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Practice Analysis

National EMS Practice Analysis & NREMT Test Plan

National EMS Practice Analysis

The goal of licensure and certification is to assure the public that individuals who work in a particular profession have met certain standards and are qualified to engage in practice (American Educational Research Association, American Psychological Association, and National Council on Measurement in Education, 1999). To meet this goal, the requirements for certification and licensure must be based on the ability to practice safely and effectively (Kane, 1982). The practice analysis is a critical component in the development of a legally defensible and psychometrically sound credentialing process.

The primary purpose of a practice analysis is to develop a clear and accurate picture of the current practice of a job or profession, in this case the provision of emergency medical care in the out-of-hospital environment. The results of the practice analysis are used throughout the entire National Registry of Emergency Medical Technicians (NREMT) examination development process, which helps to ensure a connection between the examination content and actual practice. The practice analysis helps to answer the questions, "What are the most important aspects of practice?" and "What constitutes safe and effective care?" It also enables the NREMT to develop examinations that reflect contemporary, real-life practice of out-of-hospital emergency medicine.

The NREMT conducted its first practice analysis in 1994 and at five year intervals. The most recent practice analysis was conducted in 2014. After the data is collected, an analysis is conducted that accounts for frequency and criticality. This weighted importance score is then combined for each of the five domains on the NREMT examinations: Airway, Respiration & Ventilation, Cardiology & Resuscitation; Medical & OB/Gyn, Trauma, and EMS Operations. After the weighted importance scores are calculated, the proportion represented by each area is used to set the blueprint for the next five years of NREMT examinations.

NREMT Test Plan

Based on the 2014 Practice Analysis, the current National EMS Certification Examinations covers five content areas: Airway, Respiration & Ventilation, Cardiology & Resuscitation, Trauma, Medical/Obstetrics/Gynecology, and EMS Operations. All sections, except EMS Operations have a content distribution of 85% adult and 15% pediatrics.

(90-110 items)
(70-120 items)
Advanced EMT
(135 items)
(80-150 items)
Content Area
Airway, Respiration & Ventilation
(85% adult/ 15% pediatric)
18%-22% 18%-22% 18%-22% 18%-22%
Cardiology & Resuscitation
(85% adult/ 15% pediatric)
20%-24% 20%-24% 21%-25% 22%-26%
(85% adult/ 15% pediatric)
15%-19% 14%-18% 14%-18% 13%-17%
(85% adult/ 15% pediatric)
27%-31% 27%-31% 26%-30% 25%-29%
EMS Ops 11%-15% 10%-14% 11%-15% 10%-14%

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