Introduction: Anecdotal evidence suggests that emergency medical services (EMS) educators disagree about the need for paramedic programs to be located under the umbrella of an academic institution. This study analyzed a paramedic cognitive summative examination (FISDAP Blue Exam) to reveal the relationship between program academic setting and test scores. Hypothesis: The educational setting of the paramedic program will affect paramedic students’ success on written summative examinations. Methods: Student summative test results were retrospectively reported by FISDAP, a national database of prospectively reported internship experiences. Types of educational institution were categorized into four-year academic institutions, two-year academic institutions, and non-academic institutions by three independent raters (Fleiss’ kappa = 0.73). Only institutions in which all three raters agreed were utilized. One-way analysis of variance (ANOVA) was used to measure the association between overall test scores and category test scores by type of educational institution.
Results: The overall sample was 4,111 (1,278 [31.1% from four-year, 1,955 [47.6%] from two-year, and 893 [21.7%] from non-academic institutions), with 15 students excluded because of incomplete data. The overall examination mean score was 68.1% for all students in the sample, and 68.4% at four-year, 67.4% at two-year, and 67.9% at non-academic institutions. The mean airway category score was 82.2% for all students in the sample, and 83.2% for four-year, 81.4% for two-year, and 82.7% for non-academic institutions. The mean operations category score was 71.5% for all students in the sample, and 71.4% for four-year, 71.3% for two-year, and 72.3% for non-academic institutions. The mean trauma category scores were 51.6% for four-year, 50.2% for two-year, and 50.4% for non-academic institutions. Conclusion: While there was a statistical significance in this study, no educational significance was noticed. Our results from the overall test scores do not support the theory that educational setting will impact cognitive examination scores. The study results indicate no meaningful difference between non-academic, two-year, and four-year institutions on paramedic students’ success during cognitive summative examinations.