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By Dan Limmer

Beginning June 1, 2023, the NREMT will change how they report unsuccessful exam attempts. Instead of a report on five individual sections, students will receive a numerical score for their performance with a reference for minimum, passing standard, and highest possible score.

  • Passing NREMT score is 950
  • Highest possible NREMT score is 1500
  • Lowest possible NREMT score is 100

Before you start worrying (or cursing) about this, there are a few good reasons for the change. Plus, students will get both the new and old reports over the summer before the final change on September 1, 2023.

nremt webinar screenshot: bulleted list that reads, "better and more informative feedback for future successful attempts; rationale is incomplete conclusions drawn by candidate; student preparation: how far from the mark; industry standard; NCCA accreditation"

This slide from the NREMT shows the reasons for the scoring change.

New NREMT Scoring: No Big Deal

Here are four reasons why this isn’t as big an issue as you may think.

  1. The NREMT has advanced the psychometric evaluation of candidates.
    An NREMT employee told me they often have an idea of pass/fail after just 20 questions on adaptive exams (although the entire exam is used for the final decision).
  2. The exam isn’t as dependent on the sections for scoring pass/fail as it used to be.
    This dovetails with point #1. The exam uses an overall approach and may have an asymmetrical representation of the traditional topics. The exam can now determine pass/fail independent of those topical sections.
  3. Students over-rely on the existing 5 section reports.
    Since the number of questions and difficulty level may vary widely between one exam and the other, preparing for the entire exam is generally advised—not just an individual section. Many students find that the scores of below/near/above passing sections change between different attempts.
  4. The 5 sections are expansive.
    They cover broad areas of material. Medical and obstetrics are two very different things. Operations covers material taught at the beginning and end of courses. Pathophysiology, assessment, and pediatrics are represented in each section. Even when the NREMT reported on section results, the results didn’t tell us as much as we thought.

How to Study for the NREMT After Failing Your First Attempt

If the belief that section reports provide guidance for study is flawed, how will students know what to study and in what amounts for second and subsequent attempts at the cognitive exam? Here is our advice:

Take a moment to debrief after the exam.

Write down notes on individual things you didn’t know (conditions, treatments, terms) and want to study. Remember that the NREMT forbids noting or sharing actual question content.

Reflect on the exam in a big-picture mode. How did the exam feel to you as far as difficulty level? Were you prepared? Do you think you took your time and read the questions well? Use this in the event you need another attempt.

Do some soul searching.

Did you really prepare for the exam? Did you study and participate during class? Did you get good grades in class? If the answer to any of these is “no,” you’ll need a more comprehensive study plan. Many underestimate the NREMT and believe they can get just through it.

Use diagnostic exams that help identify areas of weakness.

While doing the exams, write down anything you don’t know on a study list. Go back and study that material after finishing the practice test.

When you get a practice question wrong, be sure to read the rationale (when provided), then go back to the question to figure out what you didn’t know, missed, or misinterpreted that would help you get a similar question correct next time.

Plan for the long haul.

Students should create a plan that involves studying most days over a period of weeks—small bursts of studying work better than long cram sessions.

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