Changes to the NREMT Exam: A White Paper

Established in 1970, the mission of the National Registry of Emergency Medical Technicians (NREMT) is to develop and administer certification exams that measure the competency of emergency medical services (EMS) providers in the United States. Since most states require NREMT paramedic certification before they will issue a license to practice, the NREMT exams are high-stakes assessments need to ensure public protection.

Starting in 2017, the NREMT began to phase out the way they ensure a paramedic candidate’s psychomotor competence. Instead of assessing individual skills during their psychomotor exam, the NREMT transitioned to a new psychomotor exam and requires paramedic candidates have a psychomotor portfolio.

Rather than the highly structured skills stations that made up the legacy NREMT exam, the agency is transitioning to a comprehensive Integrated Out-Of-Hospital (IOOH) Scenario for the paramedic psychomotor examination. These types of scenarios help the NREMT verify a candidate’s ability to manage the complexity of overall patient care.

The white paper Changes to the NREMT Exam: A Rethinking of Psychomotor Competence discusses the factors that led to this change in the way the NREMT assess paramedic psychomotor competency, how it impacts paramedic education, as well as considering the additional resources and challenges the changes present to administration of the exam. It also discusses pre-planning strategies that can increase efficiency during the examination.

While the new paramedic psychomotor exam and IOOH scenarios represent a paradigm shift, they best represent how paramedics will treat real patients once they are certified. The NREMT has increased tracking requirements with student portfolios, but programs now have a tool that they can use for meaningful peer evaluation of skill and scenario performance. When administering the new psychomotor examination, host sites will need to ensure they have the logistical support that they need.

Download the white paper Changes to the NREMT Exam: A Rethinking of Psychomotor Competence.

J. Todd Vreeland is the author of Changes to the NREMT Exam: A Rethinking of Psychomotor Competence. Vreeland is the former project lead on the NREMT’s Paramedic Portfolio and Scenario-Based Exam transition. He is the owner of J. Todd Vreeland Consulting, committed to ensuring the protection of the public through high-quality EMS education and patient-centered delivery of out-of-hospital medical care.

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