December 1, 2023 • 38 mins
In this special episode, Stephanie Limmer, the guest host, interviews Dan Limmer, the Chief Knowledge Officer of Limmer Education, a textbook author, and an all-around good guy. He shares his advice for students who are preparing for the NREMT, whether it is their first attempt or an additional one.
Show notes available here: https://limmereducation.com/wp-content/uploads/2023/11/Passing-the-NREMT-SHOWNOTES.pdf
NOTE: This episode is not available for CE.
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Episode Transcript
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(00:00):
Hello and welcome to a special edition of Seven Things EMS.
(00:10):
My name is Stephanie Limmer, the Chief Business Officer at Limmer Education and I am today's
guest host for this episode of Seven Things Passing the NREMT.
I want to welcome our expert for today's episode, the co-founder and Chief Knowledge Officer
of Limmer Education, Dan Limmer.
And while I think you need no introduction, Dan, I'm just going to pass it over to you
(00:32):
really quickly and let you tell the people why you are today's expert for Seven Things.
And it's not an easy thing for me to sit here and be today's expert.
Normally I'm on the other side of this.
So thank you for having me on the show.
I'm Dan Limmer.
I've been an EMS for a long time and I've written books and the blah, blah, blah that anyone
(00:53):
that's listened to us has heard before.
But we, our company, does exam preparation and that's something I'm good at and what
we're going to talk about today.
Excellent.
And so one of our things is this episode is not about fluff.
We're not going to talk about our children or our dogs.
(01:14):
So let's just get in there and get to the seven things that you need to know and to do to
pass the NREMT.
And so I know the number one on your list is...
Put in the work.
Yeah, I think a lot of people think they're going to be able to take an EMT class and
be able to glide or coast.
(01:36):
And that really isn't the case.
It takes a lot of work to get through.
And you know, when you're thinking about the class and you're thinking about passing your
class exams and doing your skills, unfortunately you're not thinking about the national registry
exam at the end and the stress that will cause.
And quite frankly, the level of information they really want from you in taking that exam.
(02:00):
So if you're listening to this and you are finishing your class, you're like, well, you
know, there's not much I can do about it now.
Well, in that case, you have to work going forward.
But if you're one of those people that likes to prepare and know what's going on, what's
not a study, maybe you're about to take a class or in a class, remember that you're
going to have to put the work in to succeed on the national registry exam.
(02:24):
They ask questions that aren't just memorization.
They want you to think like an EMT.
And that requires a certain amount of work.
The national registry exam really shouldn't be an easy test to make someone, the person
in charge in the back of an ambulance.
They look for entry level competency.
(02:46):
It's fair.
And it's there, but it's going to take some work.
Nobody comes out of the national registry and says, holy, that was easy, at least not
a lot.
And that's why it's important to put that work in.
Yeah.
And, you know, from a non-EMS person, I have to say that I really want the person who has
(03:06):
put the work in, knows their stuff, and shows up at my door prepared.
Not the person who got a really easy test and was able to memorize how many bones were
in the body, that type of thing.
So how do we get to that point?
How do we get to preparing and being ready for the national registry?
Well, you know, if someone's broken most of those bones, the memorization of the bones
(03:32):
doesn't make a lot of difference.
But understanding how it causes shock and how to deal with that, when to develop the
priorities at the scene.
And those things that are the kind of the between the line things in class are some
of the harder things to get or to put together.
Because it's really about judgments.
(03:53):
And class is more about memorization.
I think when people get angry at the national registry and say, oh, it's a hard test and
they want us to fail, I think we sometimes don't reflect on our class and the amount
of work we put in and how much that makes a difference.
If you know there's a hard test on the end, put the work into it and do it.
(04:14):
Because that's the way it is.
It shouldn't be easy.
And I think you were kind of leading me into the second one about preparation.
I tried.
I tried to find a long.
I know I had this one set up, I guess.
But number two is prepare properly.
And there's a lot of things that can be said here.
And we want to keep this podcast to a limited time.
(04:36):
But there's a couple of really important things to say.
And first, the concept of studying is something that people really don't get.
You finish your class and say, okay, I'm going to prepare for the national registry now.
And you say, okay, well, I'm going to open my book and I'm going to read this or I'm
going to go back and do this.
And if you get any advice online or from people involved, the people that have been through
(05:00):
it, it's usually wrong.
They say, oh, go back and I write an EMT book.
It's a great thing.
But when you're preparing for the national registry, it's a reference now because you've
already been through that.
Now you need to start putting it all together and being able to think.
So the first two things I want to say is that marathon study sessions don't work, especially
(05:25):
when you're very close to the exam.
And the concept of spaced repetition where you study a topic, give it a break, then come
back and study it again, helps you build, then Batesy was on here and he talked about
it like it's like going through a jungle and you're slashing with your machete and you're
cutting down the weeds.
Well, spaced repetition makes a path for that knowledge to come out again.
(05:50):
So you're going through it.
Every time you do it, you're getting a little bit better.
Shorter study sessions and then repeating different things.
If you want to study cardiology, study it for a while, make flashcards and do things,
put it down for a while, then come back.
So when you pick up those flashcards again, you're going to first hopefully find it easier
because you've done it before, but you're burning those things in better.
(06:14):
The book is a reference.
Reading chapters, if you read during class, isn't going to help you.
But when you get a study card, you get an exam question practicing on an app, then you go
back to the book if you don't know it.
That's really, I think, the role of the book as we do this.
(06:35):
Now this is a Limer Education podcast and Limer Education has apps.
I think we can both put out the disclosure that yes, we have products and yes, we believe
that our products are the good products you want.
But get a good exam product that gives you questions that aren't like you say.
(06:57):
The bone in the thigh is called the.
You want things that are going to test you like the national registry.
And when you do that, you have a good question.
Take it.
Take your time reading it and then choose an answer and submit it.
(07:17):
Now if you get it right, good for you.
What people do is they go, oh, I got it wrong and they swipe and they get the next question.
And you haven't learned from that.
Read the rationale.
Go back to the question and say, what did I miss?
What did I did?
I read too fast that I miss a word that I misunderstand something that comes together to help you
(07:41):
make that because really, if you have the knowledge, you need to now condition yourself
to take a challenging exam.
And I'll also add almost every product out there, ours included, are going to give you
some sample exams.
And you should sit and take those sample exams in their entirety all in one sitting.
(08:03):
Because you know what it's like to sit there for two hours having the stress build if you
don't actually practice that way.
Sports, right?
Play the game the way you practice is what they say.
An exam prep should be no different.
Well how long do you have to sit in those exams?
How long do you have for each of the EMT, AEMT and paramedic exams?
(08:24):
You have plenty of time for that.
Now we're getting a little ahead to number five here, but we have...
I do the same thing.
This is great not being the host.
You have plenty of time, right?
You get a minute per question.
How about we say that?
(08:44):
The average length of time a person takes according to the National Registry, 31, 32 seconds.
So you have plenty of time.
It's relatively rare for someone to time out unless your head clogs up.
So I think that we'll say for now that you really do have plenty of time.
