The Association Between Emergency Medical Technician‐Basic (EMT‐B) Exam Score, Length of EMT‐B Certification, and Success on the National Paramedic Certification Exam

Abstract

Objectives: Factors that affect success on the national paramedic certification examination have been identified. However, there are no known studies that have examined success on the paramedic exam with respect to either Emergency Medical Technician-Basic (EMT-B) examination score or length of EMT-B certification (which may reflect field experience gained prior to enrolling in paramedic training). The objectives of this study included assessing the relationship of EMT-B examination score and length of EMT-B certification to success on the national paramedic certification examination.Methods: Study data were obtained from the National Registry of EMTs (NREMT). First attempts of the NREMT paramedic certification exam from 2002 to 2006 were included. To assure that EMT-B certification exam scores were recorded, analysis was limited to individuals in the 14 states that have utilized NREMT for initial certification of both EMT-Bs and paramedics since January 1, 1997. This also facilitated accurate calculations of the length of EMT-B certification.Results: There were 11,163 individuals meeting inclusion criteria, and a complete case analysis was performed on 9,148, of whom 5,826 (63.7%) passed the national paramedic exam. The mean (±SD) score on the EMT-B cognitive exam was 75.5 (±6.4%), and the mean (±SD) length of EMT-B certification prior to paramedic testing was 3.2 (±2.3) years. When placed in a logistic regression model, the EMT-B exam score variable was categorized in quartiles (£71%, 72%-75%, 76%-79%, and ‡80%), and the length of EMT-B certification variable was dichotomized (£1.6 years vs. >1.6 years). With respect to paramedic exam success, after controlling for known confounders, there was an increase in the odds ratio (OR) across each of the quartiles of EMT-B exam score. The largest difference was seen when comparing the lowest and highest quartiles (paramedic exam pass rates of 45.6 and 80.8%, respectively; OR = 5.4, 95% confidence interval [CI] = 4.7 to 6.2). Individuals whose length of EMT-B certification was >1.6 years had increased odds of passing the paramedic examination (OR = 1.2, 95% CI = 1.1 to 1.3). The multivariable logistic regression model demonstrated good fit (p = 0.62).Conclusions: Both EMT-B examination score and length of EMT-B certification are associated with success on first attempt at the cognitive portion of the national paramedic certification exam. Educators may wish to consider these two factors when determining paramedic program admission standards and ⁄ or consider these variables when determining how to allocate program resources.ACADEMIC EMERGENCY MEDICINE 2009; 16:881-886 ª 2009 by the Society for Academic Emergency MedicineKeywords: emergency medical technicians, emergency medical services, certification, professional education T here is a high demand for qualified paramedics, and this demand is projected to persist in the coming years.1 Almost every state requires national certification to obtain state licensure and provide patient care as a paramedic.2 As such...

Paramedic educational program attrition accounts for significant loss of potential EMS workforce

“…Program performance and overall success are difficult to define, assess, and track. Early work focused on the innate challenges associated with paramedic program education 13–17 . Margolis et al identified high performing paramedic educational programs and described subjective characteristics of paramedic programs, such as maintaining high‐level entry requirements and fostering a culture that values continuous review and improvement 18 .…”

“…Early work focused on the innate challenges associated with paramedic program education. [13][14][15][16][17] Margolis et al identified high performing paramedic educational programs and described subjective characteristics of paramedic programs, such as maintaining high-level entry requirements and fostering a culture that values continuous review and improvement. 18 Most recently, studies have evaluated paramedic program success as defined by first and cumulative third certification pass rates.…”

Administrative and Educational Characteristics of Paramedic Programs in the United States

“…Early work completed before mandatory national accreditation focused on innate challenges associated with paramedic program education. [13][14][15][16][17] Margolis, et al identified high-performing paramedic programs and described their subjective characteristics, such as maintaining high-level entry requirements and fostering a culture that values continuous review and improvement. 6 This focus was amplified by the community direction toward national accreditation as a first step in improving paramedic education.…”

The Association Between Emergency Medical Services Field Performance Assessed by High-fidelity Simulation and the Cognitive Knowledge of Practicing Paramedics

“…Research regarding educational factors and personal characteristics that affect entry level competency within EMS has been conducted. [5][6][7][8][9] However, there is very limited research assessing the continued competency of EMS professionals. A majority of the continued competency literature focuses on skill degradation, knowledge retention, and educational interventions.…”