The National Registry of EMTs (NREMT) has played an integral role in advancing the EMS profession for more than four decades.
With a staff of only 50 employees at its headquarters in Columbus, Ohio, the National Registry is the only national organization that certifies emergency medical responders, EMTs and paramedics.
A pioneering leader in EMS, Drew Dawson was appointed as the National Registry’s interim executive director in September 2017.
For nearly 50 years, Dawson has led the profession in a variety of ways—from serving as Montana’s state EMS director for more than two decades, to heading up the National Highway Traffic Safety Administration’s (NHTSA) Office of EMS from 2003 until his retirement in 2015.
Since its founding, the National Registry has been focused on maintaining the integrity of the EMS profession. However, the perception of its role can sometimes vary from one EMS professional to the next.
In an interview, Dawson addressed core principles of the National Registry and clarified its commitment and importance to both individual professionals and the industry as a whole.
As a former chairman of the National Registry Board of Directors, he stressed his role in helping prepare the organization for a smooth transition to a permanent executive director this summer.
JEMS: We know you’ve worked with the National Registry for many years in your roles as a state EMS official and director of the NHTSA Office of EMS. Coming to the organization as interim executive director, was there anything that surprised you about the work they’re currently doing?
Dawson: I’d worked with the National Registry in various capacities for decades, even as chairman of their Board of Directors, but none of that adequately prepared me to understand or to fully appreciate the amazing amount of work that goes into serving the nation’s EMS certification organization.
The complexity of the work—ranging from test development, psychometrics, test delivery networks, certification and recertification, information systems, registrant services and personnel administration—is challenging and, frankly, a bit overwhelming.
There are lots of moving pieces, all of which must work together seamlessly and efficiently. I was surprised by the number of staff I didn’t know, but soon learned they’re incredibly talented, well-educated and universally dedicated to the National Registry’s mission of advancing the EMS profession.
JEMS: What can you share with readers about the search for a new executive director?
Dawson: Great question. We’re making good progress. Following in-
person interviews of the top candidates, the search committee has narrowed the field and the Board of Directors will make the final selection at their meeting on June 12. I’ll continue as the interim executive director until the new executive director comes on board, and I will remain on-site to assist with their transition.
We’ve made some very positive changes to the National Registry’s organizational structure and processes over the last nine months, and we all want the transition to be just as smooth and seamless as possible.
JEMS: The National Registry’s role isn’t always clearly understood by everyone. Can you help us understand some of its core principles?
Dawson: First, the National Registry isn’t a “test vendor.” We’re a full-service EMS organization whose primary focus is to provide a reliable, predictable, patient-centered standard for state EMS leadership to evaluate entry-level competence for their EMS professionals. In the end, this translates to improved patient care.
The National Registry also provides a path to ensure the continued competence of EMS professionals.
Secondly, sometimes people confuse National Registry certification with a license, so it’s important to make the distinction: National Registry certification verifies entry-level competency, but it isn’t a license and it doesn’t constitute permission to practice.
Only a state government may issue a license to practice, and states frequently require National Registry certification to verify competency as a basis for issuing their license. With that, the National Registry has a close partnership with state offices of EMS.
Most importantly, you’re not a member of the National Registry, you’re nationally certified and can be justifiably proud of meeting a high standard. A national certifying body is a key element in the development and maturation of the profession as a valuable member of the healthcare community.
Additionally, the National Registry is a member of the National Commission for Certifying Agencies (NCCA), the organization that accredits certifying agencies, and has to meet its comprehensive list of requirements for certification.
JEMS: Why is the National Registry involved with research?
Dawson: As a nonprofit organization, we want to use our resources to help improve EMS. We’re in a unique position to help others understand the important issues of EMS, and our research helps us constantly improve our service to the EMS community. Also, as an organization that highly values evidence-based decisions, we take great pride in our use of research. Basing our decisions on science lends credibility to the National Registry as an unbiased organization that uses facts, not politics, to craft policies and examinations to improve the profession.
