To determine the relative effectiveness of lecture, video, and computer-assisted instruction (CAI) for the continuing education of paramedics. The study was a statewide, cross-sectional, and prospective. It used premethod, post method and 60-day evaluations addressing both cognitive knowledge and attitude toward the method. Subjects were required to complete a 20-question cognitive examination and a ten-point satisfaction inventory. Each study site was randomly assigned a method by a computer-generated table. The study involved 11 sites, systematically distributed throughout Michigan. 111 Michigan licensed paramedics. CAI subjects scored an average of 79.6% on the post-test, while lecture and video subjects scored 70.5% and 68.9%, respectively. At 60 days, CAI subjects scored 70.9%, while lecture and video subjects averaged 59.4 and 59.1, respectively. The difference among the scores was significant post method (P = .01) and at 60 days (P = .02). The subject method preference was lecture, video, and CAI premethod; lecture, CAI, and video immediately post method; and lecture, CAI, and video at 60 days. Although lecture was the preferred method, CAI was best able to impart knowledge and enhance participant knowledge retention.