The National Registry of Emergency Medical Technicians (NREMT) emergency medical technician certification designates that an individual possesses the knowledge and skills to stabilize, transport, and otherwise help victims of medical emergencies.
That means EMTs play a critical role in ensuring patient survivability between the scene of medical emergencies and an emergency room!
In addition, the Bureau of Labor Statistics estimates that the occupational demand for EMTs will surge by more than 15% leading into 2026, which is significantly higher than the average for the whole country.
It’s no wonder that today’s students are flocking to this career. It’s in demand, it’s secure, and it’s even recession-proof — and all a student needs to start is the certification!
So how can you help students pass the national EMT certification exam to become certified EMTs?
On this page, you’ll learn the ins-and-outs of what your students need to know for success on the exam. Plus, you’ll learn a few tips for preparing them for test day!
First, let’s take a minute to discuss the NREMT since they provide the EMT certification!
What Is the NREMT?
The NREMT is a non-profit organization considered to be “the nation’s emergency medical certification organization.”
The NREMT’s mission is to protect the public by ensuring EMS professionals are proficient in the skills and knowledge to effectively work in the field.
To meet this goal, the NREMT has developed certifications for four EMS professions -- including the National EMT Certification!
So now that you know why the NREMT created the exam, let’s get into the details of the EMT certification!
How Is the NREMT EMT Certification Structured?
The NREMT EMT certification is comprised of a cognitive exam and psychomotor exam.
The cognitive exam is a computer-based test that measures a student’s knowledge of the National EMS Education Standards for EMTs.
The exam could contain between 60 to 110 scored questions with 10 unscored “pilot questions” the NREMT uses to gather data.
The scored questions fall under six content areas found on the National EMS Education Standards:
- Airway Management, Respiration, and Artificial Ventilation
- Medicine
- Shock and Resuscitation
- Trauma
- Special Patient Populations
- EMS Operations
Each content area is organized into “sections” and “competencies:”
- “Sections” are the major topics that further elaborate on the overarching knowledge area
- “Competencies” are the individual concepts and skills within each section
Here you’ll learn about the sections of each content area and why the competencies within them are so important for EMTs to learn.
1. Airway Management, Respiration, and Artificial Ventilation
The Airway Management, Respiration, and Artificial Ventilation content area measures a student’s knowledge of patient management and assessment in relation to respiration.
This area is made up of 11 competencies across three sections:
- Airway Management
- Respiration
- Artificial Ventilation
These sections cover the anatomy of the respiratory system, airway assessment techniques, and different types of artificial ventilation.
These skills are essential for an EMT. They empower EMTs to stabilize patients and keep them alive until the patient is transported to a hospital for treatment.
2. Medicine
The Medicine content area requires students to apply fundamental medical knowledge to care for and transport acutely ill patients.
This content area includes 61 competencies across 15 sections:
- Medical Overview
- Neurology
- Abdominal and Gastrointestinal Disorders
- Immunology
- Infectious Diseases
- Endocrine Disorders
- Psychiatric
- Cardiovascular
- Toxicology
- Respiratory
- Hematology
- Genitourinary/Renal
- Gynecology
- Non-Traumatic Musculoskeletal Disorders
- Diseases of the Eyes, Ears, Nose, and Throat
These competencies relate to an EMT’s ability to recognize and manage medical emergencies such as strokes, anaphylactic reactions, alcohol poisoning, and heart failure.
This content area also covers much more information compared to the EMR certification requirements. That’s because EMRs aren’t always medical personnel — they may be other emergency workers trained as EMRs.
EMTs are dedicated medical personnel, meaning they require a deeper and more intense knowledge of common ailments so they can successfully stabilize a patient.
EMTs also often work with emergency medical responders (EMRs) to provide initial care, during which time EMTs may take the role of a “team lead” in an emergency.
Finally, EMTs prep patients for transport via an ambulance, which is crucial to maintaining patient safety throughout an emergency!
3. Shock and Resuscitation
The Shock and Resuscitation content area is one of the most straightforward portions of the EMT standards. Instead of sections and competencies, this content area has two requirements.
First, EMTs must be able to identify the causes, psychological symptoms, and best treatment options of:
- Shock
- Respiratory failure or arrest
- Cardiac failure or arrest
In addition, EMTs must have a fundamental understanding of post-resuscitation management of the patient.
Though this content area is short, it involves one of the most important responsibilities of an EMT.
Shock may occur in any traumatic emergency. Respiratory arrest may be a symptom of a trauma — not necessarily the problem itself. And when it comes to cardiac failure, psychological trauma (like panic attacks) can mimic the physical symptoms of a heart attack.
Recognizing and managing these emergencies is a critical skill when every second counts!
4. Trauma
The Trauma content area tests a student’s ability to provide basic emergency care and transportation of exceptionally injured individuals.
This content area is made up of 58 competencies across 11 sections:
- Trauma Overview
- Bleeding
- Chest Trauma
- Abdominal and Genitourinary Trauma
- Orthopedic Trauma
- Soft Tissue Trauma
- Head, Facial, Neck, and Spine Trauma
- Nervous System Trauma
- Special Considerations in Trauma
- Environmental Emergencies
- Multi-System Trauma
EMTs have two main responsibilities when working with trauma patients.
