The following abstract won the award for Best Research Presentation at NAEMSE in 2010.

Speed of Test Taking as a Predictor of Success on Emergency Medical Services Examinations

Heather Davis, MS, NREMT-P; David Page, MS, NREMT-P; Louise Briguglio, BA

Introduction: Anecdotal evidence suggests that many emergency medical services (EMS) instructors believe that neither the fastest nor the slowest test takers are the highest scorers. It is suggested that the fastest test takers make careless mistakes by not reading the question carefully or not considering all of the distractors. It is also believed that the slowest test takers lack the knowledge base or confidence to commit to an answer or that they change correct answers to incorrect responses. This project was designed to determine whether the amount of time required to complete an examination could predict the score on the examination.

Hypothesis: The speed at which an EMS student takes a final examination will predict the score on the examination.

Methods: Paramedic and EMT student data on the Online Summative Paramedic Exam (OSPE) and Blue Paramedic Exam as well as the EMT Readiness Exam were retrospectively reviewed from FISDAP, a national, online EMS student tracking system. All examinations have been validated and are predictive of success on the National Registry of Emergency Medical Technicians written examinations at each level. Only records from students who provided consent for research had data included in the study. More than 10,000 records from geographically diverse EMS education programs across the United States were evaluated. Elapsed times to take the Web-based examinations were compared with overall score, as well as performance on critical-thinking questions on each examination. Critical-thinking questions are considered the most difficult and often require the most reading and analysis time by students.

Results: Five thousand eight hundred forty paramedic examinations (2,719 Blue and 3,121 OSPE) and 5,603 EMT Readiness Exams were evaluated. Using a 95% confidence interval, there was no correlation between time required to complete the examination and performance on the examination at the paramedic level. However, for EMTs, a statistically significant difference did exist for students who took longer than 184 minutes.

Conclusion: The hypothesis was disproved at the paramedic level. Time required to complete a paramedic final examination does not predict success on the examination. The same is true for most EMT students. However, there does appear to be a law of diminishing returns for EMT students who take longer than 184 minutes to complete the examination. While more research is needed to determine the reason for taking so long on the examination, these data suggest that a time limit of 1 minute per question might be enough to ensure that all students who have the ability to pass the examination will do so. Enforcing a time limit on examinations may assist EMS educators in better management of classroom resources (i.e., class time and instructor hours).