If you want to look at the timer on your apps, our apps have got a timer on them, that you
(09:07):
can say, okay, if I give myself a minute per question and I have a hundred question practice
tests, I've got a hundred minutes.
If I finish in that amount of time, but I think most people will find that they'll finish
sooner.
Yeah.
So when you're preparing and you're sitting around the station or you're at the hospital
(09:28):
and you're talking to people and preparing, I always get these questions and customer
support that say, but my paramedic colleague said, always do this.
Never choose this.
What do you say to the people when they're trying to prepare and they give you that response?
Oh, man, the advice that you're going to get as a student candidate listening to this,
(09:54):
going to take the national registry, is going to mess with your head.
And it's often wrong.
It's not poorly intended.
But people will say things like, well, you always pick airway.
You always do this.
And the word always really doesn't go with the national registry because you might get
a question where you have a patient who's got this and this and this and the vital signs
(10:18):
are all there and you should.
Well, I mean, if you've got vital signs and all that stuff is done, the primary assessment
is likely done.
So when you're trying to figure out what to do, you've really always just got to pick
the best answer from what you're given.
You can't say, well, always do airway or always do this.
You've got to really read each question and break it down and see what it wants.
(10:46):
And what I really don't like about what people tell candidates, there's a lot of stress around
the registry exam.
A lot of, I don't want to give it real credibility and call it psychological trauma.
But the truth is, is people just, it builds up to be such a thing for everyone.
It's so important.
It's going to be an EMT and it causes so much stress.
(11:08):
Sometimes people are angry.
And the truth is the national registry is a fair exam.
It's a valid exam.
They're not trying to trick you.
They're not trying to get you to take it a couple of times to make money.
They're trying to determine if you are entry level competent to be an EMT, a EMT, paramedic,
(11:29):
EMR, whatever test you're doing.
All right.
So you're in there, you're studying, you're getting ready, you're preparing properly,
and it's the day of the exam.
Do you feel ready?
No.
No, I think that if you feel prepared, that's good.
(11:51):
You know, let's say you had a good class and you've been studying, you did well in class,
you feel pretty confident.
I mean, there's nothing wrong with that.
But very few people actually say, I'm going to go in and ace this test largely because
of all the things people feel around it.
I don't know if you're ever going to say, okay, I'm ready for this.
(12:12):
If you do, good for you.
And hopefully it works out.
But now people don't ever feel ready for the exam.
And I think quite frankly, that hurts a lot of people.
When I do our exam prep classes as part of EMTReview.com, paramedicreview.com, I always
start by saying, I want you to get three things out of this.
(12:32):
I want you to get knowledge.
I want you to learn how to take the National Registry Test.
And I want you to have mojo.
See, mojo is the hardest part because it's an unknown.
It's out there.
It's got this reputation.
So what this really comes down to is having enough mojo to believe you can.
All too often I see people.
(12:54):
I mean, if you look in some of the Facebook groups and some of the Reddit things, people
say, oh, I've been putting off taking the National Registry.
I'm not sure if I'm ready.
Well, the truth is, is you forget over time.
You've got a month, maybe two, but you get in that three to six month range and you're
(13:14):
starting to forget stuff.
I mean, it's pretty clear scientifically that you're not going to remember all those things.
So you've got to weigh this out and say, all right, I'm holding myself back here.
I've got to just make the appointment and go to the exam center.
And some people are taking it at home.
That scares me a little.
A lot of horror stories about that.
(13:37):
But wherever you do the exam, just schedule it and do it.
Because if you wait another couple of months, are you going to really study that much more
or know that much more?
And how much will you forget?
And how much will you in your head make that exam more and more of the bad guy because
(13:58):
you're putting it off?
It's like ripping a band-aid off.
How are you going to do it?
Are you going to slowly pull that band-aid off?
You're going to pull one of those skin cells and your hair is off one at a time?
Or do you rip it off?
Rip the band-aid off.
If you did good in class, you really think you've done some work, go and do it.
An EMT level about 70-ish percent of people pass first time.
(14:21):
Paramedic, it's up about 75.
AEMT, it's a little more challenging.
And that could be a whole other podcast because of the expectations and the number of questions,
et cetera.
Rip the band-aid off.
Get out of class, study, get in there and do it.
One of the questions that we get a lot in customer service or when you're talking to
(14:46):
students is, is there a sweet spot?
Is there something that tells me I'm ready?
Should I take it within a week of the class?
Should I take it within a month of the class?
What is it that you think is kind of that sweet spot for people?
Or does it vary from person to person?
I think it varies.
(15:07):
I think it's also somewhat cyclical.
If you're taking a class in the fall semester and you finish and take your final exam the
second week of December, a lot of people wait until January to take it to get through the
holidays.
And I think that's okay.
A month isn't going to be an issue and hopefully you'll be able to put some study time in there.
(15:29):
But the month of January shouldn't go by without you taking that exam if you've taken
a fall semester class.
And again, do your spaced repetition.
Do practice a little bit every day is better than trying to cram a day or two before the
exam because it doesn't work.
It just doesn't work.
Summer is a little bit different.
If you're taking a class in the spring, you start in January, you get done in May, just
(15:52):
get it done.
Don't let it clog your head for the summer.
If you finish on May 15th, I want you to take that test by June 15th.
Then you've got the summer ahead of you and you're okay.
If you need to retest, that's okay.
People do have to retest.
A little more than two thirds pass every time, three quarters.
If you're one of those, study and then get back in there in the next month or so.
(16:16):
So I think that's kind of the rhythm that people go.
And I like to see everybody take it within a month because then not only do you not forget,
you can structure some study in there and it's not just sitting there in your head looming
over you becoming the bad guy.
All right.
Good advice.
(16:38):
So tell us, number four on your seven things for passing the NREMT is understanding the
exam.
What does that entail?
There's a lot.
And I think there's a lot of misunderstandings about the exam.
So if we're going to do a baseline, the EMT in the paramedic is an adaptive exam, meaning
(17:01):
you start to get easy questions.
It gives you harder questions as you go along.
And once you get to a certain point at a minimum number of questions and at a minimum score,
anyone taking this knows you've got to get a 950 score.
That's the only reporting you get now.
When the computer gets you to that score and you can maintain that score, then you pass.
(17:25):
So it's adaptive.
They give you harder questions.
One of the problems with that is, is that freaks people out more.
It's like, I'm getting all these really hard questions.
And like, okay, that's probably a good sign that if you're getting questions and they're
making you scratch your head and you're on number 60 or 70, that's probably a really
good sign.
(17:46):
Nobody gets a hundred in the National Registry.
You're always going to get some wrong.
But you've just got to keep moving that bar up until you get to that 950.
Keep it there and then you pass.
So those increasingly difficult items are really kind of a good sign.
Don't let them freak you out.
But there are pilot items.
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The EMT exam, 10 of the 70 minimum questions that you're going to get if you do the minimum
are pilot items.
20 of the 80 on paramedic at the minimum are pilot items.
35 of the 135 you will get at AEMT are pilot items.
Now that does a couple things.
It messes our heads a little bit because we know that a certain percentage of these questions
(18:32):
aren't going to count.
But those pilot questions do two things.
You're going to get these pilot questions from somewhere in the exam bank that the National
Registry is testing.
