How to NREMT - Computer Adaptive Testing

From the NREMT

What is a Computer Adaptive Test?

From the NREMT (https://www.nremt.org/document/cognitive-exams) – CAT examinations are delivered in a different manner than fixed-length exams such as computer-based linear tests and pencil-paper exams and may feel more difficult. Candidates should not be concerned about the ability level of an item on a CAT exam. The examination is scored differently than a fixed-length examination. All items are placed on a standard scale to identify where the candidate falls within the scale. As a result, candidates should answer all items to the best of their ability. Let’s use an example to explain this:

An athlete is trying out to be a high jumper on the track team. Individual jumpers need to jump over a bar placed at four feet above the ground to score points. The bar is the competency standard. Athletes who cannot jump more than three feet during tryouts will rarely-- if ever--score points for their team during a track meet. Athletes who jump four feet on the first day of tryouts, after training and coaching, can not only jump four feet (the minimum) but, later may, through additional education, learn to jump five or more feet. The coach knows that it will be worth the time and effort to coach these athletes to greater heights. Therefore, those who jump over four feet at tryouts become members of the high jump team because they have met the entry-level competency standard.

The coach can hold a tryout to see who meets the entry-level competency standard. The coach will set the bar at 3 feet 6 inches for the first jump attempt. Those who make it over this bar will then progress to 3 feet 9 inches to test their ability. Again, the coach will raise the bar to 4 feet if the athlete is successful at the previous level and have the successful jumpers attempt to clear it. The coach will not tell the team the necessary height to learn the maximum ability of each athlete.The coach finds that seven of ten athletes clear the bar at the four-foot level. The coach will then raise the bar to 4 feet 3 inches and later to 4 feet 6 inches, increasing the height of the bar until the coach determines the maximum individual ability of each athlete. This process informs the coach about the athletes’ ability based on a standard scale (feet and inches). The coach then sets a standard (4 feet) for membership on the team, based upon his knowledge of what is necessary to score points at track meets (the competency standard).

The coach finds that seven of ten athletes clear the bar at the four-foot level. The coach will then raise the bar to 4 feet 3 inches and later to 4 feet 6 inches, increasing the height of the bar until the coach determines the maximum individual ability of each athlete. This process informs the coach about the athletes’ ability based on a standard scale (feet and inches). The coach then sets a standard (4 feet) for membership on the team, based upon his knowledge of what is necessary to score points at track meets (the competency standard).

A 95% Confidence is Necessary to Pass / Fail a CAT Exam

The computer stops the exam at the minimum number of items in the following situations:

There is a 95% confidence the candidate is at or above the passing standard.
There is a 95% confidence the candidate is below the passing standard
The candidate has reached the maximum allotted time

The high-jump analogy can describe the way a CAT exam works. First, the National Registry calibrates every item on a live examination to estimate its difficulty level on a standard scale. Then, the computer adaptive test learns the candidate’s ability level as they take the examination and compares their responses against that scale.

The test begins with an item that is slightly below the passing standard. The item may be from any subject area in the test plan:

Airway, Respiration & Ventilation
Cardiology & Resuscitation
Trauma Medical / Obstetrics / Gynecology
EMS Operations

After the candidate gets a short series of items correct, the computer will choose items of a higher ability, perhaps near entry-level competency. The examination selects these items from a variety of content areas of the test plan. If the candidate answers most of these questions correctly, the computer will choose new items at an even higher ability level.

Again, if the candidate answers many of these items correctly, the computer will present the candidate with more items of an even higher ability level. Eventually, every candidate will reach their maximum ability level and begin to answer items incorrectly.

Thus, the computer evaluates a candidate’s ability level in real-time. The examination ends when there is enough confidence the candidate is above or below the passing standard once the candidate responds to a minimum number of items.

SOURCE: https://www.nremt.org/document/cognitive-exams

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From the NREMT

What is a Computer Adaptive Test?

A 95% Confidence is Necessary to Pass / Fail a CAT Exam

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