Technical Report Documentation Page

1. Report No.

DOT HS 810 577

2. Government Accession No.

3. Recipient’s Catalog No.

4. Title and Subtitle

National Reregistration and the Continuing Competence of EMT-Paramedics

5. Report Date

April 2006

6. Performing Organization Code

7. Author(s)
Keith Holtermann, Dr.P.H.; Jean Johnson, Ph.D.; Roger White * , M.D.; Bonnie LaFleur, Ph.D.; William Brown, M.S.; Robert Wagner*, M.S.; Gregg Margolis*, M.S.; Mary Beth Michos*, M.S.; Gina Lohr, M.F.S.

8. Performing Organization Report No.

9. Performing Organization Name and Address

The George Washington University School of Medicine and Health Sciences
900 23 rd St. , NW., 6 th Floor , Washington, DC 20037

10. Work Unit No. (TRAIS)

11. Contract or Grant No.


12. Sponsoring Agency Name and Address

National Highway Traffic Safety Administration
Program Development and Delivery
Office of Research and Technology
Washington , DC 20590

13. Type of Report and Period Covered

Final Report

14. Sponsoring Agency Code

15. Supplementary Notes

Patti-Ellison Potter, Ph.D., and Paul J. Tremont, Ph.D., were Contracting Officer’s Technical Representatives for this project. *These authors are affiliated with the National Registry of Emergency Medical Technicians.

16. Abstract

Objective: To determine if a difference exists in the continued cognitive competence of Nationally Registered Emergency Medical Technician Paramedics (NREMT-P) who voluntarily reregistered with the NREMT (a national non-profit corporation that provides a uniform process to assess the knowledge and skills required for competent practice by EMS professionals), versus those who did not reregister since their original certification.

Methods: NREMT-Ps who voluntarily reregistered and those who did not were contacted by mail and requested to complete a multiple-choice online survey. The questionnaire consisted of a standardized exam similar to their initial certification test, an achievement test, and a demographic questionnaire. The responses from cohorts of NREMT-Ps initially certified 2, 4, and 6 years ago were compared.

Results: There was a statistically significant difference in the pass rate on the comprehensive cognitive exam between reregistered and nonreregistered groups for years 4 and 6. In both of these years the reregistered groups were approximately two times more likely to pass than the nonreregistered groups. The reregistered groups also averaged one more correct answer on the achievement test compared to the nonreregistered cohorts; this result was statistically significant for all years. The reregistered cohorts were more likely to have more self-reported Continuing Medical Education (CME) than the nonreregistered cohorts. This result was statistically significant in years 2 and 4 for the number of CME’s in the last 12 months and in years 2 and 6 for the number of CME’s since the last reregistration period.

Recommendations for Future Research: While these results suggest differences between reregistered and nonreregistered EMT-Ps, they are to be considered cautiously, given the small sample size and recognizing the fact that passing an exam does not necessarily translate into clinical competence. Future research could address these issues with a most robust sampling plan and by introducing other measures of competence. Also, a comparison of States that mandate continued registry certification in order to practice, with those who do not, would be of interest.

17. Key Words

Paramedic, EMT, EMS, Clinical Competence, Education Meas urement, Certification, Recertification, Licensure, Accreditation, Testing, Specialty Boards, Professional Competence, Time

18. Distribution Statement

This report is available from the National Technical Information Service, Springfield, VA, phone 703-487-4650, and is available free of charge on the NHTSA Web site at

19. Security Classif. (Of this report)

20. Security Classif. (Of this page)

21. No. of Pages
27 pages

22. Price

Form DOT F 1700.7 (8-72)                             Reproduction of completed page authorized