So you may get all hard questions.
You may get all questions on abdominal evisceration or placenta previa or something that's a real
(18:54):
look and cranny.
And it's going to mess with you.
Like why am I getting all these questions?
Am I answering them wrong?
The pilot questions don't have to follow any order.
You don't know when you're going to get them.
So we're going to go on and number seven is really going to address this more.
But when you go through, you've got to just take each question, answer to the best of
(19:18):
your ability, then boom, click next.
And that's it.
Those pilot questions could be easy.
They could be hard.
But that's the problem.
When I say the test gradually gets more difficult, if you get some pilot questions in the beginning
and they're really whacked out questions, there's not everyone's going to make it into
the exam.
You might be the person that's going to prove, that's a bad question, but you still get it
(19:41):
served up to you.
You just can't let it get to your head.
But I think it's important to remember that the registry is not going to trick you.
The registry is not out to do anything else except test if you're entry level competent.
And they're going to ask you questions that use things like you should.
(20:03):
You should first, you should next.
Or a diagnosis question.
You should suspect.
And when you look at those questions, they're going to ask you some type of decision or
action.
And that's one of the things that differs a lot from some class exams.
Because the way you make a question difficult is you put less wiggle room between the correct
(20:28):
answer and the wrong answers.
And you can't have any ambiguity.
There's got to be a right answer.
The registry doesn't do best answer anymore.
They've tried to get rid of that perception of voodoo or whatever.
And I think the questions are a little bit more straightforward, little bit more user-friendly,
and gentler to a great extent.
(20:49):
But there's still going to be a correct answer.
But they're not going to give you choices far apart.
They're going to, everyone's going to have a little bit of chooseability to see that
you know that you can pick that correct answer.
So this is going to be an exam, probably unlike a lot of others you've taken.
Unless you use our apps.
(21:09):
And in that, oh, sorry.
Did I say that?
Yes, I did.
But that's the general gist of the exam is that it's challenging.
That it's validated.
That it's fair.
And that it's going to require you to really think and read those questions.
(21:31):
Now within the last year, the National Registry has introduced some new styles of questions.
More specifically, the scenario style question.
Can you kind of give us an overview of what people are going to see with that scenario
style question?
It's not an individual question.
And then you move on.
(21:51):
Yeah.
The advanced level exams are using multi-part scenario questions that go over an entire
call.
These will not be considered live on the test from what the registry has said so far until
July 1 of 2024.
But you're going to see them.
And you need to know that they're there.
(22:12):
And they have, you know, before you get to the scene, on scene, and then continuing through
the call, they break it up into three different parts.
And you can see 10, 12, 15 questions are going to build on that.
Now it's nice about these as you get the continued information.
(22:32):
And you're able to build on that.
They're a little intimidating because they're different.
But I think they're fair.
And I think that they're designed to test a whole series of things.
Like, can you predict if something might be a problem later?
Can you identify a need for a skill that should be done on scene versus in the ambulance or
(22:55):
vice versa?
And I think to a certain extent, since the psychomotor exam is going to go away at the
advanced levels, they're trying to make it a more comprehensive thinking, sequencing
exam where they're going to make sure you can put a call together like you could in
a practical station.
Now there's other types too.
(23:16):
There's drag and drops where you can, you know, put these in order of severity or put
these in orders of the way you would do these with a patient.
And there's also multiple response items where you need to get two or five or three
and six correct.
And there's no partial credit.
So I personally think these things make the exam more challenging.
(23:41):
Now, other national certification exams for other health professions use these types of
questions.
This is not some evil scheme the National Registry has cooked up.
The nursing exam, the NCLEX exam, in fact, has a lot of these things.
And the National Registry has been able to use the engine that Pearson View uses for
(24:04):
NCLEX exams to be able to be able to put some of these questions in.
The exam is still going to be adaptive based on things.
I think it'll be more realistic of practice.
I think it will be different.
And I think in some ways it can be a little more challenging.
Yeah.
I heard a really good trick from Bill Brown, the former executive director of the National
(24:30):
Registry, who said, when reading these multiple response questions, a good way of getting
through, and this is going to kind of bring us to question six, which is read carefully
but don't read into the question.
But he said, basically treat these multiple response questions as true or false.
So you'll read the first one and say, is it true or is it false?
(24:52):
And then the next one, is it true or is it false based on the stem of that question
so that it's not that intimidation of, oh my gosh, I have to choose three out of these
six?
So do you think that's a solid method for kind of reading these style questions?
Yeah.
If they ask you, let's say there's one on patient refusal or a pregnancy complication
(25:13):
or shock, would I see this in shock?
True or false?
Would I see this in shock?
True or false?
And I think that that is a way to do it.
It makes it a little less intimidating.
They want you to know two or three things and also identify that two or three things
aren't part of that.
So that really does come down to that.
(25:35):
And I think it brings it down a little bit more as we do that.
You know, we've covered part five, a fair amount, right?
And now you have enough time, really.
I don't think you have to spend a ton of time on that.
You get a minute per question at any level of the exam.
(25:55):
The National Registry says 31 seconds.
And that's what the average person takes.
So you do have plenty of time.
Don't feel rushed.
Don't put that stress on yourself.
There's going to be some questions that you're going to want to read a little bit more.
Others you can go through and say, oh, that seems pretty easy.
Let me just check it again.
Yeah, that's it.
(26:16):
Boom.
And you move on.
There's plenty of time to take the test.
Please don't feel like you have to rush.
I think a lot of people go in and get really nervous.
And as a result, they rush because of the time limit.
I think that hurts people.
It's worth taking a little bit more investment in time.
Think about it.
(26:36):
EMT, 70 questions is the minimum.
Paramedic is 80.
If you take a little bit more time, read the questions, get them right, you'll probably
get less questions to begin with.
So take your time and do it right.
All right.
And so number six, read carefully, but don't read into the question.
(26:58):
Yeah, there's no trick.
Don't think that.
If let's say that they say you've got this patient and they want everyone to give them
medication.
They say, what does it say?
Think about allergies.
Well, if there's an allergy, they would tell you, don't look at a question and insert things
that are going to dismiss with your head.
(27:18):
Right?
I don't know if it's the force, right?
Just look at it.
If you're being driven in a direction, say, okay, I picked this because there's enough
material in the question to let you get to the right answer.
There'll be something in that's going to make you say, oh, no, there's good lung sound,
so it's not a pneumothorax or whatever.
(27:40):
And when you do that, it will all work.
It'll all come into play.
There's no tricks.
There's no anything.
Don't read into it.
Identify important words.
When you look at a group of words, it's not the same as looking at a patient.
Whether the patient is seven years old versus 70 years old makes a difference.
(28:03):
Patient male or female sometimes makes a difference in certain conditions and problems.
Look at the questions and read them well.
When I took the registry a couple of years ago, I read the question twice before I even
let myself look at the answers.
Identify words that make a difference, shallow, confused, pale, anxious.
(28:28):
There are certain words that indicate instability or shock that are just sleepy, tired.
We just use up so much energy breathing when we're sick that sometimes we get tired.
Sometimes we can't breathe anymore.
