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NREMT Exam and State EMT Tests
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Taking the NREMT test or State EMT exam can be a painless experience if you are prepared with the knowledge of the course material AND an understanding of what to expect of the NREMT test itself. We have created this page to aid in answering some of the more common questions associated with taking NREMT and state EMT certification tests. This includes facts and advice related to taking and passing the exams. It is intended to aid the EMT candidate is his or her pursuit of certification and registration as an EMT B, EMT I or Paramedic. NREMT exam formatting has changed to the single question deliver CAT exam. This is an adaptive exam and will vary in length. Facts you need to know about the NREMT Exam • NREMT test questions are multiple choice with 4 potential answers. All questions are created by a committee of 10-20 EMS experts who must all agree that the question is in line with the practice analysis study that was done in 1999. These EMS experts make sure that there is only one "best" or "correct" answer and that "each incorrect answer has some level of plausibility". Additionally, each question and answer must be easily found in common text books used in teaching EMT classes. • As of January 1, 2007 the NREMT has changed it's exam formatting to a CBT (Computer Based Testing) method. Exams will no longer be delivered via a paper test and completed with a pencil. All testing will be performed at a computer work station. • The CBT that the NREMT is now utilizing is called CAT or (Computer Adaptive Testing) and each exam is tailored specifically to the individual EMT candidate. This testing method is considered state of the art and uses a theory called IRT (Item Response Theory). IRT is a statistical way to measure a person's ability based on the fact that the probability of a person answering a question correctly is directly related their ability and the difficulty level of the question. Combining CAT with IRT should make NREMT exams more precise, fair and accurate. • New CAT NREMT tests will deliver questions one at a time to the candidate and will NOT be randomly chosen. They are rated along the same ability scale as the candidate is exhibiting proficiency. The first questions on the exam are generally just below the passing standard. If a question is asked that is below the candidate’s level of ability, The probability is high for the candidate to answer the question correctly. If a question asked is above a candidate's level of ability, they have a high probability of missing it. If the candidate answers the question correctly then a slightly more difficult question will be delivered next. As the difficulty of the questions increases, eventually the candidate will start to miss questions. The questions then become slightly easier and the candidate will begin to answer correctly again. At this point in the exam the application algorithm calculates an ability estimate for this candidate and begins delivering questions that are slightly harder and slightly easier than the candidate's ability. As the CAT exam progresses, the ability estimate gets more and more precise as the pattern of right to wrong answers stabilizes around the clients true ability. The exam will end at the point when there is a 95% certainty that the candidate's true ability is above or below the passing standard. • CAT and IRT match the question difficulty to the candidate's perceived level of ability and this limits the number of questions delivered as well as increases accurateness. • Exam fees can be paid online at the NREMT website, You must first be registered and sign into your account. • If you do not pass the exam you may retake it after 14 days. This period is to provide you with time to study. • NREMT test results will now be available within 24-48 hours on the NREMT website. Check your exam results here www.nremt.org Advice on how to take and pass the NREMT exam and state EMT tests: Top of Page This advice has been gleaned from dozens of sources. Information contained has been compiled from interviews with EMTs and Paramedics who have taken and passed the tests multiple times, EMS related discussion forums and nationally recognized test taking authorities. What material to study for the NREMT exam: Top of Page • Technically you should know everything that was covered in the EMT course materials. There are no secret methods or insight than can replace proper test preparation, but some things are common. The tests are heavy in the basics. Know CPR and shock as well as all of the segment categories of the test itself i.e. airway and breathing, cardiac, medical, trauma, obstetrics, pediatrics and operations. Know the major components of the airway and the normal ranges of respiration for adults and pediatric patients. Know diabetic emergencies and the various causes of syncope. • Look at the breakdown of questions. A large portion of the exam is related to operations and many students overlook this. Since September 11th a great effort has been made to incorporate more education about NIMS and ICS with regard to EMS. Understand how these systems work and how they apply to a mass casualty and you will be a step ahead of other candidates. The NREMT exam is NOT based upon the text book you used in your class. The exam is based upon the NREMT Practice