New item types introduced to the National Registry examinations With a new theoretical framework and using enhanced technology to measure clinical judgment, leadership, and communication, we are expanding the types of items found on our examinations.   

The Scenario

A 20-year-old patient (84 kilograms) reports new onset coughing and chest tightness. Past medical history includes asthma and a tibia fracture five years ago. The patient’s medications include an albuterol rescue inhaler, an inhaled corticosteroid, and a long-acting beta2 agonist. The patient is alert and oriented, and their vital signs are BP 135/85, P 105, R 28, and SpO2 90% on room air. The EtCO2 is 33 mmHg with a “shark fin” waveform. The blood glucose level is 70 mg/dL. Auscultation of the chest reveals minimal wheezing. Slight accessory muscle use is observed. ECG reveals sinus tachycardia.

Build List

Candidates are given a split screen with a list of options in the L column and an answer space in the R column. The candidate then orders content according to instructions.


When using this type of item, the candidate is required to select and reposition answers within a list or a graphic. Here, content is moved from the L to the R columns.

Option/Check Box

An item that incorporates user interface elements. In this case, the interaction is an option/check box table. The candidate's response is indicated with an option/check box feature, like a point-n-click survey.

The TEI’s increase testing fidelity by making the experience more genuine, practice-related, and engaging for test takers.  

These items are created and scrutinized through the same process and by the same standards that the National Registry has used for years past. They are still developed by EMS field experts, evaluated by psychometricians, and will meet all standards and requirements for accreditation.