There's no energy left.
And then I've been starting to teach things.
I watch people do questions and they look at it.
(28:50):
They don't pull the stuff out.
You read a question.
Identify things that are important, shallow words, shallow breathing that they're tired.
The question says they have clear lung sounds bilaterally.
Everything means something.
So identify all those pieces of information and interpret it and say, what does it mean?
Well, if they're sleepy and they have shallow breathing, are they in failure?
(29:17):
Are they in respiratory failure?
And look and interpret what does it really mean?
And then finally we value it.
What's the most important part?
We have a couple of really great exam questions that I use.
A 49-year-old guy has got a smoking history and he's got chest pain.
But because of the smoking history, you put in a choice about emphysema.
(29:40):
And everyone said, oh, the smoking history.
And you pick emphysema when the person doesn't even have difficulty breathing in the question.
But you pick one thing and if you lock on that and you said, OK, I identified that.
He's got a smoking history.
But if you don't value it, right, he's mowing the lawn.
He's got chest pain and he's everything else.
But if the fact that you hang on the wrong piece of information, you get it wrong.
(30:03):
And that's the same thing that you'll do as an EMT or AEMT or paramedic in the field.
You'll be given a lot of information.
You're going to have to figure out what's the most important.
It really isn't that far from the street.
So it's not only getting the information, but it's figuring out what's the most important.
Then you look at the choices.
You look at all the choices you have and then say, all right, if I have this, I look back
(30:28):
in the question.
It can't be that because there's lung sounds.
So spontaneous pneumothorax is out.
And there I've got, oh, and I can work them.
Then once you figure out what's important, look at the choices and then let them rule
them in or rule them out and come to an answer.
Okay.
All right.
(30:48):
So that kind of brings us to number seven, right?
Answer each question to the best of your ability and then move on.
You know, funny, I think that the moving on is as important as answering each question
of the best of your ability.
Of course, you're going to answer each question to the best of your ability.
But there's going to be a lot of times that you don't know a word in the question.
(31:11):
You freak out that you're going through and you wondered whether it's this or this.
Use the things we just talked about and you're going to pick the best answer.
Don't the question you have on your screen has no, unless it's in part of a scenario,
a multiple part scenario, has no relation to a question that you got before.
I've heard people say, I got so many questions on tension pneumothorax.
(31:33):
I thought maybe I was getting something wrong.
So I changed my answer.
No, don't do that.
Questions are very subtly different, but they're different.
Answer each question of the best of your ability.
Look at the information you've got on that question.
That question, you read it, answer the best of your ability.
Look at it again.
You might do a double check.
Don't agonize.
Don't be, you know, you have time, but let's not be crazy.
(31:56):
Then you're going to hit, boom, you're going to submit that question and a new one's going
to come up on the screen.
If your mind is still wondering whether you got a question wrong two questions ago, it's
going to mess with your ability to be able to answer this question, right?
The one that's in front of you.
And that's the move on part.
(32:17):
Answer each question of the best of your ability.
Submit that question.
There's a new one on the screen.
There's no relation to it.
Like you said, less part of the scenario.
So that's a whole new question.
You got to focus on that with nothing else in your mind from the past.
Answer that.
And then again, submit it and move on.
There's a 70 or 80 or 135 minimum questions you're going to have to get through.
(32:41):
But if you get to that number, 70, 80, or, you know, on the paramedic exam, don't freak
out if you get another question, right?
Because if you get to 70 or 80, you get to 70 and you hit that button, you wonder if
it shuts off what it means.
Don't think about anything else other than answering those questions.
Don't say, Oh, is this a harder question?
(33:02):
Is this an easier question?
Is this, you know, if you say this is hard, then give yourself a minute.
It's good.
But don't do anything else except answer that question when you've done and you send that
question in, you get a new one.
Boom.
Only that new question.
And I think that's some of the best advice people get in their head so much about the
(33:22):
time and about all the other questions.
And it's a big experience and it's a high yield exam.
You want to go out and be an EMT.
And therefore this test means a lot, but you can do it.
I think these seven things are going to get you there.
An EMT or an advanced EMT or a paramedic.
(33:44):
Or a paramedic.
There you go.
And what's interesting is even though you're an EMT and a paramedic and you may have taken
the EMT national registry exam, it doesn't seem like you've got that much of a step up.
You're still really, really nervous about it.
You're upping the ante.
You're putting in new skills.
You're putting in a lot more work and that exam is still there and still challenging.
(34:05):
But it's fair.
Put the work in.
Pay attention.
Go through and do all the things we talked about.
And I really believe this is a good recipe for success.
I completely agree with you.
But let's just give a little bonus here.
We've got a few more minutes.
What happens?
You failed it the first time.
(34:28):
What is your recommendation to that student who just was unsuccessful the first time or
even the second time?
And how do they put all of these seven things into play plus a mindset for going back and
doing it one more time and being successful at it?
Yeah.
I think the first thing I'd say is you need to do some reflection and see if you prepared
(34:53):
well enough.
Did you really prepare well enough and do what you needed to do?
And if you didn't, that is actually easily fixed.
Your ego is going to be bruised.
Whether you studied a lot or whether you studied a little, you're going to find other people
from your class passed and it's going to be, you're not going to feel good about that.
It doesn't feel good.
(35:14):
It'll be unsuccessful.
But really reflect on what you did and do something differently going forward.
Right?
And if you went through, people leave through, I'll leave through my book again or whatever.
No practice.
Do something active.
Make study cards.
Go through a chapter and make notes.
Have a study group with other people in your class.
(35:35):
Go back to your instructor and look for more practice tests.
One of the things that helps get you over the hump of failing the first time is feeling
like you've done enough the second time to make it happen.
And quite frankly, a lot of people do pass the second time.
One, because now I know what the exam is like.
I've really got to study.
(35:55):
And two, because you know what the exam is like, when you go back and take it, it's not
as big of a head thing because you at least know what it's going to be like.
You know what it's like to walk into the center and have to do all the things that they have
to do and put all your stuff down and identification and everything else they do.
It won't be as intimidating.
(36:16):
If you don't let it, don't delay it.
Come up with a study plan.
If you were to fail today and you got that email and you're devastated, you can take
a day or two to get over that.
But you know what, then pick a day, 30 days, sign up for the exam to make your study, and
(36:37):
then do something every day to get through and pass that.
There's two parts of it.
Getting the knowledge, right?
Being able to match the kind of questions you're going to see and feeling like you did
enough to pass the second time.
A lot of people go back and pass that second time.
They really do.
So it's again, it's the work and it's the mindset.
(36:58):
All right.
Great.
Well, and I think we've covered the seven and given a little bonus one for those who
might have been not successful on their first attempt.
I think we can kind of come to a close here.
I thank you so much for sitting on the other side of the microphone.
I can talk in any particular position.
(37:21):
People have probably realized by now, but it was very good to be the guests and it was
great.
It was really great to have you host.
Great.
Well, thank you.
So just to all of you, just a note, today's episode is not going to be available for CE,
but we hope that you find it informative.
(37:41):
If you are somebody who's already passed the National Registry and are listening to this,
send it off to a colleague.
