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Testing 15–45 days showed comparable pass rates, highest success occurred within 30 days, while rates declined significantly after 45 days and delays beyond 60 days strongly predicted 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[https://www.dovepress.com/](https://www.dovepress.com/)  \nFor personal use only.  \nAdvances in Medical Education and Practice  \n Open Access Full Text Article  \nORIGINAL RESEARCH  \nThe Adverse Impact of Delay Upon Successfully Completing the National Registry EMT Exam on the First Attempt  \nPeter G Kreysa 1 , Linda Martinez2 , Henry O’Lawrence2  \n1Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, CA, USA; 2Department of Health Care Management, California State University Long Beach, Long Beach, CA, USA  \nCorrespondence: Peter G Kreysa, [Email pkreysa@gmail.com](Email pkreysa@gmail.com)  \nPurpose: Emergency Medical Technicians (EMTs) provide lifesaving care to sick and injured patients. After completing a stateapproved course with cognitive and psychomotor training, EMT certification requires passing the National Registry computer-based adaptive exam. This study examined whether delays in taking the exam are associated with failure and provides context on the EMT role and certification process in the United States.  \nMethodology: Data included pass/fail results from 714 students who completed EMT courses between January 2013 and June 2025 at a large public university in Los Angeles County, California. All courses used similar curricula, equipment, facilities, instructors, and competencies. The study analyzed first-attempt exam outcomes relative to the time elapsed between course completion and testing.  \nFindings: Students who tested within 15–45 days had comparable pass rates, with the highest success among those testing within 30 days. Passage rates declined significantly after 45 days, and delays beyond 60 days were strongly associated with failure. These results indicate that the best chance of passing occurs when the exam is taken within 1–45 days of course completion.  \nOriginality: This study demonstrates that delaying the National Registry EMT exam increases the likelihood of failure, particularly after 60 days. The findings can guide administrators and instructors in advising students to minimize delays and may inform curriculum adjustments to support long-term knowledge retention.  \nPlain Language Summary:  \nWhat was the study about?  \nThis study looked at how long students wait to take the National Registry EMT exam after finishing their training, and whether that delay affects their chances of passing.  \nWhy does it matter?  \nEMTs play a critical role in emergency care. To become certified, they must pass a national exam after completing a state-approved course. Understanding what helps or hurts their chances of passing can improve training and support.  \nWhat did the researchers do?  \nThey analyzed exam results from 714 students who completed EMT courses at a large public university in Los Angeles County between 2013 and 2025. All students had similar training and resources. The key variable was how many days passed between finishing the course and taking the exam.  \nWhat did they find?  \n● Students who took the exam within 15 to 45 days had similar—and generally good—pass rates.  \n● The best results were seen in students who tested within 30 days.  \n● Students who waited more than 45 days were less likely to pass.  \n● The risk of failing was especially high if the delay was over 60 days.  \nReceived: 20 September 2025  \nAccepted: 13 December 2025  \nPublished: 19 December 2025  \nAdvances in Medical Education and Practice 2025:16 2341–2348 2341  \n© 2025 Kreysa et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at [https://www.dovepress.com/terms](https://www.dovepress.com/terms).  \nphp and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)). By accessing the work you hereby accept the Terms. Non-commercial uses of ","cbCaicjdP8vFcEUk","https://ap.wps.com/l/cbCaicjdP8vFcEUk","pdf",899326,"English","# Purpose\n# Methodology\n# Findings\n# Originality\n# Plain Language Summary\n## What was the study about?\n## Why does it matter?\n## What did the researchers do?\n## What did they find?\n# Keywords\n# Introduction","[{\"question\":\"How did the study measure the effect of delay on exam outcomes?\",\"answer\":\"It analyzed first-attempt National Registry EMT exam pass/fail results and compared them with the number of days between course completion and testing for 714 students.\"},{\"question\":\"What delay window produced the highest first-attempt success?\",\"answer\":\"Students who tested within 30 days after completing the course had the highest success rates.\"},{\"question\":\"How does delay beyond 60 days affect the likelihood of failing?\",\"answer\":\"Delays beyond 60 days were strongly associated with failure, and passage rates declined significantly after 45 days.\"}]","The Adverse Impact of Delay Upon Successfully Completing the National Registry EMT Exam on the First Attempt | PDF",1790162881]