Pre-Hospital Emergency Care Council

The Pre-Hospital Emergency Care Council relies on TestReach to ensure a high-quality online exam experience with flexible delivery options

“TestReach have a great team who are friendly and welcoming, who understand our needs and work to support us and ensure a successful delivery for our EMT and Paramedic assessments. It has been a very positive experience.”


The Pre-Hospital Emergency Care Council (PHECC) is an independent statutory body that sets standards in education, training and assessments for pre-hospital emergency care in Ireland. The Council publishes clinical practice guidelines and certifies institutions to provide pre-hospital emergency care training and education.

PHECC offers national state exams, which lead to the award of the NQEMT (National Qualification in Emergency Medical Technology) at the level of competence of emergency medical technician, paramedic or advanced paramedic. These exams are critical as they are the means to ensure an exemplary standard of frontline emergency medical care in Ireland. They are taken by a wide variety of people from different backgrounds, including the National Ambulance Service, Dublin Fire Brigade, UL, UCC and candidates from the voluntary and private sector.

Having offered online exams for eight years, PHECC took the decision to upgrade their offering and to explore technical platforms that would allow greater flexibility and innovation in the ways that exams could be managed and delivered.


PHECC management were keen to include all staff who would be involved in the day-to-day operational delivery of the exams, so that everyone would feel a sense of ownership of the new strategic approach.

From their initial engagement with the TestReach team, PHECC saw that TestReach’s solution offered scope to use a range of exam delivery methods to meet the requirements of each qualification. They could utilise a mix of live remote proctoring, test-centre delivery and on-site delivery at educational institutes that provide paramedic training. The remote proctoring could be delivered as session-based, for groups of candidates, or using an on-demand model – where individual candidates could book an exam time that suited them.

PHECC envisaged to increase the proportion of candidates choosing to take their exam via remote proctoring, while maintaining the validity, reliability and security of the state qualifications. TestReach met this objective, as the solution offers live, high-quality, remote proctoring as an integral part of a complete assessment application with TestReach employee supervisors. This ensures a secure and professional service, and a streamlined experience for candidates.


Since launching TestReach as the platform for their examination management and delivery, PHECC has seen several benefits. For EMT examinations, candidates are given the option to choose between remotely proctored exams or test centre delivery. With TestReach, the proportion of candidates choosing remote proctoring has continued to increase. Brendan Cawley, Clinical Information, Examinations and Research Programme Manager at PHECC says:“We moved to remote proctoring in 2020 and about 50% of EMT candidates used it. Since we moved to TestReach, for the EMT exams, over 90% of candidates have chosen to use remote proctoring delivery, which is a huge increase that happened in a few months. We’re very happy with this change and it’s down to the TestReach platform – it works really well, it’s straightforward and user-friendly for candidates to set up and use from home, they are comfortable with it and they have a very positive experience with TestReach invigilators.”

“While it’s important that candidates are happy, from our point of view it’s even more important that our assessments are reliable, valid and secure and that there is no opportunity for cheating. The live proctoring with a close level of supervision is essential to make sure the exam is not compromised. We also enhance security through randomisation of exam content. We have a large question bank with weightings given to questions so that every exam paper is a valid and fair assessment but unique for each candidate. TestReach advised us to on how to build the question bank in the authoring platform and set up the rules for randomisation.”

For test-centre exam delivery, TestReach worked in partnership with a third-party provider, The Exam Centre. Comprehensive dashboards and features are available to invigilators in test centres, allowing access and security to be fully controlled and monitored in real time. Test-centre functionality, backed by exceptional service from the teams at The Exam Centre, has ensured a very smooth roll-out of the exams.

Paramedic candidates have to be trained in an educational institute, such as at National Universities, National Ambulance Service Colleges and Dublin Fire Brigade, and during their course they sit an MCQ paper, a written paper and a practical assessment. With TestReach, PHECC can now go on-site to those locations and deliver computer-based exams through the TestReach portal, which gives an invaluable level of flexibility to manage paramedic assessments. No matter which exam delivery method is used, all exam data is within the TestReach solution, with detailed access permissions and audit reports to enhance security.

Brendan Cawley commented on his experience: “We were blown away, inspired and excited by our new partnership with TestReach. It’s a one-stop-shop with all the options we need and a perfect fit for us. For me I welcome the fact that exam days are so quiet - I know it’s all working smoothly! There are no problems from candidates, security is maintained, and the system just works very well.”

“I would absolutely recommend TestReach to another awarding body. TestReach have a great team who are friendly and welcoming, who understand our needs and work to support us and ensure a successful delivery for our EMT and Paramedic assessments. It has been a very positive experience. TestReach’s project manager was phenomenal throughout, working closely with PHECC to ensure a successful transition to new processes, and our candidates’ experience of TestReach delivery of the exams has been excellent.”

Access other resources for online medical assessment

Learn more about TestReach features for medical examinations here

Read our blog about challenges and considerations for medical schools modernising exam delivery

Watch a webinar on strategic change at scale in global medical assessment, featuring the Royal College of Physicians of Ireland, the Royal College of Anaesthetists, the Royal College of Surgeons of Ireland Faculty of Dentistry and TestReach here: Link to Webinar Recording

View downloadable copy of this case study.