# Mintygood's comprehensive guide to passing the NREMT-B written (v0.1 Beta)



## mintygood (May 24, 2011)

Hey all, I have been a long time lurker and a sparse contributor so I figured I would attempt to help those new EMT's who are about to venture off and take the NREMT-B.  Enjoy.

*PREFACE*
Before I go any further, I would like to preface this post with a few points.  

First, this is merely an explanation of how *I* passed the NREMT-B written test.  I happen to think that this way is the optimal way to pass this test, but I am of course biased due to my particular test taking style, study habits, work schedule, and work ethic.  Please recognize that this is not the end-all-be-all way to pass this sucker.  Keep an open mind.

This guide will be broken up into several topics ranging from moderately useless (but often times interesting) to extremely important.  Due to the relatively lengthy nature of this post, I will be using an easy system to keep those who are just looking for the "important" info interested.  The topics that are optional reading will be colored green while the topics that are required reading will be colored red.  Easy peasy.

I will be a continually editing, improving, and tweaking this guide.  I am very open to critique, suggestions, and feedback.  Please keep it constructive and please PM suggestions/corrections so the thread doesn't get mucked up.

*HOW THE TEST WORKS*
The NREMT tests are an oddity and can be extraordinarily intimidating to a student that isn't properly informed.  I will (attempt) to explain the structure, content, and procedure of this beast.

Quoted from the NREMT website.  


> The implementation of computer based testing strengthens the NREMT's commitment to serving the EMS community and providing a valid and reliable exam process. It also provides numerous benefits to the candidates, educators, and others in the EMS community as well as the American public, including:
> 
> Rapid turnaround of test results
> 
> ...



What does all of that gobbledygook mean?  It means that this computer test was developed to be more efficient, fair, and accurate in determining the skill level of the prospective EMS professional.

*How does the test do this?*
The test is generated from a bank of thousands of questions in OB/Peds, Trauma, Medical, Operations, Cardiac, and Airway among others.  The test reactively generates and modifies the test content and difficulty based on your performance.  Here's an example.

Lets say you're taking the test and you get your first question right.  The test will recognize that you are knowledgeable in that topic and probably would be able to effectively answer other questions of that difficulty, *so it makes the next question harder*.  The test will do the converse in the event of poor performance.

This dynamic administration of questions will continue throughout the test and will constant alter the difficulty.  Lets look at this hypothetical scenario.  

You are sitting there taking your test and you're doing pretty well so far.  You're on question 11 and have found each question to be relatively easy and straight forward.  The test is currently ranking you higher and higher on the register of difficulty and will continue to get harder if you continue to do well.  Think of this test having an imaginary passing threshold.  By achieving these hard questions, you will get bumped into this threshold.  Unfortunately, though, you have to maintain good performance in order to stay within this threshold and refrain from getting too many questions wrong and thus dropping back down into the "easy" questions.

This, however, does put an interesting spin on things.  Theoretically, one could miss *HALF* of their questions and still pass.  Suppose you get the first 20 right and you are well within the mystery threshold (I haven't heard of any hard figure that represents this threshold; consider this to be a tool used to gain understanding of the mechanics of this test).  You're kicking *** and taking names.  Out of nowhere, BAM, the bertha of all questions is asked.  You have no idea what the hell this test is asking and don't recall seeing this anywhere in your book... so you get this one wrong.  The next question (theoretically) will be easier and of course you get it wright because you're a smart EMT with a great smile.  Next question is another behemoth and you get it wrong.  Imagine this pattern repeating; one right, one wrong -- over and over.  *You're still in the passing threshold because of how well you did on the first 20 questions (no many how many times you repeat this pattern)!*

*Other considerations*

You will have four options, two viable and two borderline moronic.  An extremely helpful tip is to identify the two "good" answers right out of the gate.  If worse comes to worst, you have a 50-50 shot and guessing your way into success

The test will cut you off at any time.  When the computer (who will undoubtedly use its superior intellect to conquer the world in the future) decides how competent you are, it will end the test and you get to go home.

The NREMT-B test is for *BASIC* EMT's.  Yes this may sound stupid, but for people like me who happen to live in Tennessee, the content may be confusing.  Tennessee licenses EMT-IVs instead of Basics.  Said EMT-IVs can start IVs, use advanced airways like combitubes, and can administer Sub-Q epi, Nitro, Albuterol, Charcoal, Aspirin, and D50 among others.  Test within your scope, don't get tripped up by this.

Half the battle is understanding this test and being prepared to appropriately react to its style.  Arm yourself with knowledge, people.


*WHAT KIND OF STUDENT I AM*
I figured it may be helpful to describe what kind of student and test taker I am (this is a guide on how *I* passed.  Right?)

I am a pretty good student and made A's in my EMT class.  I also happen to have a horrific attention span.  I am an extremely quick learner but tend to grow bored and phase out of attention as my ego gets more and more confident that I've mastered the skill.  This is a huge weakness and I have worked for years to try and tame this tendency.  

The good part of this trait, though, is that it enables me to study very aggressively.  I use this to my advantage by studying hard and constantly reviewing past material as I progress.  My technique took 10 years of trial and error but it seems to be treating me well.

I am also a phenomenal test taker.  I'm not trying to blow smoke up my ***, I just have developed a keen sense of what the best answer might be.  This comes from years and years of taking tests that I was ill prepared for and struggling my way through.  This is certainly less than optimal but it has made me that much stronger when I am actually prepared.

