principles. The review of this list should include making notes of your strengths and weaknesses. Split your study time between the topics, making sure to cover all of them. A good plan would allocate extra time to two categories, those areas where you aren’t as confident and those areas that make up the largest percentage of the exam. Actually write down on paper the areas you need to study, and devise a time line. Some time should be devoted to all topics, with the most time allocated to those areas in which your knowledge is not as extensive. It is also important to build some extra time in your study plan for those areas that may need more time than you originally thought or for unplanned interruptions over which you may have no control.

Check your study plan often and assess the progress made. This will allow adjustments to the plan as needed, but it is important to stay with the plan and timeline to avoid a last minute panic. A study plan and timeline will allow you to feel in control and confident about the upcoming exam.

Relate the information in the textbooks and manuals to procedures and job tasks that are performed on the job. Putting the information into a real world context will bring the information alive and enable better retention of the items being studied. Another option to reinforce the item being read is to take the quiz in the textbook or do the exercises that may be provided. This will make the readings connect in your brain with the process of performing the tasks and make retention of the knowledge easier. When following this study plan, if you miss a question on a quiz, ask why you missed it. If you misread the question, slow down and read the questions more thoroughly. This is good practice for the actual exam, and might alert you to a bad habit of reading quickly and assuming too much. If the reason you missed the question is because you did not know the answer, then study the material more thoroughly than you originally planned and add this into your timeline.

It is also important to relax on learning all the detail and get the big picture first. Once there is an understanding of the main concepts, it will be easier to move on to grasping the concepts of the details. If there isn’t adequate study time for these details, the main concepts may be enough for the majority of the exam.

When studying for the exam, it is important to take a practice test, such as the one that is given with the NCRA Exam Prep Workshop. It can help identify your strengths and weaknesses. After you have identified those areas, study what you missed. Do not study what you got right, for that is a waste of valuable time. Then retake the test to confirm your understanding of the material you originally missed.

There are a number of studying philosophies that we share with our students. According to Schultz, one of the best is the “read it, write it, say it and hear it” approach. These study techniques have been well established in the education community. Study time will become much more effective and efficient when you follow at least two of these activities, and even better if you can incorporate all four. Read the chapter in the textbook in your head, write the information, then also say the text out loud, or listen to it being read by someone else. For example, many students after attending the NCRA Exam Prep Workshop also purchase the live taping that was made. It has been established that utilizing more than one activity at a time assists in better retention.

Schultz also tells the students to remember, “He who asks a question may appear a fool for 5 minutes. He who does not ask is a fool forever.” It is essential to ask for assistance if there is any question that you may not understand the material. Get clarification from a trusted source. It is also stated, “Every problem has a solution, but first you must recognize there is a problem.” Don’t assume knowledge just because those tasks, procedures or rules are part of your daily job. Always review all manuals and source documents to ensure your daily practice follows the national guidelines and rules. Just because that is how you were trained at a particular job or how you always did it, does not make it right.

Taking the CTR Exam

Once the day has arrived to take the exam, there are some pieces of advice that should be remembered. First is to relax, as it is hard to think if you are panicking and the adrenaline is flowing. A few nerves are normal and actually heighten your senses. If the study plan was followed, it should be successful and all the preparation for the test will pay off.

When taking the exam, put the test questions into a real world example. If someone asked you this question at work, or you had this chart, how would you handle it? Remember the steps in the study plan where it was recommended to connect the information in the textbooks and manuals to real world situations. Now take advantage of those studying tips. If someone came to you and asked about a rule or regulation, you would probably be able to answer without hesitation. Don’t doubt yourself now, just because the question is on the test. If the question is regarding daily tasks, such as abstracting, coding or staging, imagine for a minute that a chart is in front of you with this same information and it will immediately come to mind how this situation would be handled.

When dealing with the open book portion of the test, where you are asked to apply your knowledge, follow the same advice. Imagine you are abstracting and need to code or stage the case. Look up the information in the manual and determine the correct answer. Then verify the answer is among the choices on the exam. This will allow you to follow normal work patterns or procedures and prevent you from being confused by the other options in the multiple choice answers.

If you have no knowledge of the correct answer, follow these tips for deciding how to guess: 1) Read the question again to discern what they are asking for, 2) Disregard answer with “always” and “never,” 3) Disregard answers that are aggressive or do not make sense, and 4) Whatever is left, pick the longest, for the English language is complex and it can take a lot of words to make an answer correct.

Words are very powerful, and the phrasing can make a difference. Schultz often uses the example, “Honey when I look into your eyes time stands still” or “Your face could stop a clock” are two phrases that say the same thing but with the different words they have a totally different meaning. Read all exam questions carefully to ascertain their intent so that the answer chosen reflects the purpose of the question.

The final tip: “Make a plan, prepare well and you will be successful.”

Donna M. Gress is employed by the American College of Surgeons as the American Joint Committee on Cancer technical specialist, and has been teaching the NCRA Exam Prep Workshop for more than 10 years.

About The Author