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August Wilson had one of the most impressive debuts in the history of theater in America, an area whose highest echelons had previously been dominated, overwhelmingly, by white playwrights. The four plays Wilson brought to Broadway between 1984 and 1990, however, not only changed the scope of American drama but also the shape of its audience, drawing Black theatergoers to Broadway in numbers significant enough to impact Broadway’s sense of its audience and of the infinite possibilities of live theater. These 1980s productions thus not only set the parameters of Wilson’s ten-play cycle – one play set in each decade of the twentieth century – as it explores the tension in African American history between community expectation and heroic disappointment, but, within those parameters, also enabled Wilson to create on the American mainstage some portion of the history that might have been visible in a world where American history is always already Black.
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.
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