title: The association between Emergency Medical Technician-Basic (EMT-B) exam score, length of EMT-B certification, and success on the National paramedic certification exam.
abstract: OBJECTIVE
  Factors that affect success on the national paramedic certification examination have been identified. However, there are no known studies that have examined success on the paramedic exam with respect to either Emergency Medical Technician-Basic (EMT-B) examination score or length of EMT-B certification (which may reflect field experience gained prior to enrolling in paramedic training). The objectives of this study included assessing the relationship of EMT-B examination score and length of EMT-B certification to success on the national paramedic certification examination.
  
  
  METHODS
  Study data were obtained from the National Registry of EMTs (NREMT). First attempts of the NREMT paramedic certification exam from 2002 to 2006 were included. To assure that EMT-B certification exam scores were recorded, analysis was limited to individuals in the 14 states that have utilized NREMT for initial certification of both EMT-Bs and paramedics since January 1, 1997. This also facilitated accurate calculations of the length of EMT-B certification.
  
  
  RESULTS
  There were 11,163 individuals meeting inclusion criteria, and a complete case analysis was performed on 9,148, of whom 5,826 (63.7%) passed the national paramedic exam. The mean (+/-SD) score on the EMT-B cognitive exam was 75.5 (+/-6.4%), and the mean (+/-SD) length of EMT-B certification prior to paramedic testing was 3.2 (+/-2.3) years. When placed in a logistic regression model, the EMT-B exam score variable was categorized in quartiles (<or=71%, 72%-75%, 76%-79%, and >or=80%), and the length of EMT-B certification variable was dichotomized (<or=1.6 years vs. >1.6 years). With respect to paramedic exam success, after controlling for known confounders, there was an increase in the odds ratio (OR) across each of the quartiles of EMT-B exam score. The largest difference was seen when comparing the lowest and highest quartiles (paramedic exam pass rates of 45.6 and 80.8%, respectively; OR = 5.4, 95% confidence interval [CI] = 4.7 to 6.2). Individuals whose length of EMT-B certification was >1.6 years had increased odds of passing the paramedic examination (OR = 1.2, 95% CI = 1.1 to 1.3). The multivariable logistic regression model demonstrated good fit (p = 0.62).
  
  
  CONCLUSIONS
  Both EMT-B examination score and ength of EMT-B certification are associated with success on first attempt at the cognitive portion of the national paramedic certification exam. Educators may wish to consider these two factors when determining paramedic program admission standards and/or consider these variables when determining how to allocate program resources.
authors: National Registry of EMTs (ARF, JRS), Columbus, OH, USA. afernandez@nremt.org
authors: Antonio R
authors: AR
authors: Fernandez
authors: Jonathan R
authors: JR
authors: Studnek
authors: David C
authors: DC
authors: Cone
mesh_terms: D002568:Certification; D004521:Educational Measurement / Q000706:statistics & numerical data*; D004522:Educational Status; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D011361:Professional Competence; D014481:United States