Examination Content 



The National Registry creates examinations to measure key aspects of prehospital practice. To do this, the National Registry conducts a practice analysis, collecting information and data on the job role performed by EMS clinicians.  

Psychometricians use the data collected during the practice analysis to develop the test plan, or blueprint for test construction. SMEs then create test questions or items based on the plan. This process ensures the examinations reflect current EMS practice and have content validity. The NHTSA’s National EMS Scope of Practice Model, National EMS Education Standards, and National Registry’s Practice Analysis guide content development.  

EMS programs should review the current National Registry test plan when teaching courses and evaluating students' ability to perform essential tasks.  

The content areas covered in the National Registry examinations at the EMR, EMT, AEMT, and Paramedic levels are listed below:  
 

New EMR Certification Examination Domain Information

Content Domain Percent of Examination
Scene Size-Up and Safety   19% - 23%
Primary Assessment  37% – 41%
Secondary Assessment  4% - 8%
Patient Treatment and Transport  20% - 24%
Operations  10% - 14%
*Note: items related to pediatric patient care will be integrated throughout the examination content. 

EMR Test Plan

New EMT Certification Examination Domain Information

Content Domain Percent of Examination
Scene Size-Up and Safety   15% - 19%
Primary Assessment  39% – 43%
Secondary Assessment  5% - 9%
Patient Treatment and Transport  20% - 24%
Operations  10% - 14%
*Note: items related to pediatric patient care will be integrated throughout the examination content. 

EMT Test Plan

AEMT Certification Examination Domain Information 

Content Domain Percent of Examination
Airway, Respiration & Ventilation* 9% - 13%
Cardiology & Resuscitation* 11% – 15%
Trauma* 7% - 11%
Medical/Obstetrics/Gynecology* 25% - 29%
EMS Operations 6% - 10%
Clinical Judgment* 31% - 35%
*Note: items related to pediatric patient care will be integrated throughout the examination content. 

AEMT Test Plan

Paramedic Certification Examination Domain Information 

Content Domain Percent of Examination
Airway, Respiration & Ventilation* 8% - 12%
Cardiology & Resuscitation*  10% – 14%
Trauma* 6% - 10%
Medical/Obstetrics/Gynecology* 24% - 28%
EMS Operations 8% - 12%
Clinical Judgment* 34% - 38%
*Note: items related to pediatric patient care will be integrated throughout the examination content.  

Paramedic Test Plan

Pilot Questions

During National Registry examinations, all candidates receive pilot (unscored) questions that do not affect their scores. The number of pilot items on each examination is as follows:  

  • EMR: 30 items  

  • EMT: 10 items  

  • AEMT: 35 items  

  • Paramedic: 20 items  

Examination Results 

  • Examination results are not available at the test center or by phone. 

  • Results are posted to your National Registry account within three business days if all registration requirements are met. 

  • Candidates who pass receive National EMS Certification credentials as long as all certification requirements have been met. 

  • Those who fail receive performance feedback compared to the passing standard. 

  • To prepare effectively, focus on the tasks, knowledge, skills, and abilities required for practice. 


     

Piloting and Final Review

  • All test questions are pilot tested, though piloted items do not count toward the score. 

  • Psychometricians analyze the data and approve questions for scoring on future examinations. 

  • Questions that show poor performance are removed, reviewed, revised, and repiloted. 

Part 3: Examination Preparation