National Registry Paramedic – EMT Training
Once a candidate completes their paramedic education at a program accredited by CAAHEP (Commission on Accreditation of Allied Health Educations), they become eligible for the NREMT exam. A National Registry Paramedic candidate must successfully complete both the Cognitive and Psychomotor exams to become eligible for the NREMT’s National EMS Certification at the paramedic level.
If you don’t know whether you want to become a paramedic or an EMT, check out EMT vs. Paramedic for more information on each career.
This page will focus primarily on the National Registry of EMT Paramedic exams, however there have been some significant changes to Paramedic schooling programs and Psychomotor testing in August 2016 which will also be discussed.
All candidates that begin a Paramedic program after August 1 2016 are required to complete a paramedic portfolio that will become a part of their permanent education file.
You may be asking:
What is a paramedic portfolio?
Basically a paramedic portfolio is documented evidenced of how a student performed throughout their paramedic school program. It can be physical – with papers in a binder (Paramedic skill sheets, clinical sheets, etc) or it can be an electronic online paramedic portfolio.
The portfolio is a collection of evidence that shows the progress a student made throughout their training and it can be presented if the National Registry audits the EMS professional.
Some vital things that will be included in the paramedic portfolio are records of successful completion of the 33 required Paramedic skill sheets, Scenario Lab Forms, Clinical Evaluation Forms, and Capstone Field Shift Evaluation Worksheets.
The paramedic portfolio shows competency in emergency medical skills which means the National Registry paramedic psychomotor exam no longer needs to test candidates on 12 basic skills like in the past. Here is some information about the required paramedic portfolio forms.
The Scenario Lab forms document 20 successful performances in both the team member and team leader roles. (These patient contacts must involve any of the 15 Scenario Topic Areas.)
Ten of these will be successful team member evaluations and ten will be team leader evaluations.
In the team leader role the candidate will be required to complete:
→ Four successful adult patient leads.
→ Three successful pediatric patient leads.
→ Three successful geriatric patient leads.
Once a student demonstrates acceptable performance in any Scenario Lab topic area, the student is permitted to move on to the related clinical area. At this point a Clinical Shift Evaluation Worksheet must be completed by the Clinical Preceptor for each of the candidate’s clinical rotations.
Once these skills are completed in a clinical setting the candidate can move on to the Team Leader position at the Capstone Field Internship.
At this point Field Shift Evaluation Worksheets will be completed by the Field Preceptor for each of the candidate’s field rotation.
To clarify, during the Capstone field internship the candidate is a team leader in field and supervised by a clinician that is at least at a paramedic skill level.
The Candidate acts as team leader running all the calls and the preceptor only steps in to avoid patient safety issues, etc.
The patient contacts during this field internship will take place on an Advanced Life Support (ALS) Unit responding to critical and emergent patients (911 calls).
In order to successfully complete the field internship, the candidate will need to succeed in 18 of the last 20 patient contact evaluations.
The calls getting evaluated can be BLS (Basic Life Support) or ALS, because it can be difficult to get 20 ALS calls in a row. (“Successful” will be defined as a score of “2” in the Team Leadership category of the Capstone Field Internship Evaluation Worksheet).
National Registry Paramedic – Cognitive
The National Registry of EMT exam for the Paramedic level is a written Paramedic test that will have from 80 to 150 questions. There are 20 pilot questions in the paramedic exam that are being tested for future exams and do not count towards your final score.
The NREMT Paramedic (NRP) cognitive exam will cost $125 per testing attempt and the candidate will have up to 2 hours and 30 minutes to complete the paramedic test.
The NREMT Paramedic test is a written exam, but it is administered via computer using computer adaptive testing (CAT), which is discussed in detail below.
The cognitive portion of the NREMT exam for the Paramedic is constructed to administer test questions from 5 areas of content. The content categories are Trauma, EMS Operations, Airway; Respiration and Ventilation, Cardiology an Resuscitation, and Medical; Obstetrics and Gynecology.
