Instructional Design Variations in Internet-Based Learning for Health Professions Education: A Systematic Review and Meta-Analysis

Office of Education Research, College of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 3.47). 05/2010; 85(5):909-22. DOI: 10.1097/ACM.0b013e3181d6c319
Source: PubMed

ABSTRACT A recent systematic review (2008) described the effectiveness of Internet-based learning (IBL) in health professions education. A comprehensive synthesis of research investigating how to improve IBL is needed. This systematic review sought to provide such a synthesis.
The authors searched MEDLINE, CINAHL, EMBASE, Web of Science, Scopus, ERIC, TimeLit, and the University of Toronto Research and Development Resource Base for articles published from 1990 through November 2008. They included all studies quantifying the effect of IBL compared with another Internet-based or computer-assisted instructional intervention on practicing and student physicians, nurses, pharmacists, dentists, and other health professionals. Reviewers working independently and in duplicate abstracted information, coded study quality, and grouped studies according to inductively identified themes.
From 2,705 articles, the authors identified 51 eligible studies, including 30 randomized trials. The pooled effect size (ES) for learning outcomes in 15 studies investigating high versus low interactivity was 0.27 (95% confidence interval, 0.08-0.46; P = .006). Also associated with higher learning were practice exercises (ES 0.40 [0.08-0.71; P = .01]; 10 studies), feedback (ES 0.68 [0.01-1.35; P = .047]; 2 studies), and repetition of study material (ES 0.19 [0.09-0.30; P < .001]; 2 studies). The ES was 0.26 (-0.62 to 1.13; P = .57) for three studies examining online discussion. Inconsistency was large (I(2) >or=89%) in most analyses. Meta-analyses for other themes generally yielded imprecise results.
Interactivity, practice exercises, repetition, and feedback seem to be associated with improved learning outcomes, although inconsistency across studies tempers conclusions. Evidence for other instructional variations remains inconclusive.

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    • "E-learning in general is a rapidly growing market, reaching US$35.6 billion worldwide in 2011, and with a 5-year compound annual growth rate of 7.6% expected to reach $51.5 billion by 2016.11 With this rapidly developing market, there is an urgent need of evidence-based guidance on how to develop and implement the most effective e-learning in the future.12 Therefore, it is relevant to examine whether some e-learning methods are more effective than others on a stand-alone basis, in particular for the acquisition of practical clinical skills. "
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    ABSTRACT: Background and aims This study investigated the effectiveness of two different levels of e-learning when teaching clinical skills to medical students. Materials and methods Sixty medical students were included and randomized into two comparable groups. The groups were given either a video- or text/picture-based e-learning module and subsequently underwent both theoretical and practical examination. A follow-up test was performed 1 month later. Results The students in the video group performed better than the illustrated text-based group in the practical examination, both in the primary test (P<0.001) and in the follow-up test (P<0.01). Regarding theoretical knowledge, no differences were found between the groups on the primary test, though the video group performed better on the follow-up test (P=0.04). Conclusion Video-based e-learning is superior to illustrated text-based e-learning when teaching certain practical clinical skills.
    08/2014; 5:257-62. DOI:10.2147/AMEP.S62473
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    • "Whereas Paulus and Strittmatter (2002, pp.295-7) found no conclusive evidence that e-learning was more or less effective than face-to-face learning, Chumley-Jones et al. (2002) conclude that the quality of learning outcomes achieved via e-learning in healthcare professions is comparable to traditional classroom-based education, provided the pedagogical-didactical design meets specific quality criteria. Cook et al. (2010) reach a similar conclusion as do Childs et al. (2005), who add that both instructors and students perceive e-learning as an effective and enriching experience. Bloomfield et al. (2008) confirmed the effectiveness of e-learning in the acquisition of clinical skills. "
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    ABSTRACT: e-Learning is becoming more commonplace in nursing and healthcare professional education. Research has shown that e-learning can be just as effective at helping students achieve cognitive learning objectives as traditional face-to-face courses, provided that certain quality criteria are met. However, the decentralized, asynchronous nature of e-learning precludes spontaneous, personal interaction between the instructor and the learner. In addition to this, learning objectives in nursing and other healthcare professions are not only within the cognitive, but also within the affective and psychomotor domains. This article seeks to answer the following question: How does e-learning transform the role of nurse educators? Narrative literature review. A comprehensive database search was conducted using the English and German key words "teacher," "educator," "role," "e-learning," and "nursing" to identify literature that examined the role of (nurse) educators in e-learning. The search strategy resulted in the inclusion of 40 sources. The majority of the literature is expert opinion and examines the educator's role in e-learning from a theoretical point of view (n=30). There is a paucity of empirical research pertaining directly to the educator's role (n=10). Only four sources deal specifically with the nurse educator's role. The literature agrees on the need for a new role definition in light of e-learning. This role is more complex than the educator's traditional role. The literature does not provide any indication of how the educator's role can be adapted to the specific needs of online nurse education. There is a need for more empirical research on this subject.
    Nurse education today 04/2014; 34(11). DOI:10.1016/j.nedt.2014.04.002 · 1.46 Impact Factor
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    • "The students generally experience this specific part of the programme as difficult and were having problems in applying the principles in practice. We looked for improvements in the quality and efficiency of this programme, by applying a blended learning concept, using design features such as practice cases, multimedia, feedback and repetition, which have proven to be effective in online learning [9, 10]. This online study material was offered through a permanently accessible Learning Management System (It’s Learning). "
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    ABSTRACT: Introduction There is a demand for more attractive and efficient training programmes in postgraduate health care training. This retrospective study aims to show the effectiveness of a blended versus traditional face-to-face training design. For nurses in postgraduate Acute and Intensive Care training, the effectiveness of a blended course design was compared with a traditional design. Methods In a first pilot study 57 students took a traditional course (2-h lecture and 2-h workshop) and 46 students took a blended course (2-h lecture and 2-h online self-study material). Test results were compared for both groups. After positive results in the pilot study, the design was replicated for the complete programme in Acute and Intensive Care. Now 16 students followed the traditional programme (11 days face-to-face education) and 31 students did the blended programme (7 days face-to-face and 40 h online self-study). An evaluation was done after the pilot and course costs were calculated. Results Results show that the traditional and blended groups were similar regarding the main characteristics and did not differ in learning results for both the pilot and the complete programme. Student evaluations of both designs were positive; however, the blended group were more confident that they had achieved the learning objectives. Training costs were reduced substantially. Conclusion The blended training design offers an effective and attractive training solution, leading to a significant reduction in costs.
    01/2014; 3(4). DOI:10.1007/s40037-014-0109-0
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