Analysis done every five years. The exam questions are written to fall within the Department of Transportation EMT Curriculum. EMT text books only give you their interpretation of those standards. • Remember, although the NREMT exam looks at a minimum requirement to pass, nobody wants a "just made it by the skin of the teeth" partner. Know your stuff. • Obviously take advantage of the EMT and Paramedic Practice Tests here on our site.. There is detailed score tracking and exam review features that let you see your strong and weak areas while you continue to take exams and improve. Before taking the NREMT exam or state test: Top of Page • Eat a well balanced diet and drink plenty of water the day before. Include B vitamin foods like bananas, oatmeal, raisins and get plenty of rest. • Don't cram..... If you don't know it the night before the test, you will not likely know it for the test. Relax or sleep instead of cramming. • Don't consume a bunch of coffee or sugar before the exam it will only make your anxiety worse. • Study regularly over a period of weeks before your test. Maybe even skip the night before the exam. • Know exactly where the test center is and arrive early to eliminate the stress of being late. Remember you have to be signed up for the test. You cannot just walk in and take it. Bring your photo ID and a couple pencils. Scrap paper will be provided for you and it must be turned in with your exam. • When you go to take the test dress in multiple layers so that you can shed what you do not need and still be comfortable. Temperatures of testing centers can vary a great deal throughout the day especially if it is a rarely used room or building. • Go to the bathroom before the test. You are allowed to go during the exam, but take care of it sooner than later. You will be required to take one form of ID with you while the other stays within the testing center. It will be verified each time to leave and enter. • You must bring two forms of ID to the exam site. At least one with a photo ID. During the NREMT exam or state test: Top of Page • You CANNOT skip a question and come back to it later. The nature of the CAT exam requires that you answer each question individually before any additional questions are delivered. • Look out for words like EXCEPT, ALWAYS, NEVER, MOST APPROPRIATE and other qualifiers. Anything that puts limits on the potential answer. • Read the whole question thoroughly at least a couple of times and formulate the answer in your head BEFORE you look at the answer choices. If you look at the answer choices prior to understanding the question completely, you can be lead to choose an incorrect answer. • There are 4 potential answers. Two of them can usually be eliminated right away after reading the question a couple times. Now you just have to decide the "best" choice between the two remaining answers. • Do not complicate the scenario or situation. Do not bring elements into the questions that are not there. This will cause you to overlook the basics which is probably what the question is testing for. • Relax, remember to breath adequately.....EMT The NREMT First Responder Exam The breakdown of the NREMT First Responder Exam is as follows:
The NREMT EMT-Basic Exam
The NREMT EMT-I85 Exam
The NREMT EMT-I99 Exam
The NREMT EMT-P Exam
How NREMT Exams and Questions are Constructed Top of Page Most of the National exams given in the United States follow the formula below in developing questions. The NREMT is one of these tests. If you begin to understand what type of questions you are being asked it will allow you to begin to know how to apply the correct response. This is some deep reading, but has helped me a lot in my test taking. Read through the information then see if you can start to figure it out as you take practice tests. I’ll try to give a few examples at the end. In 1956, Benjamin Bloom headed a group of educational psychologists who developed a classification of levels of intellectual behavior important in learning. Bloom found that over 95% of the test questions students encountered required them to think only at the lowest possible level...the recall of information. Bloom identified six levels within the cognitive domain, from the simple recall or recognition of facts as the lowest level, through increasingly more complex and abstract mental levels, to the highest order which is classified as evaluation. Verb examples that represent intellectual activity on each level are listed here. 1. Knowledge: arrange, define, duplicate, label, list, memorize, name, order, recognize, relate, recall, repeat, reproduce, state. 2. Comprehension: classify, describe, discuss, explain, express, identify, indicate, locate, recognize, report, restate, review, select, translate, 3. Application: apply, choose, demonstrate, dramatize, employ, illustrate, interpret, operate, practice, schedule, sketch, solve, use, write. 4. Analysis: analyze, appraise, calculate, categorize, compare, contrast, criticize, differentiate, discriminate, distinguish, examine, experiment, question, test. 5. Synthesis: arrange, assemble, collect, compose, construct, create, design, develop, formulate, manage, organize, plan, prepare, propose, set up, write. 