Learning Outcomes and Educational Effectiveness of E-Learning as a Continuing Professional Development Intervention for Practicing Surgeons and Proceduralists: A Systematic Review

Abstract

Electronic learning (e-Learning) has become a prevalent mode of delivering medical education. We aimed to determine the learning outcomes and educational effectiveness of e-Learning as a continuing professional development (CPD) intervention for practicing surgeons and proceduralists. We searched MEDLINE databases and included studies reporting learning outcomes of e-learning CPD interventions for practicing surgeons and physicians performing technical procedures. We excluded articles only studying surgical trainees and those not reporting learning outcomes. Two reviewers independently screened, extracted data, and assessed study quality using the Critical Appraisal Skills Programme (CASP) tools. Learning outcomes and educational effectiveness were categorized using Moore's Outcomes Framework (PROSPERO: CRD42022333523). Of 1307 identified articles, 12 were included- 9 cohort studies, one randomized controlled trial and 2 qualitative studies, with a total of 2158 participants. Eight studies were rated as moderate, five as strong, and 2 as weak in study quality. E-Learning CPD interventions included web-based modules, image recognition, videos, a repository of videos and schematics, and an online journal club. Seven studies reported participants' satisfaction with the e-Learning interventions (Moore's Level 2), 4 reported improvements in participants' declarative knowledge (Level 3a), 1 reported improvements in procedural knowledge (Level 3b) and five reported improvements in participants' procedural competence in an educational setting (Level 4). No studies demonstrated improvements in participants' workplace-based performance, the health of patients, or community health (Levels 5-7). E-Learning as a CPD educational intervention is associated with high satisfaction and improvements in knowledge and procedural competencies of practicing surgeons and proceduralists in an educational setting. Future research is required to investigate whether e-Learning is associated with higher-level learning outcomes.