Abstract
BackgroundOnline training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs) in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs) on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction.MethodsSeven databases were searched for randomised controlled trials (RCTs) from January 2000 to June 2015. Two independent reviewers rated trial quality and extracted trial data. Comparative effects were summarised as standardised mean differences (SMD) and 95% confidence intervals. Pooled effect sizes were calculated using a random-effects model for three contrasts of online versus (i) interactive workshops (ii) taught lectures and (iii) written/electronic manuals.ResultsWe included 14 studies with a total of 1089 participants. Most trials studied medical professionals, used a workshop or lecture comparison, were of high risk of bias and had small sample sizes (range 21-183). Using the GRADE approach, we found low quality evidence that there was no difference between online training and an interactive workshop for clinical behaviour SMD 0.12 (95% CI -0.13 to 0.37). We found very low quality evidence of no difference between online methods and both a workshop and lecture for knowledge (workshop: SMD 0.04 (95% CI -0.28 to 0.36); lecture: SMD 0.22 (95% CI: -0.08, 0.51)). Lastly, compared to a manual (n = 3/14), we found very low quality evidence that online methods were superior for knowledge SMD 0.99 (95% CI 0.02 to 1.96). There were too few studies to draw any conclusions on the effects of online training for practical skills, self-efficacy, and satisfaction across all contrasts.ConclusionsIt is likely that online methods may be as effective as alternative methods for training HCPs in clinical interventions for the outcomes of knowledge and clinical behaviour. However, the low quality of the evidence precludes drawing firm conclusions on the relative effectiveness of these training methods. Moreover, the confidence intervals around our effect sizes were large and could encompass important differences in effectiveness. More robust, adequately powered RCTs are needed.
Highlights
Online training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs) in clinical interventions is not clear
Study selection and data extraction Inclusion criteria Studies in any language were included if they (i) were a randomised controlled trial (RCT), (ii) included licensed health care professionals, (iii) evaluated online learning to provide training in a clinical intervention, (iv) included a comparison arm of a training manual, a training lecture, or an interactive training workshop, and (v) assessed one of the following outcomes: Health Care Professionals (HCPs) satisfaction, knowledge, practical skills, self-efficacy, clinical behaviour, and patient outcomes
For clinical behaviour (4 RCTs, n = 280), we found low quality evidence that there was no difference between online training and an interactive workshop [standardised mean differences (SMD) 0.12; 95% Confidence interval (CI): -0.13, 0.37]
Summary
Online training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs) in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs) on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction. Internet based (online) training packages are growing in popularity, offering potential advantages over alternative training methods such as widespread access in a range of settings (home, work, public spaces), personalised instruction, and regularly updated content [5,6,7] Despite these advantages, there are several cited concerns including no physical presence of a teacher, learner isolation, and lack of peer support and competition [7]. We will provide a more in depth exploration of the intervention aims, content, and delivery to help guide future research in this area and provide practical implications for educators in this field
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