(Spoiler alert: skip to the bottom to learn how to pass the NREMT exam) But the rest of the info is great too!
Know Your Enemy
The first step to passing the NREMT is to know your enemy. The NREMT exam is certainly intimidating, but with preparation, you can go in confident and walk out proud. In or to do this it’s helpful to understand what to expect and how to prepare yourself.
The NREMT is split into two parts, psychomotor, and cognitive. The psychomotor portion tests practical skills in a proctored environment. Your program and clinicals will prepare you well for this, and it is a lot easier to prepare for because the stations are somewhat predictable. Some of the areas that will be covered in the psychomotor portion are: demonstrating airway techniques, assessing a patient, reading and interpreting EKGs, and delivering Cardiopulmonary resuscitation.
The portion of the exam that scares most students is the cognitive exam. It is multiple choice has a bad rap for some legitimate and some not so legitimate reasons. This portion can be very intimidating because it is unique to every individual. No one is able to know exactly which questions and what types of questions will be asked. Studying for this portion consists of reviewing everything you have learned over the past 6-18 months in your EMT or paramedic program, which is a very daunting task.
Adaptive Testing
The NREMT exam uses computer adaptive testing. This differs from most other standardized tests, that use a linear model of examination. Linear exams have a set number of questions that are the same for everyone and require a certain number of correct in order to pass. For example, a 100 question exam might require 75 or more correct in order to pass. We are familiar with this format, but adaptive testing is nothing like it.
Computer adaptive testing, like the NREMT, uses a scale of difficulty of questions from a large bank to determine if you are meeting a standard over time. As you get questions right, the questions will get harder and harder until you start to get questions wrong. If you get questions wrong, then the exam may give you a simpler question. Assuming you are scoring a certain level of question right consistently, or exceeding the level of competency consistently, you pass.
So what does this mean for you? Well, it means that no matter how good you are, you will walk out of the NREMT failing around 50% of the questions. So feeling like you did lousy is completely normal. Your mind is telling you that you flunked based on the number of questions you got wrong when really, you’re being judged on the quality of questions you got right.
If anyone walks out of the NREMT feeling like they nailed it based on the number of questions they answered correctly, it probably means they are feeling some false confidence, or the test did not find them worthy of ramping up to higher-level questions because of their scores. Bottom line – DON’T GET IN YOUR HEAD.
So shutting off at 45, 75, 95, or 120 questions, has little bearing on how you did. You can fail or pass in a short amount of time, or fail or pass in a long period of time. There’s no need to be nervous after or during the test because of the number of questions you completed.
Pilot Questions
Another reason not to worry about the number of questions is pilot questions. Every test will contain pilot questions that the National Registry is trying out that doesn’t mean anything for your score. The computer could potentially give you 50 questions and determine your good-to-go, then use you as a lab rat for another 70 questions that have no bearing on you at all.
One Right Answer
Let’s debunk some other rumors. A lot of people think the NREMT will ask questions that have multiple right answers or all wrong answers, and you have to determine which is the most right, or the least wrong. You’ve probably heard this from reputable sources; maybe even your instructors. Well, they’re not lying to you, at least not intentionally, because this used to be true. However, for a few years now the NREMT has only been writing questions with one factual correct answer. The answer is there and it is undebatable. You just have to find it.
Local Protocol is a Myth
How about the old “local protocol” issue? You hear things like, “Well in my area we use a certain dosage. If the NREMT asks me what to put for dosage, do I use that dose or the book’s dose, or the college’s dose or some other dose?” Here’s the good news, the NREMT strives to stay away from any local protocol-like questions and aims for industry standards. This means having to recall the specific dose of an obscure medication is highly unlikely. The Registry is more concerned that you know what type of medication to use, or recognize things like contraindications, and mechanism of action. It’s not trying to mess you up with debatable minutia. It’s trying to make sure you understand general clinical concepts.
Who Writes the Questions?
Another myth is that the National Registry is hard because it’s not created by practicing providers; just some old people behind a desk. This isn’t true either. The NREMT uses practicing providers throughout the country and strives to ask relevant, practical questions.
So How Do I Pass the Exam?
Now that you know your enemy let’s answer the question that brought you here. The simple answer is that you need to study. The trick is that every student learns differently, so the goal is to find an EMT test prep program that fits how you learn. We are of course biased, and approach learning with a comprehensive approach with easy-to-understand and enjoyable video lectures as well as workbooks and quizzes to test your comprehension. You can rest assured that the Guardian Test Prep NREMT test prep course is dedicated to helping you succeed!