6. Evaluation: appraise, argue, assess, attach, choose, compare, defend, estimate, judge, predict, rate, core, select, support, value, evaluate. The chart below shows the increasing level of complexity of question construction. The NREMT exam follows a similar formula in that it starts with the basic Knowledge then begins to increase the style of question to determine the candidate’s true grasp of a subject. This is why you will see similar questions during the test. Questions will be written in a slightly different way to see if you truly grasp the concept around it. Questions given during your training are questions in the "knowledge" category 80% to 90% of the time. These questions are not bad, but using them all the time is. Instructors should try to utilize higher order level of questions. These questions require much more "brain power" and a more extensive and elaborate answer. Below are the six question categories as defined by Bloom. After each one is an example of how the question would be worded (started) so that you can begin to decipher at what level this question is being formed. KNOWLEDGE
COMPREHENSION
APPLICATION
ANALYSIS
SYNTHESIS
EVALUATION
This is the nuts and bolts of how an NREMT exam is built. Below is an example of how an NREMT question is constructed. This will give you some insight into the thinking behind each question. Steps to Question Writing A well-designed multiple-choice item consists of three main components: a stem (asks a question or poses a statement which requires completion), key (the correct answer/s), and distracter(s) (incorrect option/s). The following section is designed to enhance the candidate’s understanding of the NREMT question writing process. Step 1. Select an area of the test plan for the focus of the item * Patient Assessment Step 2. Select a subcategory from the chosen area of the test plan * Multiple patient incidents Step 3. Select an important concept within that subcategory * Assess and triage among a group of patients to prioritize the order of care delivery Step 4. Use the concept selected and write the stem * The EMT arrives on scene of a vehicle accident. Which is the most critical patient that should be transported first? Step 5. Write a key to represent important information the entry-level EMT should know * Altered Level of Consciousness ~ A patient who doesn’t remember the accident or what the day is. Step 6. Identify common errors, misconceptions, or irrelevant information * Distracting injuries * Smell of alcohol * Lack of understanding of expected findings related to a specific clinical finding Step 7. Use the previous information and write the distracters ~ A patient who has a large bleeding gash to the right arm ~ A patient who smells of alcohol and is having trouble walking ~ A patient with moderate Alzheimer’s disease (AD) who is asking to talk with the spouse who died several years ago Step 8. Complete the item using the stem, key, and distracters The EMT arrives on scene of a multiple vehicle accident. After assuring scene safety and assessing the patients, whom should the EMT transport first? 1. The patient who doesn’t remember the accident or what day it is. (Key) 2. The patient with a large bleeding gash to the right arm. 3. The patient who smells like alcohol and is having trouble walking straight. 4. The patient, whose family states, has moderate Alzheimer’s disease and is asking to talk to a spouse who died several years ago. In this example you can see that the question is asked at the Evaluation level of Bloom’s Taxonomy. That is the highest form of question. It requires you to know information about each answer option, and then weigh each against the other to determine an order of care. In this sample question you can see that a patient with an altered level of consciousness would be the most critical given the information you have. A large bleeding gash is a distracting injury, easily treated with bandaging, and not requiring the most immediate transport. A patient who smells like alcohol and is possibly intoxicated does not in itself warrant immediate transport. This would probably be the second most critical due to mechanism and not being able to determine LOC as easily as others. The patient who is asking to speak to a dead spouse has a disease that would make this type of response normal. This is the type of question that the NREMT likes to give. It requires you to really think about each option and only use the information presented in the question and answers. EMT-National-Training.com would encourage every person to read all the available information on the NREMT website. They detail for you how their tests are constructed and administered. Knowing this information helps you be better prepared and more sure in your ability to test.
NREMT Practical Exams: Top of Page The practical portion of the NREMT exam is not often given the attention that it deserves during EMT courses. Many times the instructor will only go over a practical skill once or twice in class. This does not provide the EMT student with adequate repetition to learn the skill well enough to pass an exam. Additionally some of the newest and most used text books still have the old NREMT skill sheets in them! Skills like Cardiac Arrest Management/AED have changed significantly and if you go into the exam and perform the skill according to old protocols you will fail the exam. Here are links to the 15 potential EMT-B practical skill sheets and the 12 potential EMT-Paramedic practical skill sheets that you could be asked to perform. THESE ARE DIRECTLY FROM THE NREMT NOT AN OUTDATED BOOK. |
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