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by Limmer Education
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Many have been posting and writing about the upcoming changes to the NREMT exams at the advanced level, but few have gone into any detail on the how, why, and what it will mean for candidates beginning on July 1, 2024. This post will give my interpretation of the changes and how they will affect AEMT and paramedic candidates sitting for the exam.
While many believe that the psychomotor is necessary, it isn’t. An end-test for skills can be performed in several ways in class. The NREMT is accredited as a testing agency, but the psychomotor wasn’t reliable. It has to be dropped for the NREMT to maintain this accreditation. We all know that students shop exam sites because they know who was easiest—and two different examiners testing the same station on the same day could have completely different results. Let it go.
A student minimum competency (SMC) validation will now be required for AEMT students, but the details are still pretty fuzzy. States are required to create the SMC, but not all have—and may not by July. Stay tuned for more on how this will work.
Many have focused on the new exam items called technology-enhanced items (TEI). Here’s an overview of the new questions and how to practice them.
They’re new to EMS (although not to other health professions), and they’re not evil. I do think they are a bit more challenging and require higher level thinking. The issue that many people aren’t looking at is how will this affect pass rates?
This is normal when an exam changes. It takes some time for EMS to get used to these—and to teach better and more deeply to prepare students. The NREMT writes very challenging questions. Now, take NREMT questions based on a scenario with multiple responses and in the drag-and-drop format looking for ordering and prioritization. The challenge is real!
In 2023, the national pass rate for the AEMT exam (first sitting) was 58%. We are struggling already. The exam will now ask questions in a different and more challenging format.
The NREMT initially stated that there would be no partial credit for these TEI questions. More recent documents have stated that they haven’t decided on partial credit. For reference, the NCLEX (nursing exam) does offer partial credit on multiple response items.
I’d wait to take the exam until July 2, 2024, and skip the stress and expense of the paramedic psychomotor examination. If your program requires the psychomotor, you may not have a choice. But if it isn’t required, don’t go through that gauntlet. If you wait until July to take your exam, you’ll be taking the new format anyway.
I’d recommend this, especially for those who did well in class. Yes, the exam may be a little bit tougher with the new questions counting toward your score, but I still think that beats having to do a full psychomotor exam. Don’t wait much longer than early July. Knowledge degrades over time.
AEMT students may have to complete a skills minimum competency (SMC) verification. If this was done as part of your AEMT course, you would be able to avoid the practical examination as well.
In a recent webinar, the NREMT announced that the NREMT paramedic cognitive examination will increase to a minimum of 110 questions (it is 80 now) with an extended time of 3 hours for completion.
The AEMT exam will remain a computer-based, linear exam for the foreseeable future.
This means that the NREMT is bringing the exam into the present day for psychometric theory and is in line with cognitive exams for other health professions.
It means we will have an adjustment period where pass rates for AEMT and paramedic cognitive exams will likely waver a bit beginning in July.
It means educators will need to up their game to make sure students are prepared—especially at the AEMT level where the pass rate is already low. Practice tests will help students prepare for the exam (Limmer is here for you), but they won’t make up for a class that doesn’t teach the depth required to succeed.
It means that this is a change that will happen. Don’t spend time being angry or confused. Study and pass the test!
The NREMT has published answers to FAQs about these changes here.
Limmer Education
Dan Limmer, BS, NRP
Limmer Education