title: Effectiveness of interactive videodisc instruction for the continuing education of paramedics.
abstract: OBJECTIVE
  To evaluate the effectiveness of interactive videodisc (IVD) instruction of paramedics through the use of computer analysis of trip sheets.
  
  
  METHODS
  Prospective, controlled, in an urban 9-1-1, paramedic, emergency medical services (EMS) system with total call volume of 62,000/year; 15,000 advanced life support (ALS).
  
  
  METHODS
  All 150 paramedics in the system received eight hours of IVD instruction covering five subject areas: 1) airway; 2) head/cervical trauma; 3) chest; 4) shock; and 5) cardiac arrest. Trip sheets from 9,943 runs in the pre-IVD period were subjected to computer analysis, and a compliance score was generated using previously developed algorithms that assigned a weight to each omission and commission. After a nine-month IVD training period, 4,303 cases were collected and analyzed in the post-IVD period. Statistical analyses were made using "Student's" t-test and Chi-square with alpha set at 0.05.
  
  
  METHODS
  Only those records of adult patients who fit one of the five protocols were eligible for computer analysis. Of the 9,943 cases in the pre-IVD group, 480 (4.8%) were excluded, all due to inadequate data recording by the paramedics. A statistically similar portion, 233 (5.4%) of the 4,303 post-IVD instruction cases were excluded (p = .15).
  
  
  RESULTS
  Overall the mean compliance score of the pre-IVD group was 0.65 +/- 0.19 (+/- SD). The post-IVD group score was 0.65 +/- 0.19 (p = 0.99). Analysis of scores for each algorithm also showed no significant differences. This study had an observed power of .94 to detect a difference in compliance as small as 0.030.
  
  
  CONCLUSIONS
  Eight hours of IVD instruction did not result in improved paramedic performance as judged by computer analysis of trip sheets.
authors.affiliation: Emergency Medicine Residency Program of the Lehigh Valley, St. Luke's Hospital, Bethlehem, Penn. 18015, USA.
authors.forename: M
authors.initials: M
authors.lastname: Heller
authors.forename: W A
authors.initials: WA
authors.lastname: Stoy
authors.forename: L J
authors.initials: LJ
authors.lastname: Shuman
authors.forename: H
authors.initials: H
authors.lastname: Wolfe
authors.forename: C A
authors.initials: CA
authors.lastname: Zavada
mesh_terms: D000328:Adult; D000465:Algorithms; D019034:CD-I; D002983:Clinical Competence; D003479:Curriculum; D004496:Education, Continuing / Q000379:methods*; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D008499:Medical Records; D011446:Prospective Studies