Let if you're an instructor, let your students know this is out here.
And we are always out here at Limmer Education to help anyone who is looking to pass the
National Registry with advice, with test questions, whatever it is that you need.
(38:04):
So for both Dan and myself, for Limmer Education, thank you so much.
Hello and welcome to a special edition of Seven Things EMS.
(00:10):
My name is Stephanie Limmer, the Chief Business Officer at Limmer Education and I am today's
guest host for this episode of Seven Things Passing the NREMT.
I want to welcome our expert for today's episode, the co-founder and Chief Knowledge Officer
of Limmer Education, Dan Limmer.
And while I think you need no introduction, Dan, I'm just going to pass it over to you
(00:32):
really quickly and let you tell the people why you are today's expert for Seven Things.
And it's not an easy thing for me to sit here and be today's expert.
Normally I'm on the other side of this.
So thank you for having me on the show.
I'm Dan Limmer.
I've been an EMS for a long time and I've written books and the blah, blah, blah that anyone
(00:53):
that's listened to us has heard before.
But we, our company, does exam preparation and that's something I'm good at and what
we're going to talk about today.
Excellent.
And so one of our things is this episode is not about fluff.
We're not going to talk about our children or our dogs.
(01:14):
So let's just get in there and get to the seven things that you need to know and to do to
pass the NREMT.
And so I know the number one on your list is...
Put in the work.
Yeah, I think a lot of people think they're going to be able to take an EMT class and
be able to glide or coast.
(01:36):
And that really isn't the case.
It takes a lot of work to get through.
And you know, when you're thinking about the class and you're thinking about passing your
class exams and doing your skills, unfortunately you're not thinking about the national registry
exam at the end and the stress that will cause.
And quite frankly, the level of information they really want from you in taking that exam.
(02:00):
So if you're listening to this and you are finishing your class, you're like, well, you
know, there's not much I can do about it now.
Well, in that case, you have to work going forward.
But if you're one of those people that likes to prepare and know what's going on, what's
not a study, maybe you're about to take a class or in a class, remember that you're
going to have to put the work in to succeed on the national registry exam.
(02:24):
They ask questions that aren't just memorization.
They want you to think like an EMT.
And that requires a certain amount of work.
The national registry exam really shouldn't be an easy test to make someone, the person
in charge in the back of an ambulance.
They look for entry level competency.
(02:46):
It's fair.
And it's there, but it's going to take some work.
Nobody comes out of the national registry and says, holy, that was easy, at least not
a lot.
And that's why it's important to put that work in.
Yeah.
And, you know, from a non-EMS person, I have to say that I really want the person who has
(03:06):
put the work in, knows their stuff, and shows up at my door prepared.
Not the person who got a really easy test and was able to memorize how many bones were
in the body, that type of thing.
So how do we get to that point?
How do we get to preparing and being ready for the national registry?
Well, you know, if someone's broken most of those bones, the memorization of the bones
(03:32):
doesn't make a lot of difference.
But understanding how it causes shock and how to deal with that, when to develop the
priorities at the scene.
And those things that are the kind of the between the line things in class are some
of the harder things to get or to put together.
Because it's really about judgments.
(03:53):
And class is more about memorization.
I think when people get angry at the national registry and say, oh, it's a hard test and
they want us to fail, I think we sometimes don't reflect on our class and the amount
of work we put in and how much that makes a difference.
If you know there's a hard test on the end, put the work into it and do it.
(04:14):
Because that's the way it is.
It shouldn't be easy.
And I think you were kind of leading me into the second one about preparation.
I tried.
I tried to find a long.
I know I had this one set up, I guess.
But number two is prepare properly.
And there's a lot of things that can be said here.
And we want to keep this podcast to a limited time.
(04:36):
But there's a couple of really important things to say.
And first, the concept of studying is something that people really don't get.
You finish your class and say, okay, I'm going to prepare for the national registry now.
And you say, okay, well, I'm going to open my book and I'm going to read this or I'm
going to go back and do this.
And if you get any advice online or from people involved, the people that have been through
(05:00):
it, it's usually wrong.
They say, oh, go back and I write an EMT book.
It's a great thing.
But when you're preparing for the national registry, it's a reference now because you've
already been through that.
Now you need to start putting it all together and being able to think.
So the first two things I want to say is that marathon study sessions don't work, especially
(05:25):
when you're very close to the exam.
And the concept of spaced repetition where you study a topic, give it a break, then come
back and study it again, helps you build, then Batesy was on here and he talked about
it like it's like going through a jungle and you're slashing with your machete and you're
cutting down the weeds.
Well, spaced repetition makes a path for that knowledge to come out again.
(05:50):
So you're going through it.
Every time you do it, you're getting a little bit better.
Shorter study sessions and then repeating different things.
If you want to study cardiology, study it for a while, make flashcards and do things,
put it down for a while, then come back.
So when you pick up those flashcards again, you're going to first hopefully find it easier
because you've done it before, but you're burning those things in better.
(06:14):
The book is a reference.
Reading chapters, if you read during class, isn't going to help you.
But when you get a study card, you get an exam question practicing on an app, then you go
back to the book if you don't know it.
That's really, I think, the role of the book as we do this.
(06:35):
Now this is a Limer Education podcast and Limer Education has apps.
I think we can both put out the disclosure that yes, we have products and yes, we believe
that our products are the good products you want.
But get a good exam product that gives you questions that aren't like you say.
(06:57):
The bone in the thigh is called the.
You want things that are going to test you like the national registry.
And when you do that, you have a good question.
Take it.
Take your time reading it and then choose an answer and submit it.
(07:17):
Now if you get it right, good for you.
What people do is they go, oh, I got it wrong and they swipe and they get the next question.
And you haven't learned from that.
Read the rationale.
Go back to the question and say, what did I miss?
What did I did?
I read too fast that I miss a word that I misunderstand something that comes together to help you
(07:41):
make that because really, if you have the knowledge, you need to now condition yourself
to take a challenging exam.
And I'll also add almost every product out there, ours included, are going to give you
some sample exams.
And you should sit and take those sample exams in their entirety all in one sitting.
(08:03):
Because you know what it's like to sit there for two hours having the stress build if you
don't actually practice that way.
Sports, right?
Play the game the way you practice is what they say.
An exam prep should be no different.
Well how long do you have to sit in those exams?
How long do you have for each of the EMT, AEMT and paramedic exams?
(08:24):
You have plenty of time for that.
Now we're getting a little ahead to number five here, but we have...
I do the same thing.
This is great not being the host.
You have plenty of time, right?
You get a minute per question.
How about we say that?
(08:44):
The average length of time a person takes according to the National Registry, 31, 32 seconds.
So you have plenty of time.
It's relatively rare for someone to time out unless your head clogs up.
So I think that we'll say for now that you really do have plenty of time.
If you want to look at the timer on your apps, our apps have got a timer on them, that you
(09:07):
can say, okay, if I give myself a minute per question and I have a hundred question practice
tests, I've got a hundred minutes.
If I finish in that amount of time, but I think most people will find that they'll finish
sooner.
Yeah.
