Entrance Exam Prediction on Paramedic Student Terminal Performance

David I. Page, MS, NRP; L. Michael Bowen, NRP; Luke Stanke, PhDc

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
Fisdap’s entrance exam scores can positively predict passing the NREMT-CE on first attempt.

Methods
Paramedic programs using Fisdap, a national online testing cooperative community that measures paramedic student progress and summative competency, administered Fisdap’s Entrance Exam (EE) to matriculating paramedic students. The EE is designed to measure cognitive ability with breakdowns in math, reading comprehension, anatomy & physiology, and EMT-level critical thinking. Program directors from participating institutions reported attrition and National Registry of Emergency Medical Technician Paramedic Cognitive Exam (NREMT-CE) performance results. A logistic regression model was fit to the data to determine if there was association with EE score and first time pass rates on the NREMT-CE.

Results
A total of 550 consenting students from 33 geographically diverse programs completed the EE between July 1, 2012 and August 30, 2013. Of these, 177 (32%) attrited or were dismissed for poor academic performance (n=47;9%), poor affect (n=11;2%), or other reasons, including personal circumstances (N=31; 6%). Of the 340 graduating students, 293 (53%) passed the NREMT-CE on first attempt and 47 failed (9%).

First-time Pass Rates

Accredited Schools (n=25)Rates
Passed0.59
Failed0.10
Attrited0.31
Did not test NREMT-CE0.00

Not or unknown accredited status (n=8)Rates
Passed0.49
Failed0.05
Attrited0.38
Did not test NREMT-CE0.08

The results of the logistic regression show a statistically significant, positive relationship between the EE anatomy & physiology, mathematics, and reading comprehension sections and NREMT-CE first-time pass rate (p<.001). The results suggest that for every 10 point increase on the Entrance Exam anatomy & physiology section, a student is 3.8 times more likely to pass the NREMT-CE. Odds of passing for the average composite score on the Entrance Exam, 79, is 92%.

Conclusion
Fisdap’s Entrance Exam scores positively predict first-time pass rate on the NREMT-CE. Further research is needed to understand the best use of this data to increase retention and improve pass rates.

Table 1 displays the coefficients and standard errors of the model.
 
Table 1: Results from the logistic regression.
 EstimateStandard Error
Intercept (b0)-23.904.01
A&P (b1)0.140.03
EMT (b2)0.050.04
Math (b3)0.080.02
Reading (b4)0.070.03

Unrelated to this research project, David Page has a paid consultation relationship with Fisdap. Luke Stanke received financial compensation for work on this project from Fisdap. L. Michael Bowen is an employee of Fisdap.