A systematic review and meta-analysis of online versus alternative methods for training licensed health care professionals to deliver clinical interventions

Abstract

BackgroundOnline training is growing in popularity and yet its effectiveness for training licensed health professionals (HCPs) in clinical interventions is not clear. We aimed to systematically review the literature on the effectiveness of online versus alternative training methods in clinical interventions for licensed Health Care Professionals (HCPs) on outcomes of knowledge acquisition, practical skills, clinical behaviour, self-efficacy and satisfaction.MethodsSeven databases were searched for randomised controlled trials (RCTs) from January 2000 to June 2015. Two independent reviewers rated trial quality and extracted trial data. Comparative effects were summarised as standardised mean differences (SMD) and 95% confidence intervals. Pooled effect sizes were calculated using a random-effects model for three contrasts of online versus (i) interactive workshops (ii) taught lectures and (iii) written/electronic manuals.ResultsWe included 14 studies with a total of 1089 participants. Most trials studied medical professionals, used a workshop or lecture comparison, were of high risk of bias and had small sample sizes (range 21-183). Using the GRADE approach, we found low quality evidence that there was no difference between online training and an interactive workshop for clinical behaviour SMD 0.12 (95% CI -0.13 to 0.37). We found very low quality evidence of no difference between online methods and both a workshop and lecture for knowledge (workshop: SMD 0.04 (95% CI -0.28 to 0.36); lecture: SMD 0.22 (95% CI: -0.08, 0.51)). Lastly, compared to a manual (n = 3/14), we found very low quality evidence that online methods were superior for knowledge SMD 0.99 (95% CI 0.02 to 1.96). There were too few studies to draw any conclusions on the effects of online training for practical skills, self-efficacy, and satisfaction across all contrasts.ConclusionsIt is likely that online methods may be as effective as alternative methods for training HCPs in clinical interventions for the outcomes of knowledge and clinical behaviour. However, the low quality of the evidence precludes drawing firm conclusions on the relative effectiveness of these training methods. Moreover, the confidence intervals around our effect sizes were large and could encompass important differences in effectiveness. More robust, adequately powered RCTs are needed.Electronic supplementary materialThe online version of this article (10.1186/s12909-017-1047-4) contains supplementary material, which is available to authorized users.

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“…Pursuing the same goal, we then conducted a forward search, using Google Scholar to identify studies that cited the included articles. We also consulted the reference lists of 12 earlier reviews and meta-analyses of online and distance education (Cook et al, 2008(Cook et al, , 2010Bernard et al, 2009;Means et al, 2009Means et al, , 2013Martin et al, 2014;Schmid et al, 2014;Liu et al, 2016;Margulieux et al, 2016;Taveira-Gomes et al, 2016;McKinney, 2017;Richmond et al, 2017). This second step of the literature search resulted in another three publications (Harned et al, 2014;Alnabelsi et al, 2015;Olson and McCracken, 2015) that met all the inclusion criteria.…”

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“…Therefore, it is important to link online content to course objectives and assessment of progress toward objectives to help the students "connect the dots" between the content with which students engage outside of face-to-face classroom time and its importance to their educational experience and clinical application (Foster et al, 2014). Since much clinical continuing education for licensed practitioners is online (Lawn, Zhi, & Morello, 2017;Richmond, