To work in the United States, all EMTs must first pass the NREMT exam. The NREMT exam consists of two parts: the psychomotor test and the cognitive test. The psychomotor test measures your ability to perform the physical responsibilities of an EMT. The cognitive portion of the NREMT exam assesses your general knowledge of medical care.
If you’re considering a career in Emergency Medical Services (EMS), you may be looking for more information on the national certification process. We will provide you with an overview of the National Registry of Emergency Medical Technicians (NREMT) exam and offer tips for passing the psychomotor portion of the exam.
About the NREMT Exam
To become certified, all EMTs must pass the NREMT exam. The exam consists of a psychomotor (physical/skills) test and a cognitive (written) test. The cognitive portion is a standardized test administered by the NREMT at various locations throughout the U.S. The psychomotor part is also sanctioned and observed by the NREMT. The test is administered by either the state EMS office or educational institutions under the state’s authority.
About the NREMT Psychomotor Test
The best way to find an examination site for the NREMT psychomotor test is to contact your course instructor. You can also find a current listing of advanced-level examination sites on the NREMT Find a Psychomotor Exam page. If examinations are listed in a state, call the state EMS office, and ask them when and where you can take the subsequent psychomotor examination.
What You Need to Know
The psychomotor examination is broken down into seven parts. Six of these sections are fixed, and one is randomly selected for each exam. The six fixed sections are:
- Patient Assessment and Management – Trauma. Includes scene size-up, primary survey, resuscitation, history taking, secondary assessment, and reassessment.
- Patient Assessment and Management – Medical. Includes scene size-up, primary survey resuscitation, history taking, secondary assessment, vital signs, and reassessment.
- BVM Ventilation of an Apneic Adult Patient. The exam tests your skills at bag-valve-mask (BVM)ventilation on an adult patient who isn’t breathing. Among other competencies, the exam will check for PPE precautions, responsiveness, when to request additional EMS assistance, breathing and pulse, opening the airway, preparing rigid suction catheter, and BVM ventilation.
- Oxygen Administration by Non-Rebreathing Mask. This portion tests your ability to administer oxygen using a non-rebreather mask. Among other competencies, this includes PPE precautions, assembly of the regulator to the oxygen tank, and attaching a non-rebreather mask to the regulator and patient’s face.
- Cardiac Arrest Management/AED. The exam includes a review of your treatment of cardiac arrest and the use of an automated external defibrillator (AED). The portion also consists of PPE precautions, scene safety, patient responsiveness, requesting additional EMS assistance, breathing and pulse, chest compressions, CPR, and operating an AED.
- Spinal Immobilization (Supine Patient). Your skill at properly immobilizing a patient with spinal injury will be tested, including PPE precautions, directing an assistant to place/maintain head position, reassessment of motor, sensory, and circulatory function in each extremity, applying extrication collar, directing patient movement without compromising the integrity of the spine, and more.
These six sections are always a part of the psychomotor exam and are essential to understand. Knowledge of these topics can help you pass the test on your first try and with a high score. In addition to these six fixed topics, another topic is chosen at random. The random topic is one of the four listed below. Only one of these four topics will be on the exam, but it is important to have a solid understanding of all of them since you do not know which one you will be asked to demonstrate.
The four randomly selected topics are:
- Bleeding Control/Shock Management. Your ability to control bleeding and manage shock will be tested in a number of ways. These include PPE precautions, applying pressure to the wound, and applying a tourniquet. Also, your ability to treat hypoperfusion will be tested.
- Joint Immobilization. Your ability to immobilize and manage an injured patient will be tested. This includes PPE precautions, manual stabilization of injury, assessment of injured extremity, splinting, immobilization of injury, bone (above and below) injury, and reassessment.
- Long Bone Immobilization. Your ability to immobilize long bones (most of the bones in arms and legs) will be tested. This includes PPE precautions, manual stabilization of injury, applying a splint, immobilizing the hand/foot in the position of function, and reassessment.
- Spinal Immobilization (Sitting Patient). This will include PPE precautions, directing the assistant to place/maintain head position, reassessment of motor, sensory, and circulatory function in each extremity, applying an extrication collar, directing movement of a patient without compromising the integrity of the spine, and more.
