Certification Policies and Procedures

Certification means you have met the standards of the certifying body in credentialing. Certification is recognized by employers, state licensing agencies, and the public as being tied to competency.

State Licensure, on the other hand, is what gives you the right to work in a particular capacity. Nationally certified EMS providers who are not state licensed cannot practice. After you obtain National Certification you must obtain a license to work.

NATIONAL EMS CERTIFICATION LEVELS
First Responder, EMT-Basic, EMT-Intermediate/85, EMT-Intermediate/99, Paramedic

National EMS Certification is important to the American Public. It assures them that the EMS professionals providing care are competent. The goal of the NREMT is to offer this assurance to the public. Obtaining National Certification is the best way for you to communicate to the public and your employer that you have demonstrated a national level of competency. National Certification provides a standard that American citizens deserve – at their moment of greatest need.

All NREMT certification levels require successful completion of both cognitive and psychomotor exams. Passed portions of the exam (both cognitive and psychomotor) remain valid for a twelve (12) month period. Applicants not completing the remaining portion of the examination within that twelve month period are required to repeat the invalid portion.

COGNITIVE EXAMINATION

Committed to determining competency in the most fair, accurate and precise method possible, the NREMT uses computer adaptive testing to deliver First Responder, EMT-Basic, EMT-Intermediate/85 and Paramedic examinations. With computer adaptive testing (CAT), each question is tailored to the individual candidate. This means that if you answer the question correctly, the next question can be slightly more challenging. If you answer a question incorrectly, the following question will be slightly easier. With each question you are asked, the computer algorithm statistically re-estimates your ability. This estimate gets more and more precise as the exam progresses. This means no two exams are exactly alike. The exam, however is designed so that all competent candidates can pass. The number of items a candidate can expect on the exams and maximum amount of time given to complete the examination vary by exam.  

All exams include pilot test items that do not count for or against your exam results. Pilot questions are being evaluated for possible inclusion on future exams. There is no way for you to identify pilot items, so it is in your best interest to answer every question to the best of your ability.

There are two important concepts to remember about computer adaptive tests:

1. There is no minimum number or percent of correct items needed to pass as with a traditional paper-and-pencil test.
2. All candidates will be challenged to the limit of their ability, so everyone taking the exam will think it is difficult.

Unlike from the exams described above, the EMT-Intermediate/99 cognitive exam is a linear exam, consisting of 150 multiple-choice items based upon the Intermediate level practice as identified in the 1993 EMS Education and Practice Blueprint and current American Heart Association guidelines. Two hours and 30 minutes are allowed for completion of the examination.

All exams cover the entire spectrum of EMS care including: Airway and Breathing, Cardiology, Trauma, Medical, Obstetrics and Pediatrics, and EMS Operations.

In order to pass the exam, you must meet a standard level of competency. The passing standard is defined by the ability to provide safe and effective entry level emergency medical care.

The NREMT will provide feedback on your performance in these areas in the event you are unsuccessful in passing the exam. Details regarding retesting are found within each certification level section.

PSYCHOMOTOR EXAMINATION

The psychomotor examination provides a hands-on opportunity for you to demonstrate the skills you have learned.

First Responder and EMT-Basic

Speak with your instructor or State EMS Office about the format and logistics of completing a state-approved psychomotor examination.

EMT-Intermediate/85, Intermediate/99 and Paramedic

Arrangements for this examination should be made with the designated Examination Coordinator. A current listing of scheduled psychomotor examination sites can be found here.

The National Registry Representative who oversees the administration of the psychomotor examination will forward results of your exam to the NREMT for official processing.

Details regarding psychomotor skills requirements are found within each certification level section.

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