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Effectiveness of Interactive Videodisc Instruction for the Continuing Education of Paramedics

Published online by Cambridge University Press:  28 June 2012

Michael Heller ,
Walt A. Stoy ,
Larry J. Shuman ,
Harvey Wolfe  and
Chalice A. Zavada
Michael Heller*
Affiliation:
Emergency Medicine Residency Program of the Lehigh Valley, St. Luke's Hospital, Bethlehem, Penn.; Associate Professor, Division of Emergency Medicine,University of Pittsburgh, Pittsburgh, Penn.
Walt A. Stoy
Affiliation:
University of Pittsburgh, School of Medicine, Division of Emergency Medicine, Pittsburgh, Penn.
Larry J. Shuman
Affiliation:
University of Pittsburgh, School of Engineering, Health Operations Research Group (HORG), Pittsburgh, Penn.
Harvey Wolfe
Affiliation:
University of Pittsburgh, School of Engineering, Health Operations Research Group (HORG), Pittsburgh, Penn.
Chalice A. Zavada
Affiliation:
University of Pittsburgh, School of Engineering, Health Operations Research Group (HORG), Pittsburgh, Penn.
*
Emergency Medicine Residency Program, St. Luke's Hospital, 801, Ostrum St., Bethlehem, PA 18015USA
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Abstract

Objectives:

To evaluate the effectiveness of interactive videodisc (IVD) instruction of paramedics through the use of computer analysis of trip sheets.

Design/Setting:

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).

Interventions:

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.

Exclusions:

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.

Conclusion:

Eight hours of IVD instruction did not result in improved paramedic performance as judged by computer analysis of trip sheets.

Keywords

airwayabdomencardiac arrestchestcompliancecomputer analysiscontinuing educationEMS educationinstructioninteractive video discparamedicsshocktraumaPittsburghprehospital head/neckprotocolsrun recordsskillstrip sheets
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 9 , Issue 3 , September 1994 , pp. 165 - 171
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1994

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