• M Heller, W A Stoy, L J Shuman, H Wolfe, and C A Zavada.
• Emergency Medicine Residency Program of the Lehigh Valley, St. Luke's Hospital, Bethlehem, Penn. 18015, USA.
• Prehosp Disaster Med. 1994 Jul 1; 9 (3): 165-70; discussion 171.

ObjectivesTo evaluate the effectiveness of interactive videodisc (IVD) instruction of paramedics through the use of computer analysis of trip sheets.Design/SettingProspective, 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).InterventionsAll 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.ExclusionsOnly 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).ResultsOverall 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.ConclusionEight hours of IVD instruction did not result in improved paramedic performance as judged by computer analysis of trip sheets.

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