Advanced Level Psychomotor Examinations

About the National Registry Advanced Level Psychomotor Examination

National Registry psychomotor examinations are standardized examinations administered in a variety of locations across the United States. All advanced level psychomotor examinations (Advanced EMT and Paramedic) are authorized by the National Registry and monitored by an official National Registry Representative. Candidates must successfully complete a predesignated set of skills for each level as part of the certification process.

Important Reminders

  • Candidates are required to bring a copy of their PATT with them to the examination site.
  • Candidates are required to bring a government-issued form of identification with them to the examination site.
  • Candidates may cancel their reservation for an examination at any time until the deadline listed in the examination details. After this deadline, they may no longer cancel their reservation. Candidates who do not show up for the examination will be unable to reschedule for another examination until the original examination has been processed. Candidates can only register for one examination at a time. Failure to attend an examination does not count as an attempt.
Find A Psychomotor Examination

The Advanced EMT psychomotor examination consists of nine skills presented in a scenario-type format. All skills have been developed by subject matter experts in accordance with the national standards.

The psychomotor examination process is a formal verification of the candidate's practical abilities and knowledge. Apart from Pass or Fail, candidates are not provided with specific feedback regarding their examination performance.

Advanced EMTs are required to demonstrate proficiency in the following skills:

Patient Assessment-Trauma

Patient Assessment - Trauma

Candidates are required to perform a head-to-toe physical assessment and verbalize treatment of a simulated patient for a given scenario, including:

  • Scene Assessment
  • Initial Assessment/Resuscitation
  • Focused History and Physical Examination - Rapid Trauma Assessment
  • Detailed Physical Examination

Patient Assessment-Medical

Patient Assessment - Medical

Candidates are required to perform a head-to-toe physical assessment and verbalize treatment of a simulated patient for a given scenario, including:
  • Scene Assessment
  • Initial Assessment/Resuscitation
  • Focused History and Physical Examination - Rapid Trauma Assessment
  • On-Going Assessment

Ventilatory Management

Supraglottic Airway Device
Pediatric Respiratory Compromise

Candidates are evaluated over the following two ventilatory management scenarios:

  1. Apneic Adult
    • Given a scenario of having just found an apneic adult patient with a palpable carotid pulse, candidates must demonstrate immediate management of the patient using simple airway maneuvers and adjuncts, a BVM device, and supplemental oxygen, followed by the placement of a supraglottic airway device.
  2. Pediatric Respiratory Compromise
    • ​​Given a scenario with an infant in respiratory distress, candidates must demonstrate immediate management of the patient using simple airway maneuvers, adjuncts, and supplemental oxygen. Candidates will then be required to demonstrate BVM ventilations as the patient progresses from respiratory distress to respiratory failure.

Cardiac Arrest Management/AED

Cardiac Arrest Management

Candidates will be evaluated on their ability to manage a cardiac arrest situation with the proper use of an AED and 1-rescuer CPR.

​IV and Medication Skills

Intravenous Therapy - Bolus
Intravenous Bolus Medications

Intravenous Therapy: Candidates are required to establish a patent IV in a manikin arm in accordance with a given scenario.

Intravenous Bolus Medications: Candidates must administer an IV bolus of medication in accordance with a given scenario.

Pediatric Intraosseous Infusion Skills

Pediatric Intraosseous Infusion

Candidates are required to establish an intraosseous line in a pediatric IO manikin. (Manual insertion with a Jamshidi® needle or battery-powered drill-type devices are permitted.)

Random EMT Skills

Each candidate will be evaluated on one of the following randomly selected EMT skills.

Long Bone Immobilization
Joint Immobilization
Bleeding Control/Shock Management

Find A Psychomotor Exam

Paramedic candidates are tested on six skills: Patient Assessment – Trauma, Dynamic Cardiology, Static Cardiology, Oral Station Case A, Oral Station Case B, and the Integrated Out-Of-Hospital (IOOH) Scenario.

