A systematic review to compare the effectiveness of face-to-face versus online (including blended learning) delivery of CME/CPD for healthcare practitioners (HCPs)

Abstract

Objectives: With the ever increasing use of online learning, a systemic review of randomized clinical trials from January 2000 to October 2014 was conducted to investigate the effectiveness of education delivery for CME/CPD between face-to-face and online (including blended) learning modalities in healthcare practitioners (HCPs). Settings: Thirteen studies fit the inclusion criteria and of these four were from North America, two from Iran, two from Asia, four from Europe and one from Australia. Populations varied with five of the studies being conducted amongst primary care physicians (GPs), one with occupational physicians, five with nurses, one with allied health including physiotherapists, occupational therapists and exercise physiologists and one with a mixture of scientists and physicians. Interventions: The interventions used across the studies varied with eleven of the studies comparing face-to-face with online learning, and only two studies comparing blended with face-to-face learning. There were no studies comparing blended with online learning only. Outcomes Measures: The predominant outcomes measured by ten of the thirteen studies focused on knowledge gain and skills with eight of these also reviewing acceptability and satisfaction with the course. Knowledge gain was mostly assessed through pre and post-testing of knowledge immediately before and immediately post-intervention although several of the studies did include additional post-testing at two weeks, three months and six months. Only one study assessed preference for learning styles for future CME activities and found that all those in the web-based group (100%) and 97% of the face-to-face group wanted to stay with the same learning medium as they had experienced in the intervention. Results: Of the eleven studies comparing online with face-to-face education, all found similar and usually lasting improvements in knowledge gain from baseline with both groups suggesting that online learning was comparable or at least as effective as onsite or face-to-face training. Increased knowledge, attitudes (perception of confidence) or change in practice were found in three of the studies [1-3] with another two assessing disease detection, diagnosis and management or concordance with guidelines. Discussion: Although numerous studies have been conducted comparing the effectiveness of online learning or the effectiveness of face-to-face learning in CME/CPD delivery for HCPs, it appears this is the first review that has looked specifically at studies comparing the two modalities. Conclusions: Further comparative research of the different delivery modalities is required. Any new studies should include those elements known to be effective in CME delivery (multimedia, multiple techniques and multiple exposures), should have similar populations, include case-based learning and be randomized. Further studies conducted with these elements should help to assure educators and learners that the time, energy and funds spent in developing and deploying effective continuing education for HCPs achieves the behavior outcomes required to enhance patient care.