So when you're preparing and you're sitting around the station or you're at the hospital
(09:28):
and you're talking to people and preparing, I always get these questions and customer
support that say, but my paramedic colleague said, always do this.
Never choose this.
What do you say to the people when they're trying to prepare and they give you that response?
Oh, man, the advice that you're going to get as a student candidate listening to this,
(09:54):
going to take the national registry, is going to mess with your head.
And it's often wrong.
It's not poorly intended.
But people will say things like, well, you always pick airway.
You always do this.
And the word always really doesn't go with the national registry because you might get
a question where you have a patient who's got this and this and this and the vital signs
(10:18):
are all there and you should.
Well, I mean, if you've got vital signs and all that stuff is done, the primary assessment
is likely done.
So when you're trying to figure out what to do, you've really always just got to pick
the best answer from what you're given.
You can't say, well, always do airway or always do this.
You've got to really read each question and break it down and see what it wants.
(10:46):
And what I really don't like about what people tell candidates, there's a lot of stress around
the registry exam.
A lot of, I don't want to give it real credibility and call it psychological trauma.
But the truth is, is people just, it builds up to be such a thing for everyone.
It's so important.
It's going to be an EMT and it causes so much stress.
(11:08):
Sometimes people are angry.
And the truth is the national registry is a fair exam.
It's a valid exam.
They're not trying to trick you.
They're not trying to get you to take it a couple of times to make money.
They're trying to determine if you are entry level competent to be an EMT, a EMT, paramedic,
(11:29):
EMR, whatever test you're doing.
All right.
So you're in there, you're studying, you're getting ready, you're preparing properly,
and it's the day of the exam.
Do you feel ready?
No.
No, I think that if you feel prepared, that's good.
(11:51):
You know, let's say you had a good class and you've been studying, you did well in class,
you feel pretty confident.
I mean, there's nothing wrong with that.
But very few people actually say, I'm going to go in and ace this test largely because
of all the things people feel around it.
I don't know if you're ever going to say, okay, I'm ready for this.
(12:12):
If you do, good for you.
And hopefully it works out.
But now people don't ever feel ready for the exam.
And I think quite frankly, that hurts a lot of people.
When I do our exam prep classes as part of EMTReview.com, paramedicreview.com, I always
start by saying, I want you to get three things out of this.
(12:32):
I want you to get knowledge.
I want you to learn how to take the National Registry Test.
And I want you to have mojo.
See, mojo is the hardest part because it's an unknown.
It's out there.
It's got this reputation.
So what this really comes down to is having enough mojo to believe you can.
All too often I see people.
(12:54):
I mean, if you look in some of the Facebook groups and some of the Reddit things, people
say, oh, I've been putting off taking the National Registry.
I'm not sure if I'm ready.
Well, the truth is, is you forget over time.
You've got a month, maybe two, but you get in that three to six month range and you're
(13:14):
starting to forget stuff.
I mean, it's pretty clear scientifically that you're not going to remember all those things.
So you've got to weigh this out and say, all right, I'm holding myself back here.
I've got to just make the appointment and go to the exam center.
And some people are taking it at home.
That scares me a little.
A lot of horror stories about that.
(13:37):
But wherever you do the exam, just schedule it and do it.
Because if you wait another couple of months, are you going to really study that much more
or know that much more?
And how much will you forget?
And how much will you in your head make that exam more and more of the bad guy because
(13:58):
you're putting it off?
It's like ripping a band-aid off.
How are you going to do it?
Are you going to slowly pull that band-aid off?
You're going to pull one of those skin cells and your hair is off one at a time?
Or do you rip it off?
Rip the band-aid off.
If you did good in class, you really think you've done some work, go and do it.
An EMT level about 70-ish percent of people pass first time.
(14:21):
Paramedic, it's up about 75.
AEMT, it's a little more challenging.
And that could be a whole other podcast because of the expectations and the number of questions,
et cetera.
Rip the band-aid off.
Get out of class, study, get in there and do it.
One of the questions that we get a lot in customer service or when you're talking to
(14:46):
students is, is there a sweet spot?
Is there something that tells me I'm ready?
Should I take it within a week of the class?
Should I take it within a month of the class?
What is it that you think is kind of that sweet spot for people?
Or does it vary from person to person?
I think it varies.
(15:07):
I think it's also somewhat cyclical.
If you're taking a class in the fall semester and you finish and take your final exam the
second week of December, a lot of people wait until January to take it to get through the
holidays.
And I think that's okay.
A month isn't going to be an issue and hopefully you'll be able to put some study time in there.
(15:29):
But the month of January shouldn't go by without you taking that exam if you've taken
a fall semester class.
And again, do your spaced repetition.
Do practice a little bit every day is better than trying to cram a day or two before the
exam because it doesn't work.
It just doesn't work.
Summer is a little bit different.
If you're taking a class in the spring, you start in January, you get done in May, just
(15:52):
get it done.
Don't let it clog your head for the summer.
If you finish on May 15th, I want you to take that test by June 15th.
Then you've got the summer ahead of you and you're okay.
If you need to retest, that's okay.
People do have to retest.
A little more than two thirds pass every time, three quarters.
If you're one of those, study and then get back in there in the next month or so.
(16:16):
So I think that's kind of the rhythm that people go.
And I like to see everybody take it within a month because then not only do you not forget,
you can structure some study in there and it's not just sitting there in your head looming
over you becoming the bad guy.
All right.
Good advice.
(16:38):
So tell us, number four on your seven things for passing the NREMT is understanding the
exam.
What does that entail?
There's a lot.
And I think there's a lot of misunderstandings about the exam.
So if we're going to do a baseline, the EMT in the paramedic is an adaptive exam, meaning
(17:01):
you start to get easy questions.
It gives you harder questions as you go along.
And once you get to a certain point at a minimum number of questions and at a minimum score,
anyone taking this knows you've got to get a 950 score.
That's the only reporting you get now.
When the computer gets you to that score and you can maintain that score, then you pass.
(17:25):
So it's adaptive.
They give you harder questions.
One of the problems with that is, is that freaks people out more.
It's like, I'm getting all these really hard questions.
And like, okay, that's probably a good sign that if you're getting questions and they're
making you scratch your head and you're on number 60 or 70, that's probably a really
good sign.
(17:46):
Nobody gets a hundred in the National Registry.
You're always going to get some wrong.
But you've just got to keep moving that bar up until you get to that 950.
Keep it there and then you pass.
So those increasingly difficult items are really kind of a good sign.
Don't let them freak you out.
But there are pilot items.
(18:06):
The EMT exam, 10 of the 70 minimum questions that you're going to get if you do the minimum
are pilot items.
20 of the 80 on paramedic at the minimum are pilot items.
35 of the 135 you will get at AEMT are pilot items.
Now that does a couple things.
It messes our heads a little bit because we know that a certain percentage of these questions
(18:32):
aren't going to count.
But those pilot questions do two things.
You're going to get these pilot questions from somewhere in the exam bank that the National
Registry is testing.
So you may get all hard questions.
You may get all questions on abdominal evisceration or placenta previa or something that's a real
(18:54):
look and cranny.
And it's going to mess with you.
Like why am I getting all these questions?
Am I answering them wrong?
