Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

E. Paulette Isaac-Savage, EdD.


Isaac-Savage, Evelyn

Bolton, Natalie

Calvert, Wilma J.

Carhart, Elliot


Certification as an Emergency Medical Technician (EMT) is often the entry point for firefighting careers and is a pre-requisite to enter Advanced EMT or paramedic programs. EMT candidates in most of the United States must pass the National Registry of EMTs cognitive examination (NREMT-C) to be eligible for state licensure. Many candidates who fail their first NREMT-C attempt never take even one of the five additional possible attempts within the specified two-year time frame. Using binary logistic regression with de-identified existing NREMT test data from 2007 though 2012, this research attempted to develop a model to show the relative contribution of previous NREMT-C score, demographic factors, pay status, employment status, and school accreditation to predict candidates’ likelihood of retesting. A literature review suggested that these factors influence candidates’ success on their first exam attempt, however no literature has examined if these factors predict a candidate’s decision to take at least one additional examination attempt. Results showed that the theta score from the prior attempt was a strong predictor of reattempting examinations two through six. Female gender was negatively associated with attempting examinations two through five. Younger candidates were more likely to attempt examinations two through four, whereas at attempt five the odds an older candidate would try again were slightly higher. Military candidates were much more likely to persist through examination attempt three, however this trend reversed at attempts four and five when they were less likely to reattempt. Having someone pay for the prior exam enhanced candidates’ odds of taking the second and third examination. All race and ethnic categories (except Hispanic) were weakly associated with the odds of taking a second examination but not in any subsequent attempts. Students who attended schools associated with accredited paramedic programs were slightly more likely to persist through exams two through four as were individuals having more education. While this analysis identifies some factors related to examination persistence, it produced weak models, suggesting that many more individual variables are associated with the decision to persist after failing the NREMT-C EMT examination than those examined.

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