Long story short, recognize what kind of student you are and play to your strengths.  Until you figure out how your mind works, you will be doomed in everything you do.  Studying efficiently is more effective than brute force learning.  *Work smarter, not harder.*


*PREPARING FOR THE TEST*
When I scheduled the test, I gave myself a solid week of preparation.  Is this too soon?  Well, not for me (see above).  *Figure out how much time your study style needs.*  It may also be nice to know that I work a full time job and have little free time.  If a dumb-dumb like me can do this, so can you.

*Resources*
I used four fabulous resources that made me more than prepared for this sucker.

1.  JBLearning
I can not express how useful this resource was.  At the low cost of $25.00, you have access to thousands of questions in computer test form.

2.  FISDAP
Many of you may use this site to track clinical progress but it also has an NREMT preparation test.  While the user interface is an absolute abomination, the tests helped me tremendously.  For $25.00, you get 2 tests.  

Think of your first test as your "calibration" run.  You take the 200 question test and you will receive a printout of your weaknesses.  *This printout is your best friend for the next week.  Love it, cherish it, respect it, use it.*  The second test will be taken after you have reviewed the things on the critique printout.  After taking the last test, it will tell you that you are either ready to take the NREMT or to reschedule.  

I have heard a few different figures to shoot for but the general consensus (from my experience) is that if you score an 80% on the FISDAP, you have a 97% chance of passing the NREMT the first time.  I buy this because this sucker is hard.  It will destroy you when you first take it but I promise you, it is for your own good.

*NOTE: You must have instructor approval in order to use this service.  I happened to piggyback off of my EVOC instructor's code.
*
3.  REA's Interactive Flashcards: EMT-Basic
This book cost me a whopping $8.95.  You'd be stupid not to invest in this book.  It contains 300 questions in flash card style and is a killer book for that spare 5 minute pause you have during work.

4.  Classroom textbook (Mosby's EMT Prehospital Care in my case)
I used this mostly for reference after getting my results from the FISDAP.  While there is controversy as to which book is the best, I happen to think that this one is a very good representation of what the NREMT wants.

Tally:
JBLearning - $25.00
FISDAP - $25.00
REA Flashcard book - $8.95
Mosby's EMT book - $78.95
Passing the NREMT-B the _first_ time - *Priceless*


*MY STUDY SCHEDULE*
I will break up this section into days of the week.  Remember, I only had a week to study and I worked 8 hour shifts on 5 of the 7 days and a 14 hour shift on Saturday.  You can do this.

*Wednesday*

90 Question JB Learning test consisting of 15 question from each topic (before work)

Create detailed study guide consisting of the questions I missed complete with detailed explanation and internet references

Review study guide during work

90 Question JB Learning test consisting of 15 question from each topic (after work)

*Thursday*

90 Question JB Learning test consisting of 15 question from each topic (before work)

Create detailed study guide consisting of the questions I missed complete with detailed explanation and internet references

Approximately 75 flashcard questions during work

Review study guide during work

90 Question JB Learning test consisting of 15 question from each topic (after work)

*Friday*

90 Question JB Learning test consisting of 15 question from each topic (before work)

Create detailed study guide consisting of the questions I missed complete with detailed explanation and internet references

Approximately 75 flashcard questions during work

Review study guide during work

90 Question JB Learning test consisting of 15 question from each topic (after work)

*Saturday*

No studying done due to busy work day.  I did, however, quiz myself to keep the information fresh.

*Sunday*

90 Question JB Learning test consisting of 15 question from each topic (before work)

Create detailed study guide consisting of the questions I missed complete with detailed explanation and internet references

Approximately 75 flashcard questions during work

Review study guide during work

90 Question JB Learning test consisting of 15 question from each topic (after work)

*Monday*

FISDAP Calibration Test

Create detailed study guide based on the FISDAP printout with detailed explanation and internet references

Approximately 75 flashcard questions during work

Review study guide during work

90 Question JB Learning test consisting of 15 question from each topic (after work)

*NOTE: I did not take the 2nd FISDAP test.  I got an 80% first try so my cockiness got to me and I decided not to follow through.  Don't do this. *

*Tuesday* (day before test)

50 question JB Learning test strictly consisting of Cardiology questions.

50 question JB Learning test strictly consisting of Medical questions.

50 question JB Learning test strictly consisting of OB/Pedi questions.

Final study guide consisting of any topic that I personally felt unconfident about.
*NOTE: After the final study guide was made, I didn't touch the material for the rest of the night.  Not even at work.*

My theory is this: If I don't know the material 12 hours before the test, I'm not going to know it.  If I try to cram it in and half-*** it on the test, then I deserve to fail because it will ultimately lead to poor patient care.  Know the material, change the profession, go above and beyond.

The night before the test I watched a movie, talked to my lovely girlfriend on the phone and went to bed at 9pm.

*Wednesday* (D-Day (Did you know that the "D" in D-Day stands for Day?  As in Day-Day, or the day of all days.  Pretty cool, huh?)

Wake up at 6am

Drive to Atlanta (approximately 2.75 hour drive from Chattanooga with traffic)

Arrive at testing center, break out the Final study guide (see above) and study to relaxing, instrumental music.

The key to D-Day is to provide enough time to get where you need to be.  Reducing the stress level will be crucial in being successful.  Going to bed at 1am after down jagerbombs is doing a disservice to yourself and ultimately your patients.  Don't be that guy.


*MY RESULTS*
*I passed the NREMT-B test first try.  It took me 36 minutes and I was cut off at question 74.*



I'm sorry to leave off here but I am very tired.  I plan to add more detail and continue to update this guide.  As said before, I am very open to critique and correction (nobody's perfect) but please, PLEASE, bring this kind of stuff up with me via PM.  I want to try and keep the comment section clean.  I would be happy to credit those who correct me on factual information.  Hope this helps!


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## mintygood (May 24, 2011)

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## mintygood (May 24, 2011)

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