By Dan Limmer
The NREMT announced in 2019 and reiterated their position at the recent NAEMSE virtual conference that the NREMT is switching from a “best answer” to a “one correct answer” format.
Before I take what might seem like a slightly contrary viewpoint, I want to be sure to state that I am and remain a fan of the NREMT. Their forward-facing attitude and approachability are positive. Their response to the pandemic has been appropriate and practical.
So what am I going to say that may appear to go against the NREMT? I just don’t think it will make a big difference in the questions on the exam. Consider these points:
The NREMT “best answer” format was often seen as a code word for trickery.
Conspiracy theorists are a dime a dozen today. The “NREMT is a money grab” mentality is sadly too pervasive. The change from the “best answer” to “one correct answer” gives these people one less thing about which to complain. That isn’t a bad thing and shows an awareness and positive messaging from the NREMT.
The NREMT exam still has well-constructed questions.
What makes a question challenging? A solidly written stem with one correct answer and three good distractors. This isn’t going to stop. The NREMT will still have plausible distractors. It would be a mistake to make the exam too easy.
NREMT questions will still be different than the ones on your exams.
Face it – it is tough to create questions like the NREMT. They have item writing panels with talented writers, psychometricians, and the ability to validate questions from a giant pool of candidates. You don’t. It is challenging and time-consuming to write questions like that. Students will still find the NREMT different and scary. This hasn’t changed at all.
Technology Enhanced Items (TEI) will raise the bar a bit.
The NREMT hasn’t taken a step back with the “one correct answer” announcement. Almost concurrently, they announced TEIs: a multiple response format plus questions with images and videos. This brings the NREMT into the new century. Intuitively, I believe the new question types will up the ante without the “best answer” baggage. But time will tell. Generally, I predict our students will need a more in-depth understanding to succeed at some of these questions. Pathophysiology, somewhat undervalued and not taught to full potential, will be king here. Depth is important, however, even in things like intro and operations.
TEIs are used on other major health profession certification examinations and seem like a natural extension of the EMS certification examination into the 21st century.
The NREMT is our certification examination, and it isn’t going anywhere. It is the responsibility of students and educators to stay up-to-date on the most current science in their certification level and the pathophysiology, assessment, and management of patients they may encounter. That part will never change.