Applicants who have completed their EMS training, at any level, must pass the National Registry of Emergency Medical Technicians (NREMT) exam. Created by the National Transportation and Safety Administration (NTSA), the EMS exam standards of the NTSA apply to all states due to the importance of a high and consistent standard of quality care. While the examination content does not reflect local or state protocols; it reflects the National EMS Educational Standards.
Whether certification at the Emergency Medical Responder, Emergency Medical Technician, or Paramedic levels, a person must take and pass a Computerized Adaptive Test (CAT). No longer using any paper tests, the National Registry use of the CAT allows for the creation of a shorter, more precise test that is individualized to each applicant’s level of knowledge and skills.
Applicants pursing National EMS Certification as an Advanced-EMT must take and pass Computer Based Linear Tests (CBT). A linear CBT exam is a fixed length, computer version of a paper and pencil exam.
For each level, a passing standard, identical for all those testing at their level of certification, is used to determine whether a person has passed or failed the cognitive exam. The lowest minimum passing standard will be the degree of knowledge or ability that a qualified EMS provider must demonstrate. This passing standard is set by the National Registry Board of Directors and is continually under review, usually about every three years.
When the exam begins,
the individual testing receives pilot questions that are a vague form of ‘live’ items. While not factored into a candidate’s exam performance, the pilot questions set the tone for the actual exam. They help determine the knowledge and training level of the candidate, in order to customize the exam to that level. The number of “pilot test” items on each exam are as follows:
- Emergency Medical Responder: 30 items
- Emergency Medical Technician: 10 items
- Advanced EMT: 35 items
- Paramedic: 20 items
NREMT test questions are multiple choice with 4 probable answers. They cover emergency medical service operations, airway and respiration issues, cardiology and resuscitation, trauma, and medical and obstretics/ gynecology paramedicine.
There’s a single pass score for each individual. The pass score determines that the candidate obtained the level of competence required by the NREMT. Scores below the pass level are scored as failures. It is crucial to answer every question as best as you can; one cannot go back and change answers. No test will be the same, questions will vary for each individual.
All exam items evaluate your ability to apply knowledge from your course and textbook to the types of tasks and situations that are expected of entry-level EMS professionals. Questions that are answered incorrectly on the exam mean the individual could choose the wrong assessment or treatment in the field. Therefore, the test is essential and valuable to providing the public with quality emergency care.
Each exam item evaluates a capability to utilize knowledge of the EMS training courses and textbooks, to varieties of tasks, conditions, scenarios which are expected of entry-level EMS personnel. The determination of the tester’s capabilities is extremely important because incorrect answers could mean that an individual might choose the wrong diagnosis or treatment when on the job and in the field.
The number of questions asked varies from 65 to 120. Once the computer has reached a degree of approximately 95 percent that a level of competence has been scored, the test will end. A maximum of two hours is allowed to complete the exam. An individual will usually have the results available within 24 to 48 hours. These test results are posted on the NREMT website, accessed by a password protected link.
It is highly recommended that one take advantage of the many NREMT practice tests and handbooks that prepare one for the NREMT exam.
Upon having successfully completing the exam, a person will become licensed to practice in their state of certification. One can next apply for national certification. In some states and countries a licensed EMT or Paramedic can work without getting registered. Nevertheless, it is wise to register, verifying to the public and employers, that you are qualified to perform emergency service skills and responsibilities.