JEMS: What do you say to people who are frustrated with the National Registry or who say the test is too hard or irrelevant?
Dawson: National Registry certification protects the public by evaluating EMS competence using an examination written by a broad range of professionals, including educators, medical directors, administrators, state directors and current EMS professionals. We acknowledge that the examinations are hard; however, they’re also relevant, current and rigorously evaluated. Before any question is used for assessment on an examination, it’s been taken by hundreds of examinees as a practice item. Each item is evaluated to ensure the content is relevant, the item is fair, and there’s only one correct response.
Examination items are written by EMS educators, providers and medical directors from across the U.S.. They’re not written by National Registry staff. We’re happy to answer questions and concerns about exam content. If you’re interested in helping to write exam items, you can sign up at our website at www.volunteer.nremt.org.
JEMS: What’s the process for writing & validating test questions and practical scenarios? How often are the tests updated?
Dawson: The tests are constantly being updated. We have between 15–20 examination development panels each year.
The panels are made up of volunteer EMS professionals who help update the examination to reflect the values and knowledge of the EMS community.
We also employ psychometricians to ensure our test processes follow best practices in testing.
Our goal is to ensure that each candidate receives a fair opportunity to demonstrate their skills as a provider.
JEMS: The National Registry recently issued new requirements for continuing education (CE). Can you explain the CE requirements to clarify what they mean to an EMT or paramedic?
Dawson: We’re in the final stages of implementing the new CE requirements across the country, and most states are already using them. There are fewer hours required, but more specific content requirements for continuing education.
The new CE totals are 40 hours for EMTs, 50 hours for AEMTs and 60 hours for paramedics (compared to 72 hours for all levels in the traditional model).
Content requirements are defined for each level based on the current medical evidence, which can be found on the National Registry website.
It’s always a challenge to stay up-to-date, so we provide training officers with sample materials that can be used in their lesson plans.
Of course, this information must be tailored to local protocols and issues, but references, outlines and objectives are provided as a resource.
Also, the National Registry website has a personal certification site for registrants, including a transcript for CE.
The site stores a lifetime record of education that can be applied in many ways, including certificates and descriptions for each course, which makes the recertification application and audits much quicker and easier.
We also released our first National Registry iOS app in April, allowing EMS professionals to easily track their EMS education and recertification from their phone.
JEMS: What are some of the advantages of being certified by the National Registry?
Dawson: Achieving National Registry certification makes you eligible, in part, for licensure in almost all states at some level, and is required for licensure in 46 states at some level.
As a profession, National Registry certification places EMS professionals “in step” with virtually all other U.S. health professions that are nationally certified and helps to advance the EMS profession and protect the public.
National Registry certification isn’t just about getting a card and a job, it demonstrates that you’ve met and continue to meet rigorous national standards for competency in the EMS profession.
It also demonstrates to employers that you have a certain level of competence and that you’re continually learning. It allows for more flexibility in terms of job options and crossing state lines.
JEMS: Is there anything you’d like to add?
Dawson: Recently, I looked at the top shelf of the bookcase in my office and saw a gavel that was donated to the National Registry by Dr. J.D. Farrington, Chair of the Board, from 1971–75. Farrington is known as the “Father of Modern EMS,” and he served the National Registry during its formative stages.
My thoughts then turned to another EMS legend and our building’s namesake,
Rocco Morando. Rocco was on a task force that created the first EMT-Ambulance program and made recommendations that resulted in the creation of our organization (where Rocco also served as the first executive director).
As I reflect on our history, I’m overwhelmed by the passion and foresight of the National Registry’s creators, and I’m inspired by their mission to improve prehospital care throughout our nation.
After my brief tenure as interim executive director and my participation in the search committee, I’m confident that the Board, the staff and the next executive director will continue this long-standing commitment.