Within these content areas, any questions related to patient care will pertain to 85% adult and elderly and 15% pediatric patients.
The goal of the National Registry Paramedic exam is to determine whether candidates possess the complex knowledge and skills needed provide patient care at a competent level. The paramedic tests need to assess whether candidates can successfully apply book learning and course knowledge to field experience while they provide safe patient care.
The paramedic test is designed to create situations and tasks an advanced EMS professional will need to respond to once on duty.
Wrong answers on the paramedic exam may reflect wrong decisions in the field that can lead to incorrect assessment or treatment of patients in the field.
The paramedic cognitive exam is organized using a test plan approved by the National Registry of EMT Board. The test plan is a blue-print that communicates with the computer testing software and instructs it on how to build each candidate’s exam.
According to the test plan each Paramedic exam will focus on:
• 13% – 17% Trauma
• 10% – 14% EMS Operations
• 18% – 22% Airway; Respirations and Ventilations
• 22% – 26% Cardiology and Resuscitation
• 25% – 29% Medical; Obstetrics and Gynecology
These 5 areas of content cover Emergency Medical Services (EMS) care and the standard for passing each is providing safe and effective entry-level emergency medical care.(This is also true for the for EMT-B and AEMT when taking the NREMT Exam )
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COMPUTER ADAPTIVE TESTING
Computer adaptive testing is a specific type of testing and being familiar with it can give you an advantage when taking the Paramedic test. The directions for the National Registry Paramedic exam are simple and you don’t need to be familiar with computers to do well on this test.
However, understanding computer adaptive testing (CAT) and getting comfortable with it can help a candidate pass the National Registry Paramedic exam and further your goal towards becoming a paramedic.
Computer adaptive testing (CAT) is different from the computer based linear tests that candidates may be used to. These linear tests are similar to taking a test with pencil and paper.
Linear tests have a fixed number of questions and the computer allows candidates to go back and change answers, mark questions for review, and skip questions. There is also no penalty for guessing with a linear test.
Computer adaptive testing however doesn’t have a set number of questions, there is no skipping questions or going back to change answers, and there will be a penalty for guessing. Now that you know the differences between these two types of tests, lets talk about how CAT works on the National Registry Paramedic test.
The computer adaptive test algorithm used for the NREMT Paramedic exam is a variable length (80-150 questions) test during which questions are delivered in a specific logical manner.
The paramedic test algorithm begins by presenting a medium or medium-easy item as the first question. The next paramedic test question is chosen based on whether the candidate gets the first question right or wrong.
Question Answered Correctly – If the candidate answers the National Registry Paramedic test question correctly, they will be given a question on the same topic that is of a higher difficulty level. This higher difficulty level question may not be asked immediately because the algorithm may test on other medium and medium-easy topics before moving to medium hard difficulty topics.
If the candidate continues to get answers correct on a topic, the difficulty level will increase until they either reach maximum ability level and begin to get the questions wrong or they reach the level of competency needed to pass that topic.
Question Answered Wrong – If the candidate answers the first National Registry paramedic test question incorrectly, the algorithm will at some point offer an easier question on that topic. If they answer wrong again they will be given an even easier question.
If they answer this question correctly, the algorithm will increase the difficulty level again and give the candidate another chance to get a question correct at that level of difficulty.
If the candidate gets it right, the difficulty gets harder until they reach their maximum ability level and consistently answer wrong on the same measured difficulty level, or they show the required level of competency needed to pass a content topic area.
Reasons Paramedic Test Will End – The algorithm continues to assess the test takers knowledge with each question and the National Registry paramedic exam will end when:
– It’s 95% confident the candidate is competent in each area of content.
– It’s 95% confident the candidate can’t reach the level of competency needed to pass the exam.
– The 2 hour 30 minute time limit is up.
– Candidate has answered the maximum allowed 150 questions.
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