The pilot questions don't have to follow any order.
You don't know when you're going to get them.
So we're going to go on and number seven is really going to address this more.
But when you go through, you've got to just take each question, answer to the best of
(19:18):
your ability, then boom, click next.
And that's it.
Those pilot questions could be easy.
They could be hard.
But that's the problem.
When I say the test gradually gets more difficult, if you get some pilot questions in the beginning
and they're really whacked out questions, there's not everyone's going to make it into
the exam.
You might be the person that's going to prove, that's a bad question, but you still get it
(19:41):
served up to you.
You just can't let it get to your head.
But I think it's important to remember that the registry is not going to trick you.
The registry is not out to do anything else except test if you're entry level competent.
And they're going to ask you questions that use things like you should.
(20:03):
You should first, you should next.
Or a diagnosis question.
You should suspect.
And when you look at those questions, they're going to ask you some type of decision or
action.
And that's one of the things that differs a lot from some class exams.
Because the way you make a question difficult is you put less wiggle room between the correct
(20:28):
answer and the wrong answers.
And you can't have any ambiguity.
There's got to be a right answer.
The registry doesn't do best answer anymore.
They've tried to get rid of that perception of voodoo or whatever.
And I think the questions are a little bit more straightforward, little bit more user-friendly,
and gentler to a great extent.
(20:49):
But there's still going to be a correct answer.
But they're not going to give you choices far apart.
They're going to, everyone's going to have a little bit of chooseability to see that
you know that you can pick that correct answer.
So this is going to be an exam, probably unlike a lot of others you've taken.
Unless you use our apps.
(21:09):
And in that, oh, sorry.
Did I say that?
Yes, I did.
But that's the general gist of the exam is that it's challenging.
That it's validated.
That it's fair.
And that it's going to require you to really think and read those questions.
(21:31):
Now within the last year, the National Registry has introduced some new styles of questions.
More specifically, the scenario style question.
Can you kind of give us an overview of what people are going to see with that scenario
style question?
It's not an individual question.
And then you move on.
(21:51):
Yeah.
The advanced level exams are using multi-part scenario questions that go over an entire
call.
These will not be considered live on the test from what the registry has said so far until
July 1 of 2024.
But you're going to see them.
And you need to know that they're there.
(22:12):
And they have, you know, before you get to the scene, on scene, and then continuing through
the call, they break it up into three different parts.
And you can see 10, 12, 15 questions are going to build on that.
Now it's nice about these as you get the continued information.
(22:32):
And you're able to build on that.
They're a little intimidating because they're different.
But I think they're fair.
And I think that they're designed to test a whole series of things.
Like, can you predict if something might be a problem later?
Can you identify a need for a skill that should be done on scene versus in the ambulance or
(22:55):
vice versa?
And I think to a certain extent, since the psychomotor exam is going to go away at the
advanced levels, they're trying to make it a more comprehensive thinking, sequencing
exam where they're going to make sure you can put a call together like you could in
a practical station.
Now there's other types too.
(23:16):
There's drag and drops where you can, you know, put these in order of severity or put
these in orders of the way you would do these with a patient.
And there's also multiple response items where you need to get two or five or three
and six correct.
And there's no partial credit.
So I personally think these things make the exam more challenging.
(23:41):
Now, other national certification exams for other health professions use these types of
questions.
This is not some evil scheme the National Registry has cooked up.
The nursing exam, the NCLEX exam, in fact, has a lot of these things.
And the National Registry has been able to use the engine that Pearson View uses for
(24:04):
NCLEX exams to be able to be able to put some of these questions in.
The exam is still going to be adaptive based on things.
I think it'll be more realistic of practice.
I think it will be different.
And I think in some ways it can be a little more challenging.
Yeah.
I heard a really good trick from Bill Brown, the former executive director of the National
(24:30):
Registry, who said, when reading these multiple response questions, a good way of getting
through, and this is going to kind of bring us to question six, which is read carefully
but don't read into the question.
But he said, basically treat these multiple response questions as true or false.
So you'll read the first one and say, is it true or is it false?
(24:52):
And then the next one, is it true or is it false based on the stem of that question
so that it's not that intimidation of, oh my gosh, I have to choose three out of these
six?
So do you think that's a solid method for kind of reading these style questions?
Yeah.
If they ask you, let's say there's one on patient refusal or a pregnancy complication
(25:13):
or shock, would I see this in shock?
True or false?
Would I see this in shock?
True or false?
And I think that that is a way to do it.
It makes it a little less intimidating.
They want you to know two or three things and also identify that two or three things
aren't part of that.
So that really does come down to that.
(25:35):
And I think it brings it down a little bit more as we do that.
You know, we've covered part five, a fair amount, right?
And now you have enough time, really.
I don't think you have to spend a ton of time on that.
You get a minute per question at any level of the exam.
(25:55):
The National Registry says 31 seconds.
And that's what the average person takes.
So you do have plenty of time.
Don't feel rushed.
Don't put that stress on yourself.
There's going to be some questions that you're going to want to read a little bit more.
Others you can go through and say, oh, that seems pretty easy.
Let me just check it again.
Yeah, that's it.
(26:16):
Boom.
And you move on.
There's plenty of time to take the test.
Please don't feel like you have to rush.
I think a lot of people go in and get really nervous.
And as a result, they rush because of the time limit.
I think that hurts people.
It's worth taking a little bit more investment in time.
Think about it.
(26:36):
EMT, 70 questions is the minimum.
Paramedic is 80.
If you take a little bit more time, read the questions, get them right, you'll probably
get less questions to begin with.
So take your time and do it right.
All right.
And so number six, read carefully, but don't read into the question.
(26:58):
Yeah, there's no trick.
Don't think that.
If let's say that they say you've got this patient and they want everyone to give them
medication.
They say, what does it say?
Think about allergies.
Well, if there's an allergy, they would tell you, don't look at a question and insert things
that are going to dismiss with your head.
(27:18):
Right?
I don't know if it's the force, right?
Just look at it.
If you're being driven in a direction, say, okay, I picked this because there's enough
material in the question to let you get to the right answer.
There'll be something in that's going to make you say, oh, no, there's good lung sound,
so it's not a pneumothorax or whatever.
(27:40):
And when you do that, it will all work.
It'll all come into play.
There's no tricks.
There's no anything.
Don't read into it.
Identify important words.
When you look at a group of words, it's not the same as looking at a patient.
Whether the patient is seven years old versus 70 years old makes a difference.
(28:03):
Patient male or female sometimes makes a difference in certain conditions and problems.
Look at the questions and read them well.
When I took the registry a couple of years ago, I read the question twice before I even
let myself look at the answers.
Identify words that make a difference, shallow, confused, pale, anxious.
(28:28):
There are certain words that indicate instability or shock that are just sleepy, tired.
We just use up so much energy breathing when we're sick that sometimes we get tired.
Sometimes we can't breathe anymore.
There's no energy left.
And then I've been starting to teach things.
I watch people do questions and they look at it.
(28:50):
They don't pull the stuff out.
You read a question.
Identify things that are important, shallow words, shallow breathing that they're tired.
The question says they have clear lung sounds bilaterally.
