I think a lot of people were overly negative on the level 0 version of this card, which I felt was fairly powerful if not game changing. I think, on the contrary, most people are in agreement that both upgrades to it are strong additions to their respective factions.
In the best case scenario this card draws you an extra card each turn, while giving you +1 to one skill test. This is a reasonably powerful effect, though it comes at the cost of 3xp, 3 resources and an accessory slot. If Grisly Totem always maanaged to deliver on this potential it would be a reasonable if somewhat unexciting spend of 3xp. However, in order to get this effect you have to be comitting a card to a skill test every turn and on top of that you have to pass that skill test. Now, the Totem does help you to pass the skill test so its not overly likely you'll fail and miss out on the card draw, but there's always the . Needing to commit a card every turn however is a little more of a restriction, though the card draw Grisly Totem provides can help to fuel itself in this regard.
Now that is the best case scenario. If you dont draw this in your opening hand then suddenly its looking a lot worse. The big question really is, how many cards do you need to draw for 3 resources and 3xp for it to be worth it? And then, how early does this need to be in play for that to regularly happen. To compare, for 2xp you could include Preposterous Sketches which will draw you a guaranteed 3 cards for 0 resources, no matter when in the game you draw it. So how many cards does the Grisly Totem need to draw on average to be worth an extra 3 resources and an xp? To simplify, lets say that the extra experience and the plus one to a skill test cancel out. So the question is how many cards is 3 resources worth? I feel like a reasonable heuristic would be 2, in line with Emergency Cache. So to recap, we have to regularly be drawing 5 cards per game with the Grisly Totem before its beating Preposterous Sketches for efficiency. If we figure that we're likely to pass 75% of the tests we use this on, that means we have to have this in play for about 7 turns for it to be the better option. Which doesnt seem too tall an ask, though the later you play it the more you are likely risking by doing so.
For a brief aside, I do think this card bears comparison to the fairly medium Tooth of Eztli. Both provide you with bonuses to skill tests, and both reward you with a card draw once per turn for passing them. They both costs 3 and they both take an accessory slot. Now, you have more control over when Grisly Totem triggers, as you can use it on any skill test and not just encounter cards. However, you do need to commit a card to the test so you may not even be netting a card necessarily, whereas Tooth of Eztli only asks you to pass tests you would have to take anyway. I'm not saying that I think Tooth of Eztli is better, but it is 3 fewer xp and fills a similar role, so it bears considering.
All of this adds up to a card that sounds pretty okay, if not hugely exciting. But that's in a vacuum. What are the situations where this card over-performs? Well I think a big thing to consider with Grisly Totem is that since you are adding both a skill icon and a card draw to a test, its going to stack up well with other cards that are relying on you passing big tests. For example, applying this to Deduction isn't just giving you a card draw, its also improving your chances of getting the succeed by two effect on Deduction. In a similar vein, I think if you have a teammate who is using Double or Nothing then you can really help them out with Grisly Totem.
Another case where this card might shine is in a more support focused build. While has a lot of card draw options, the class is definitely a lot lighter on ways to help out other investigators with drawing cards. I think trying to leverage the ability to add card draws to other people's tests could be a fun way to build with this card, particularly if you are co-ordinating with your team on deckbuilding and you know one of your allies is going to be struggling for card draw.
All that said, this does all come with the caveat that you are able to keep committing cards to skill tests. This somewhat limits the usefulness of this card to investigators who already want to be proactively committing cards to their tests. This makes the most obvious use case, by far, Minh Thi Phan. Minh meets the criteria of wanting to proactively commit cards to skill tests, it also stacks with her Analytical Mind to allow her to draw multiple cards per test. Minh is also already incentivized to stack up test rewards in order to best take advantage of her ability, which is a playstyle thats get stronger the more ways you have to stack those benefits up. Outside of Minh, I'm not convinced this is a high priority upgrade. Its biggest advantage is not having much competition for the accessory slot, but even then I feel that for 3xp you can be finding more reliable sources of card draw.