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Online eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction
Beskrivelse
I denne systematiske oversikten har forfatterne undersøkt effekten av e-læring i forhold til tradisjonell undervisning. Forfatternes konklusjon er at e-læring er like effektivt som tradisjonell undervisning, men at svakhetene ved de inkluderte studiene gjør at det ikke kan dras en sikker konklusjon. Selv om utgangspunktet til forfatterne er den globale mangelen på helsepersonell med særlig fokus på det globale sør, er de aller fleste studiene som er inkludert i artikkelen gjennomført i høyinntektsland og resultatene er trolig overførbare til en norsk kontekst.
Background Health systems worldwide are facing shortages in health professional workforce. Several studies have demonstrated the direct correlation between the availability of health workers, coverage of health services, and population health outcomes. To address this shortage, online eLearning is increasingly being adopted in health professionals’ education. To inform policy-making, in online eLearning, we need to determine its effectiveness.
Methods We performed a systematic review of the effectiveness of online eLearning through a comprehensive search of the major databases for randomized controlled trials that compared online eLearning to traditional learning or alternative learning methods. The search period was from January 2000 to August 2013. We included articles which primarily focused on students’ knowledge, skills, satisfaction and attitudes toward eLearning and cost-effectiveness and adverse effects as secondary outcomes. Two reviewers independently extracted data from the included studies. Due to significant heterogeneity among the included studies, we presented our results as a narrative synthesis.
Findings Fifty-nine studies, including 6750 students enrolled in medicine, dentistry, nursing, physical therapy and pharmacy studies, met the inclusion criteria. Twelve of the 50 studies testing knowledge gains found significantly higher gains in the online eLearning intervention groups compared to traditional learning, whereas 27 did not detect significant differences or found mixed results. Eleven studies did not test for differences. Six studies detected significantly higher skill gains in the online eLearning intervention groups, whilst 3 other studies testing skill gains did not detect differences between groups and 1 study showed mixed results. Twelve studies tested students’ attitudes, of which 8 studies showed no difference in attitudes or preference for online eLearning. Students’ satisfaction was measured in 29 studies, 4 studies showed higher satisfaction for online eLearning and 20 studies showed no difference in satisfaction between online eLearning and traditional learning. Risk of bias was high for several of the included studies.
Conclusion The current evidence base suggest that online eLearning is equivalent, possibly superior to traditional learning. These findings present a potential incentive for policy makers to cautiously encourage its adoption, while respecting the heterogeneity among the studies.
Denne systematiske oversikten er tilsynelatende utarbeidet på en god måte og forfatterne har vært tydelig på metoden de har brukt for å utarbeide oversikten. Det finnes også et eget vedlegg på nett som gir utfyllende informasjon. Det er kun randomiserte, kontrollerte studier som er inkludert og disse er oppsummert tematisk. Forfatterne foretar en vurdering av risikoen for bias i de inkluderte studiene, men det er noe uklart hvordan denne vurderingen gjenspeiles i fremstillingen og diskusjonen av resultatene.