First, they must be able to quickly assess the extent of the trauma to appropriately care for it.
Depending on the type of trauma and extent of it, EMTs must be ready to perform the correct procedure in order to treat the patient.
Then, once the patient has been stabilized, the EMT needs to properly move them into the transport vehicle for further treatment at a hospital.
These responsibilities are some of the most important tasks for EMTs to master so they can provide safe, effective care in emergency situations!
5. Special Patient Populations
Special Patient Populations tests a student’s knowledge of working with specific groups of individuals in emergency situations, most often based on the patient’s age.
This area includes 39 competencies across five sections:
- Obstetrics
- Neonatal Care
- Pediatrics
- Geriatrics
- Patients with Special Challenges
EMTs must understand how certain emergency treatments (like CPR) require changes to help someone in a special population.
In addition, EMTs need to know how to manage emergencies unique to patients with special considerations, such as pregnant women or elderly individuals.
These detailed skills ensure that an EMT is able to provide the best emergency care and transportation for any patient, no matter their unique needs!
6. EMS Operations
The EMS Operations content area measures a student’s knowledge of the roles and responsibilities of emergency response professionals.
This area includes 14 competencies across six sections:
- Principles of Safely Operating a Ground Ambulance
- Incident Management
- Multiple Casualty Incidents
- Air Medical
- Vehicle Extrication
- Hazardous Materials Awareness
- Mass Casualty Incidents
These competencies cover emergency transportation, patient triage, vehicle extraction, and post-traumatic stress, among other ideas.
Understanding these roles and responsibilities ensures every EMT works effectively as part of the EMS team during an emergency!
Summary: The EMT Cognitive Exam
On test day, students have two hours to complete the cognitive exam.
Results are posted on each student’s NREMT account within two business days.
After passing the cognitive exam, students must take a hands-on skills assessment called the psychomotor exam.
The EMT Psychomotor Exam
The EMT psychomotor exam measures a student’s ability to apply their skills and knowledge in a variety of incidents an EMT may encounter.
This portion of the EMT certification process is administered either by the State EMS Office or at the student’s training institution (with the approval of the State EMS Office).
The NREMT has example performance checklists to help students know what to expect from the skills assessment.
Some scenarios include:
- Patient assessment and management of trauma
- Patient assessment and management of a medical emergency
- BVM ventilation of an apneic adult patient
- Oxygen administration by non-rebreather mask
- Spinal immobilization (seated patient)
- Spinal immobilization (supine patient)
- Bleeding control and shock management
- Cardiac arrest management
- Joint immobilization
- Long bone immobilization
During the psychomotor exam, students must follow certain steps in the correct order to earn enough points to pass.
Students earn points by properly following procedure and using context clues to determine the proper short-term treatment for a patient.
Students may lose points by taking “shortcuts” in processes, hesitating on certain steps, or skipping procedures entirely.
After completing the hands-on assessment, students instantly receive their results from the exam proctor.
It’s important to note that these results are unofficial. The official results will post to the student’s NREMT account within four weeks.
If a student has passed, they are certified as a nationally registered EMT!
So, now that you know the details of the EMT certification, there’s one last question -- how do you actually prepare your students for the exam?
How Do You Prepare Students for the NREMT EMT Certification Exam?
When you want to prepare your students for a certification exam, you probably want to use test prep materials from the certification provider.
Unfortunately, the NREMT doesn’t provide any official test prep materials.
Luckily, you can find dozens of unofficial EMT study guides and practice tests online!
Because those materials don’t come directly from the NREMT, it’s important for you to perform due diligence. Some materials may be missing key information your students need to know.
On top of that, solely teaching to the test can hurt your student’s long-term information retention!
If you use test prep materials as the main part of your EMT curriculum, you could put your students at a disadvantage in certification prep and future success in their careers!
That’s why many teachers take a two-step approach to EMT certification prep:
- Teach your EMT curriculum
- Supplement with test prep materials
It’s smart to start by teaching your students the foundational skills and concepts found on the National EMS Education Standards.
The standards include the detailed competencies on the EMT cognitive exam, plus additional information every EMT must know before entering the workforce.
It’s also important to share your own experiences as an EMS provider to tie classroom instruction into real-world examples.
Along with the detailed competencies found on the standards, many EMT teachers include lessons on communication, professionalism, and empathy to help students hone their soft skills.
Toward the end of your semester, you can introduce the second step to successful test prep.
Practice exams can help you and your students see how prepared they are for test day.
You can also provide study materials to help your students review, especially if there’s an area they struggled with on the practice exam!
Again, it’s important to perform due diligence and read over any materials that you get online. You can also choose to create your own test prep materials, though that may eat into your personal time!
Regardless of your choice, this two-step approach will help you get your students ready both for the national certification exam and their careers as EMTs!
So how do you make this process work in your classroom?
Some teachers will build their own EMT curriculum from scratch using textbooks and other resources. That’s a great way to provide a customized experience for your students but creating everything on your own could take an entire summer of planning!
That’s why dozens of EMT instructors have chosen a comprehensive curriculum system to do the heavy lifting when it comes to planning curriculum that aligns to the NREMT EMT certification exam!