Everything means something.
So identify all those pieces of information and interpret it and say, what does it mean?
Well, if they're sleepy and they have shallow breathing, are they in failure?
(29:17):
Are they in respiratory failure?
And look and interpret what does it really mean?
And then finally we value it.
What's the most important part?
We have a couple of really great exam questions that I use.
A 49-year-old guy has got a smoking history and he's got chest pain.
But because of the smoking history, you put in a choice about emphysema.
(29:40):
And everyone said, oh, the smoking history.
And you pick emphysema when the person doesn't even have difficulty breathing in the question.
But you pick one thing and if you lock on that and you said, OK, I identified that.
He's got a smoking history.
But if you don't value it, right, he's mowing the lawn.
He's got chest pain and he's everything else.
But if the fact that you hang on the wrong piece of information, you get it wrong.
(30:03):
And that's the same thing that you'll do as an EMT or AEMT or paramedic in the field.
You'll be given a lot of information.
You're going to have to figure out what's the most important.
It really isn't that far from the street.
So it's not only getting the information, but it's figuring out what's the most important.
Then you look at the choices.
You look at all the choices you have and then say, all right, if I have this, I look back
(30:28):
in the question.
It can't be that because there's lung sounds.
So spontaneous pneumothorax is out.
And there I've got, oh, and I can work them.
Then once you figure out what's important, look at the choices and then let them rule
them in or rule them out and come to an answer.
Okay.
All right.
(30:48):
So that kind of brings us to number seven, right?
Answer each question to the best of your ability and then move on.
You know, funny, I think that the moving on is as important as answering each question
of the best of your ability.
Of course, you're going to answer each question to the best of your ability.
But there's going to be a lot of times that you don't know a word in the question.
(31:11):
You freak out that you're going through and you wondered whether it's this or this.
Use the things we just talked about and you're going to pick the best answer.
Don't the question you have on your screen has no, unless it's in part of a scenario,
a multiple part scenario, has no relation to a question that you got before.
I've heard people say, I got so many questions on tension pneumothorax.
(31:33):
I thought maybe I was getting something wrong.
So I changed my answer.
No, don't do that.
Questions are very subtly different, but they're different.
Answer each question of the best of your ability.
Look at the information you've got on that question.
That question, you read it, answer the best of your ability.
Look at it again.
You might do a double check.
Don't agonize.
Don't be, you know, you have time, but let's not be crazy.
(31:56):
Then you're going to hit, boom, you're going to submit that question and a new one's going
to come up on the screen.
If your mind is still wondering whether you got a question wrong two questions ago, it's
going to mess with your ability to be able to answer this question, right?
The one that's in front of you.
And that's the move on part.
(32:17):
Answer each question of the best of your ability.
Submit that question.
There's a new one on the screen.
There's no relation to it.
Like you said, less part of the scenario.
So that's a whole new question.
You got to focus on that with nothing else in your mind from the past.
Answer that.
And then again, submit it and move on.
There's a 70 or 80 or 135 minimum questions you're going to have to get through.
(32:41):
But if you get to that number, 70, 80, or, you know, on the paramedic exam, don't freak
out if you get another question, right?
Because if you get to 70 or 80, you get to 70 and you hit that button, you wonder if
it shuts off what it means.
Don't think about anything else other than answering those questions.
Don't say, Oh, is this a harder question?
(33:02):
Is this an easier question?
Is this, you know, if you say this is hard, then give yourself a minute.
It's good.
But don't do anything else except answer that question when you've done and you send that
question in, you get a new one.
Boom.
Only that new question.
And I think that's some of the best advice people get in their head so much about the
(33:22):
time and about all the other questions.
And it's a big experience and it's a high yield exam.
You want to go out and be an EMT.
And therefore this test means a lot, but you can do it.
I think these seven things are going to get you there.
An EMT or an advanced EMT or a paramedic.
(33:44):
Or a paramedic.
There you go.
And what's interesting is even though you're an EMT and a paramedic and you may have taken
the EMT national registry exam, it doesn't seem like you've got that much of a step up.
You're still really, really nervous about it.
You're upping the ante.
You're putting in new skills.
You're putting in a lot more work and that exam is still there and still challenging.
(34:05):
But it's fair.
Put the work in.
Pay attention.
Go through and do all the things we talked about.
And I really believe this is a good recipe for success.
I completely agree with you.
But let's just give a little bonus here.
We've got a few more minutes.
What happens?
You failed it the first time.
(34:28):
What is your recommendation to that student who just was unsuccessful the first time or
even the second time?
And how do they put all of these seven things into play plus a mindset for going back and
doing it one more time and being successful at it?
Yeah.
I think the first thing I'd say is you need to do some reflection and see if you prepared
(34:53):
well enough.
Did you really prepare well enough and do what you needed to do?
And if you didn't, that is actually easily fixed.
Your ego is going to be bruised.
Whether you studied a lot or whether you studied a little, you're going to find other people
from your class passed and it's going to be, you're not going to feel good about that.
It doesn't feel good.
(35:14):
It'll be unsuccessful.
But really reflect on what you did and do something differently going forward.
Right?
And if you went through, people leave through, I'll leave through my book again or whatever.
No practice.
Do something active.
Make study cards.
Go through a chapter and make notes.
Have a study group with other people in your class.
(35:35):
Go back to your instructor and look for more practice tests.
One of the things that helps get you over the hump of failing the first time is feeling
like you've done enough the second time to make it happen.
And quite frankly, a lot of people do pass the second time.
One, because now I know what the exam is like.
I've really got to study.
(35:55):
And two, because you know what the exam is like, when you go back and take it, it's not
as big of a head thing because you at least know what it's going to be like.
You know what it's like to walk into the center and have to do all the things that they have
to do and put all your stuff down and identification and everything else they do.
It won't be as intimidating.
(36:16):
If you don't let it, don't delay it.
Come up with a study plan.
If you were to fail today and you got that email and you're devastated, you can take
a day or two to get over that.
But you know what, then pick a day, 30 days, sign up for the exam to make your study, and
(36:37):
then do something every day to get through and pass that.
There's two parts of it.
Getting the knowledge, right?
Being able to match the kind of questions you're going to see and feeling like you did
enough to pass the second time.
A lot of people go back and pass that second time.
They really do.
So it's again, it's the work and it's the mindset.
(36:58):
All right.
Great.
Well, and I think we've covered the seven and given a little bonus one for those who
might have been not successful on their first attempt.
I think we can kind of come to a close here.
I thank you so much for sitting on the other side of the microphone.
I can talk in any particular position.
(37:21):
People have probably realized by now, but it was very good to be the guests and it was
great.
It was really great to have you host.
Great.
Well, thank you.
So just to all of you, just a note, today's episode is not going to be available for CE,
but we hope that you find it informative.
(37:41):
If you are somebody who's already passed the National Registry and are listening to this,
send it off to a colleague.
Let if you're an instructor, let your students know this is out here.
And we are always out here at Limmer Education to help anyone who is looking to pass the
National Registry with advice, with test questions, whatever it is that you need.
(38:04):
So for both Dan and myself, for Limmer Education, thank you so much.
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