How to Prepare for the Exam
There are many ways to prepare for the psychomotor exam. The best way to prepare for this exam is to enroll in and complete a comprehensive training program, such as the 14-day EMT Boot Camp offered by Unitek EMT.
Every year, hundreds of emergency professionals receive their EMT and EMS training from Unitek EMT. The comprehensive courses and boot camps equip graduates with the latest theories and techniques for first-response treatment of patients. Taught by experienced trainers with current expertise, Unitek EMT workshops include real-world implementations, hands-on training, and one-on-one instruction to ensure that graduates have mastered the knowledge and skills they need to save lives and succeed in their profession.
For those who have registered for the boot camp and preparing for the exam, the best strategy is to use effective studying techniques. Here are a few tips to remember for your exam:
- Know the Basics: First and foremost, it is important to remember the basics. Remember the procedure to start each station—determining the scene safety and body substance isolation (BSI). Every EMT checks both scene safety and BSI for every call. If you start to feel overwhelmed, just remember the basics and check scene safety and BSI first.
- Ask for updates on vitals as needed: Asking for vital updates can give you a moment to find your train of thought and proceed as needed. If you get stuck and become unsure of the next step, ask for vitals, and take time to move forward confidently. Remember, the proctor provides all the information you need to succeed. Make sure you communicate with the proctor what you are doing. For example, if you check the patient’s pupils, say, “I am checking the patient’s eyes. Are they pearl?”
- Become familiar with the NREMT skill sheet: Familiarize yourself with the stations that will or can appear during your exam. You should feel confident with the six standards and randomly selected stations. A deep understanding and familiarity with each station will help keep a clear head during each section.
- Be aware of the critical criteria: In each station, there are critical criteria to keep in mind. The NREMT is clear on what you can and cannot do during each station in the psychomotor exam. The critical criteria are aspects that must be done correctly, or you risk immediate failure. This may be stressful. However, it can be an advantage. Being aware of and familiar with the critical criteria means knowing precisely what you need to do to pass the exam.
- Practice: The most important step to mastering any skill is practice. Be prepared for your exam by practicing as often as possible. Thinking through the exam on your toes can be helpful but muscle memory can be much more effective. Be sure to practice as much as you can so you can meet each station with confidence.
- Watch psychomotor exam videos: Observing others can be a great way to learn. Watching a video of another person taking the test allows you to step back and critique more effectively than you can when you do the exam yourself. This may enlighten you about specific details you haven’t considered or strategies on how to improve for your exam. Furthermore, watching other people take the test may help you feel more natural and comfortable while you take it. You can watch the example video to help get you started.
- Connect with the proctor: At the beginning of your exam, say hello and be friendly. Take a moment to connect with the proctor. This will allow them to see you as a person and help build rapport. Being social can help increase your confidence and make the exam go more smoothly.
How Hard is the NREMT Psychomotor Test?
The NREMT psychomotor test is difficult but doable. To pass, you will need to score 70%. You will have to pay attention in your training classes, apply yourself, and study the materials provided. According to the NREMT, 70% of first-time exam takers passed the NREMT exam in 2022—which means many students have to re-take the test, but most do pass the first time, and by following our guide, you can be one of them.
Curious about the timetable for the exam’s results? The NREMT website states that unofficial results are typically given to the candidate on the day of the psychomotor exam. However, official results can be found on the National Registry’s website within four weeks. You’ll need to log into your account to see the results.
It’s important to remember that you can only qualify for national certification if you successfully complete both the psychomotor exam and the cognitive exam. If you have any questions, be sure to visit the NREMT website, speak with your course instructor, or contact your state EMS office.
About Unitek EMT
Unitek EMT is one of the premier EMT schools in Arizona. Our mission is simple: training the next wave of top-notch EMT professionals. We offer a variety of training options to fit your needs, including an accelerated EMT program to get you mission-ready and certified fast. We also offer EMS Continuing Education courses to update your expertise and enhance your career. Unitek EMT instructors are experienced leaders in their fields, and our real-world training scenarios are ideal for aspiring EMT professionals.