Can a Short Survey Predict Outcomes on the NREMT Exam?

Hypothesis: A short survey of clinical questions and student perceptions can be used to identify student outcomes on the NREMT cognitive EMT exam.

Methods: The National Registry of Emergency Medical Technician Readiness Assessment Test (NREMT-RAT) containing two parts, perceptions of preparation and core clinical concepts, was administered to EMT students at the U.S. Army EMT training program. Clinical components of the NREMT-RAT contained multiple-choice items relating to core EMT knowledge points, including pathophysiology, airway, cardiology and resuscitation, medical emergencies, obstetrics, and trauma. Three questions in the perception of preparation and readiness section asked about the student’s EMT class, study efforts, and ability to focus. Surveys were evaluated in an attempt to identify differentiating characteristics between students who passed and failed the NREMT.

Results: The 752 students in two cohorts completed the NREMT-RAT. The NREMT pass rate for the combined cohorts was 78% (586 students). Of the students who failed the NREMT (166), 86.7% scored 7 or fewer correct. 3.8% (22) of the students who failed the NREMT scored 8 or more correct. Also, 66% (389) of the students who scored 7 or fewer correct passed the NREMT. The student’s perception of preparation varied widely from their actual NREMT results. Of those who failed the NREMT cognitive examination, 89% (147) believed they were prepared well by their EMT class, and 55% (91) thought their study was effective. In addition, 40% (66) of those who failed reported feeling able to focus during study, compared to 52% (303) of successful students.

Conclusions: The NREMT-RAT identified students who were likely to be unsuccessful on the NREMT cognitive examination but was not a predictor of exam success. This will be helpful in identifying students in need of remediation before testing as well as highlighting foundational educational concepts to be highlighted in the EMT classroom. Students’ perceptions of preparation did not correspond to actual performance on the examination.