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The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review.
Int J Nurs Stud. 2016 May; 57:70-81.IJ

Abstract

BACKGROUND

The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal programme of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes.

OBJECTIVE

To identify, appraise and synthesise the best available evidence for the effectiveness of e-learning programmes on health care professional behaviour and patient outcomes.

DESIGN

A systematic review of randomised controlled trials was conducted to assess the effectiveness of e-learning programmes on clinician behaviour and patient outcomes. Electronic databases including CINAHL, Embase, ERIC, MEDLINE, Mosby's Index, Scopus and Cochrane - CENTRAL were searched in July 2014 and again in July 2015.

QUALITY ASSESSMENT AND DATA EXTRACTION

Studies were reviewed and data extracted by two independent reviewers using the Joanna Briggs Institute standardised critical appraisal and data extraction instruments.

DATA SYNTHESIS

Seven trials met the inclusion criteria for the analysis. Due to substantial instructional design, subject matter, study population, and methodological variation between the identified studies, statistical pooling was not possible and a meta-analysis could not be performed. Consequently, the findings of this systematic review are presented as a narrative review.

RESULTS

The results suggest that e-learning was at least as effective as traditional learning approaches, and superior to no instruction at all in improving health care professional behaviour. There was variation in behavioural outcomes depending on the skill being taught, and the learning approach utilised. No papers were identified that reported the effectiveness of an e-learning programme on patient outcomes.

CONCLUSION

This review found insufficient evidence regarding the effectiveness of e-learning on healthcare professional behaviour or patient outcomes, consequently further research in this area is warranted. Future randomised controlled trials should adhere to the CONSORT reporting guidelines in order to improve the quality of reporting, to allow evaluation of the effectiveness of e-learning programmes on healthcare professional behaviour and patient outcomes.

Authors+Show Affiliations

University of Newcastle, Australia. Electronic address: peter.sinclair@newcastle.edu.au.University of Newcastle, Australia.University of Newcastle, Australia.University of Newcastle, Australia.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

27045566

Citation

Sinclair, Peter M., et al. "The Effectiveness of Internet-based E-learning On Clinician Behaviour and Patient Outcomes: a Systematic Review." International Journal of Nursing Studies, vol. 57, 2016, pp. 70-81.
Sinclair PM, Kable A, Levett-Jones T, et al. The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review. Int J Nurs Stud. 2016;57:70-81.
Sinclair, P. M., Kable, A., Levett-Jones, T., & Booth, D. (2016). The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review. International Journal of Nursing Studies, 57, 70-81. https://doi.org/10.1016/j.ijnurstu.2016.01.011
Sinclair PM, et al. The Effectiveness of Internet-based E-learning On Clinician Behaviour and Patient Outcomes: a Systematic Review. Int J Nurs Stud. 2016;57:70-81. PubMed PMID: 27045566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review. AU - Sinclair,Peter M, AU - Kable,Ashley, AU - Levett-Jones,Tracy, AU - Booth,Debbie, Y1 - 2016/02/04/ PY - 2015/08/01/received PY - 2016/01/25/revised PY - 2016/01/26/accepted PY - 2016/4/6/entrez PY - 2016/4/6/pubmed PY - 2017/1/10/medline KW - Education KW - Health care professional KW - Information communication technology KW - Systematic review KW - e-Learning SP - 70 EP - 81 JF - International journal of nursing studies JO - Int J Nurs Stud VL - 57 N2 - BACKGROUND: The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal programme of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes. OBJECTIVE: To identify, appraise and synthesise the best available evidence for the effectiveness of e-learning programmes on health care professional behaviour and patient outcomes. DESIGN: A systematic review of randomised controlled trials was conducted to assess the effectiveness of e-learning programmes on clinician behaviour and patient outcomes. Electronic databases including CINAHL, Embase, ERIC, MEDLINE, Mosby's Index, Scopus and Cochrane - CENTRAL were searched in July 2014 and again in July 2015. QUALITY ASSESSMENT AND DATA EXTRACTION: Studies were reviewed and data extracted by two independent reviewers using the Joanna Briggs Institute standardised critical appraisal and data extraction instruments. DATA SYNTHESIS: Seven trials met the inclusion criteria for the analysis. Due to substantial instructional design, subject matter, study population, and methodological variation between the identified studies, statistical pooling was not possible and a meta-analysis could not be performed. Consequently, the findings of this systematic review are presented as a narrative review. RESULTS: The results suggest that e-learning was at least as effective as traditional learning approaches, and superior to no instruction at all in improving health care professional behaviour. There was variation in behavioural outcomes depending on the skill being taught, and the learning approach utilised. No papers were identified that reported the effectiveness of an e-learning programme on patient outcomes. CONCLUSION: This review found insufficient evidence regarding the effectiveness of e-learning on healthcare professional behaviour or patient outcomes, consequently further research in this area is warranted. Future randomised controlled trials should adhere to the CONSORT reporting guidelines in order to improve the quality of reporting, to allow evaluation of the effectiveness of e-learning programmes on healthcare professional behaviour and patient outcomes. SN - 1873-491X UR - https://www.unboundmedicine.com/medline/citation/27045566/The_effectiveness_of_Internet_based_e_learning_on_clinician_behaviour_and_patient_outcomes:_A_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-7489(16)00012-2 DB - PRIME DP - Unbound Medicine ER -