ObjectiveAlthough adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding the efficacy of AEEs in improving knowledge, skills and clinical behaviour in health professionals and students.DesignSystematic review and meta-analysis.Data sourcesCINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science from the first year of records to February 2019.Eligibility criteriaControlled studies that evaluated the effect of an AEE on knowledge, skills or clinical behaviour in health professionals or students.Screening, data extraction and synthesisTwo authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. AEEs were reviewed with regard to their topic, theoretical framework and adaptivity process. Studies were included in the meta-analysis if they had a non-adaptive e-learning environment control group and had no missing data. Effect sizes (ES) were pooled using a random effects model.ResultsFrom a pool of 10 569 articles, we included 21 eligible studies enrolling 3684 health professionals and students. Clinical topics were mostly related to diagnostic testing, theoretical frameworks were varied and the adaptivity process was characterised by five subdomains: method, goals, timing, factors and types. The pooled ES was 0.70 for knowledge (95% CI −0.08 to 1.49; p.08) and 1.19 for skills (95% CI 0.59 to 1.79; p<0.00001). Risk of bias was generally high. Heterogeneity was large in all analyses.ConclusionsAEEs appear particularly effective in improving skills in health professionals and students. The adaptivity process within AEEs may be more beneficial for learning skills rather than factual knowledge, which generates less cognitive load. Future research should report more clearly on the design and adaptivity process of AEEs, and target higher-level outcomes, such as clinical behaviour.PROSPERO registration numberCRD42017065585

IntroductionSerious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals’ and students’ education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students.Methods and analysisA systematic search of the literature will be conducted using a combination of medical subject headings terms and keywords in Cumulative Index of Nursing and Allied Health, Embase, Education Resources Information Center, PsycInFO, PubMed and Web of Science. Studies assessing SGs on engagement and educational outcomes will be included. Two independent reviewers will conduct the screening as well as the data extraction process. The risk of bias of included studies will also be assessed by two reviewers using the Effective Practice and Organisation of Care criteria. Data regarding DEs in SGs will first be synthesised qualitatively. A meta-analysis will then be performed, if the data allow it. Finally, the quality of the evidence regarding the effectiveness of SGs on each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationAs this systematic review only uses already collected data, no Institutional Review Board approval is required. Its results will be submitted in a peer-reviewed journal by the end of 2018.PROSPERO registration numberCRD42017077424.

Serious games (SGs) are interactive and entertaining software designed primarily with an educational purpose. This systematic review synthesizes evidence from experimental studies regarding the efficacy of SGs for supporting engagement and improving learning outcomes in healthcare professions education. Randomized controlled trials (RCTs) published between January 2005 and April 2019 were included. Reference selection and data extraction were performed in duplicate, independently. Thirty-seven RCTs were found and 29 were included in random-effect meta-analyses. Compared with other educational interventions, SGs did not lead to more time spent with the intervention {mean difference 23.21 minutes [95% confidence interval (CI) = −1.25 to 47.66]}, higher knowledge acquisition [standardized mean difference (SMD) = 0.16 (95% CI = −0.20 to 0.52)], cognitive [SMD 0.08 (95% CI = −0.73 to 0.89)], and procedural skills development [SMD 0.05 (95% CI = −0.78 to 0.87)], attitude change [SMD = −0.09 (95% CI = −0.38 to 0.20)], nor behavior change [SMD = 0.2 (95% CI = −0.11 to 0.51)]. Only a small SMD of 0.27 (95% CI = 0.01 to 0.53) was found in favor of SGs for improving confidence in skills.

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BackgroundAdaptive e-learning environments (AEEs) can provide tailored instruction by adapting content, navigation, presentation, multimedia, and tools to each user’s navigation behavior, individual objectives, knowledge, and preferences. AEEs can have various levels of complexity, ranging from systems using a simple adaptive functionality to systems using artificial intelligence. While AEEs are promising, their effectiveness for the education of health professionals and health professions students remains unclear.ObjectiveThe purpose of this systematic review is to assess the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students.MethodsWe will follow the Cochrane Collaboration and the Effective Practice and Organisation of Care (EPOC) Group guidelines on systematic review methodology. A systematic search of the literature will be conducted in 6 bibliographic databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed, and Web of Science) using the concepts “adaptive e-learning environments,” “health professionals/students,” and “effects on knowledge/skills/behavior.” We will include randomized and nonrandomized controlled trials, in addition to controlled before-after, interrupted time series, and repeated measures studies published between 2005 and 2017. The title and the abstract of each study followed by a full-text assessment of potentially eligible studies will be independently screened by 2 review authors. Using the EPOC extraction form, 1 review author will conduct data extraction and a second author will validate the data extraction. The methodological quality of included studies will be independently assessed by 2 review authors using the EPOC risk of bias criteria. Included studies will be synthesized by a descriptive analysis. Where appropriate, data will be pooled using meta-analysis by applying the RevMan software version 5.1, considering the heterogeneity of studies.ResultsThe review is in progress. We plan to submit the results in the beginning of 2018.ConclusionsProviding tailored instruction to health professionals and students is a priority in order to optimize learning and clinical outcomes. This systematic review will synthesize the best available evidence regarding the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. It will provide guidance to policy makers, hospital managers, and researchers in terms of AEE development, implementation, and evaluation in health care.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews: CRD42017065585; https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42017065585 (Archived by WebCite® at http://www.webcitation.org/6rXGdDwf4)

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IntroductionThe optimisation of health science communication (HSC) between researchers and the public is crucial. In the last decade, the rise of the digital and social media ecosystem allowed for the disintermediation of HSC. Disintermediation refers to the public’s direct access to information from researchers about health science-related topics through the digital and social media ecosystem, a process that would otherwise require a human mediator, such as a journalist. Therefore, the primary aim of this scoping review is to describe the nature and the extent of the literature regarding HSC strategies involving disintermediation used by researchers with the public in the digital and social media ecosystem. The secondary aim is to describe the HSC strategies used by researchers, and the communication channels associated with these strategies.Methods and analysisWe will conduct a scoping review based on the Joanna Briggs Institute’s methodology and perform a systematic search of six bibliographical databases (CINAHL, EMBASE, IBSS, PubMed, Sociological Abstracts and Web of Science), four trial registries and relevant sources of grey literature. Relevant journals and reference lists of included records will be hand-searched. Data will be managed using the EndNote software and the Rayyan web application. Two review team members will perform independently the screening process as well as the full-text assessment of included records. Descriptive data will be synthesised in a tabular format. Data regarding the nature and the extent of the literature, the HSC strategies and the associated communication channels will be presented narratively.Ethics and disseminationThis review does not require institutional review board approval as we will use only collected and published data. Results will allow the mapping of the literature about HSC between researchers and the public in the digital and social media ecosystem, and will be published in a peer-reviewed journal.