An analysis of Michigan EMT licensure examination results as a predictor of paramedic licensure examination success.
INTRODUCTION: Predicting paramedic candidate performance on the written licensure examination is of considerable importance to educators, students, employers, and state regulators. There has been little investigation of the available statistical data regarding examinee pass rate and examination score. No studies have measured an examinee's sequential success pattern on the basic emergency medical technician (EMT) or paramedic examinations. There has been no analysis of the relationship between the number of examinations required for successful paramedic licensure and examination score. OBJECTIVE: The purpose of this study was to determine the frequency with which paramedic licensure examinees successfully pass the State of Michigan written examination on the first or subsequent attempts; to determine the frequency with which the paramedic examinees pass the prerequisite basic EMT licensure examination; to determine whether the frequency of paramedic examination attempts is related to examination score; and to determine whether there is a relationship between successfully passing the basic EMT examination and successfully passing the paramedic examination. METHODS: A retrospective study of Michigan paramedic licensure examination results for 1994 was done on the basis of a review of reports prepared for Michigan Department of Public Health Emergency Medical Services (MDPH-EMS) by Professional Examination Services. Analysis of paramedic examination score and the number of examination attempts is correlated to EMT score and number of attempts required to pass. Success in the first or subsequent paramedic examinations is correlated to paramedic score, and success in passing the first or subsequent EMT examination is then related to success in passing the paramedic examination. RESULTS: Paramedic examinees (n = 869) generated a 72.1% pass rate in 1994 (mean score = 82.2%). The minimum passing score is 80%. The average score for examinees who passed (n = 627) was 86.2% (95% confidence interval [CI] = 85.8-86.6%); those who failed (n = 242) averaged 71.9% (95% CI = 71.1-72.6%). Paramedic examinees successful on the first attempt (n = 500) had higher average scores (mean = 87.1%; 95% CI = 86.7-87.5%) than did those who required multiple attempts (mean = 82.8%; 95% CI = 82.3-83.3%; n = 127). A total of 702 (90.5%) paramedic examinees passed the EMT examination on the first attempt. Examinees who passed the EMT examination the first time averaged fewer attempts on the paramedic examination (mean 1.5; 95% CI = 1.4-1.6) than did those who required multiple EMT examinations (mean 2.3; 95% CI = 2.0-2.6). Paramedic examinees passing the EMT examination in one attempt had higher average paramedic scores (82.6%; 95% CI = 82.1-83.2%) than those needing multiple EMT attempts (75.5%; 95% CI = 73.4-77.5%). CONCLUSION: Paramedic examinees who pass their EMT licensure examination on the first attempt have a significantly better chance of passing the paramedic licensure examination. Paramedic licensure examinees who pass the paramedic examination on the first attempt score significantly higher than do examinees who require additional attempts. Paramedic programs should incorporate EMT examination performance into their student selection criteria. Further study of variables predictive of success is needed.