Can you fail your way to success? Do one or more formative examination failures predict a summative examination failure?
Marilee L. Vosper, M.Ed., Paramedic, Alan Batt, MS(c), GradCert ICP, CCP, Jennifer Berry, BA, NREMT, CSPO,
James Dinsch, MS, NRP, CCEMT-P, Thomas Fentress, BS, NRP, LPM, PI, Erin Gallert, BS, William Leggio, EdD, NRP,
Xin Lucy Liu, Ph.D, Paige Reinfeld, BS, BA, Elizabeth D. Shaw, BA, NREMT, Tiffany Sliter, AB, Kelly Walsh, RN, BSN, PHRN
Paramedic programs utilize formative assessments to determine cognitive competency. There are institutions
that terminate students based on not achieving a pre-determined score on one or more formative examinations.
Previously published research has shown that students’ exposure in clinical and field settings, particularly to
emergent patients and successful team leads, improved critical thinking abilities on a summative examination.
A student can fail one or more formative examinations and still pass the summative examination.
Formative and summative scores for paramedic students with accounts in Fisdap™, an Internet-based
administrative database, were retrospectively reviewed for the following criteria: provided consent for research,
completed all six formative (unit) examinations, and completed a summative (comprehensive) examination
from 2011–2016. Analyses were performed with Pearson correlations and linear regression.
A total of 1406 students were included based on inclusion criteria. Correlation with each formative and the
summative examination are all significant, p < .001: Cardiology .597; Airway .571; Medical .571; Trauma .566;
Ob/Pediatrics .549; Operations .495. The number of formative examination failures is a significant predictor
of the probability of passing the summative examination, t(1405) = –31.02, p < 0.001.
A formative cardiology examination was shown to have the strongest predictive value on summative
performance, whereas operations had the weakest. Students who do not achieve a pre-determined cut
score on a formative examination can still pass the summative examination. In fact, students can fail three
formative examinations and have a 60% likelihood of passing the summative examination.