Patient Assessment-Trauma

Patient Assessment - Trauma

Candidates are required to perform a head-to-toe physical assessment and verbalize treatment of a simulated patient for a given scenario, including:

  • Scene Assessment
  • Primary Survey/Resuscitation
  • History Taking
  • Secondary Assessment

Cardiac Management Skills

Candidates are evaluated on their ability to manage cardiac arrhythmias and interpret ECGs. This will be verified in two portions:

Dynamic Cardiology
Candidates will be evaluated on their ability to manage a cardiac arrest situation, including actual delivery of electrical therapy, and must verbalize all interpretations and treatments given a scenario.

Static Cardiology

Given four (4) prepared ECG tracings with associated patient information, candidates must verbalize the interpretation of each rhythm and verbalize all associated treatments.

Oral Station - Scenario A & B

Oral Station

Candidates will be evaluated on their ability to verbally manage all aspects of an out-of-hospital call given two (2) separate cases: Oral A & Oral B

In each case, candidates will be evaluated in the following categories:

Integrated Out-of-Hospital Scenario

Integrated Out-of-Hospital Scenario
The Integrated Out-of-Hospital Scenario (IOOH) will reflect either a pediatric, geriatric, or adult patient. Candidates will be provided with a professional paramedic partner and evaluated on their ability to manage a call, lead a team, effectively communicate, and maintain professionalism throughout the simulated patient encounter.
OBTAINING A PSYCHOMOTOR AUTHORIZATION TO TEST (PATT)

Candidates will receive a Psychomotor Authorization to Test (PATT) number once the following conditions are met:

  1. The candidate creates a National Registry account by clicking here
  2. The candidate creates an application
  3. The candidate affiliates with an approved EMS education site
  4. The EMS Program Director of the approved EMS education site will confirm candidate eligibility for the Advanced Level Psychomotor Examination based on state requirements
REGISTERING FOR AN EXAMINATION

Advanced Level Psychomotor Examinations can be found by state and level here. To register for an Advanced Level Psychomotor Examination, candidates must provide their Psychomotor Authorization to Test (PATT) number to the Examination Coordinator listed in the examination information page. The National Registry will not add candidates to a roster without permission from an Examination Coordinator. Candidates must be entered on a psychomotor examination roster no later than 14 days prior to the examination date. Therefore, candidates should plan to provide their PATT number to an Examination Coordinator well in advance of the 14-day deadline to ensure roster addition. Once the candidate is listed on the official roster, the PATT page of the candidate’s account will reflect the examination information.

RETEST POLICY AND SKILL REMEDIATION
For information on the retest policy and skill remediation, please click here.
PSYCHOMOTOR EXAMINATION ASSESSMENTS

Candidates may choose to take the psychomotor examination as an assessment. Assessment candidates are not eligible for National Registry certification, but may require proof of successful completion of a National Registry examination for the following reasons:

  • State EMS licensure
  • Instructor status/licensure
  • Remediation
  • Other reasons at the request of State EMS office

Psychomotor assessment candidates will not receive a PATT number. Instead, they will be handwritten onto the roster on examination day. Candidates must make arrangements with the Examination Coordinator 14 days prior to the exam to avoid walk-ins / confusion on exam day. The candidate’s examination results will be returned to the National Registry and then forwarded to the State EMS office upon their request.

AMERICANS WITH DISABILITIES ACT INFORMATION

The National Registry complies with the Americans with Disabilities Act (ADA) of 1990 and offers reasonable accommodations for individuals with disabilities. Pearson VUE test centers are also ADA compliant. Complete information about the National Registry Accommodations Disability Policy can be found here.

EMR & EMT Exam Psychomotor Exam Accommodations

All candidates must complete the psychomotor examination in the same standardized format. The presentation of any skill may not be altered to accommodate a candidate’s request without first obtaining approval from the State EMS Office. The State EMS Official or approved agent is not authorized to individually make any determination for accommodation of the psychomotor examination. For example, it is not appropriate to move the Simulated Patient in the Patient Assessment/Management – Trauma skill from the floor to an examination table at the candidate’s request because the candidate is physically unable to bend down and assess a patient found lying on the floor. The psychomotor examination is intended to present simulated patients with realistic situations that approximate the candidate’s ability to function in the out-of-hospital environment. The State EMS Official or approved agent and all Skill Examiners must remain vigilant for any situation that may alter the normal presentation of any skill other than that which is intended throughout the psychomotor examination. When in doubt, contact the State EMS Office for assistance.