The following abstract was developed during the 2013 Research Summit and presented at the 2013 NAEMSE Symposium in Washington, DC.

Entrance Exam Prediction on Paramedic Student Performance

David Page, MS, NREMT-P; Michael L. Bowen, NREMT-P; Luke Stanke, PhD.c

Introduction: Paramedic education can be costly and time consuming. Previous allied health entrance screening tools have been shown to have little predictive value to overall paramedic student success. Employers, students and educators could benefit from accurate pre-paramedic program assessment tools to guide admission and remediation of key abilities.

Hypothesis: Paramedic entrance exams scores can positively predict performance during key unit exams.

Methods: Paramedic programs using Fisdap, a national online testing cooperative community that measures paramedic student progress and summative competency, administered a new Fisdap Entrance Exam (EE) to new paramedic students at the beginning of their courses. The EE is designed to measure cognitive ability (CA) with breakdowns in Math, Reading, Inference/Analysis, Anatomy, Physiology, and EMT level critical thinking. The EE also measures personality traits associated with highly reliable employees. The Fisdap Entrance Exam (EE; n=861), Airway Exam (AE; n=937), and Cardiology Exam (CE; n=821) were fit to the Rasch model (Rasch, 1960) to obtain latent trait score estimates (logits) for each of the examinees. The Rasch model estimates the probability of a correct response given the test question difficulty and the latent ability of the examinee. 

The ability of a person is described as latent because it is not directly observed. To determine the reproducibility of scores, coefficient alpha was estimated for each of the three scales. George and Mallery (2003) provide the following rules of thumb; .9 = excellent; .8 = good; .7 = acceptable; .6 = questionable; >.5 poor; and <.5 = unacceptable. The alpha coefficients were .86, .88, and .90 for the Airway, Cardiology, and Entrance Exams, respectively. While this statistic provides a measure of the consistency of scores, it does not wholly represent the validity of a measure. Additional validity measures were examined and evaluated for each of the measures, including: content validity; criterion-related validity; and construct validity.
 
A correlational analysis of the true scores was then completed across examinees between the EE, and the two AE and CE subject tests.
 
Results: A total of 125 examinees completed both the EE and the AE, and 144 examinees completed both the EE and the CE. The correlations between the EE and the subjects tests were strong-to-very strong, and statistically significant (AE: r=.59; CE: r=.63, p<.001).
 
Table 1 displays scatterplot of the Airway logit scores and the Entrance Exam logit scores, and shows the positive linear relationship between the variables.
 
Table 1.
Scatterplot of latent Airway trait scores and latent Entrance Exam trait scores.
 
Table 2 displays a scatterplot of the  Cardiology logit scores and the Entrance exam logit scores, and shows a positive linear relationship between the two variables.
 
Table 2.
 
Scatterplot of latent Cardiology trait scores and latent Entrance Exam trait scores.
 
Conclusion: The Fisdap Entrance Exam shows a strong association with the cardiology and airway unit exams. More research is needed to determine the practical value and accuracy of the EE in predicting overall success.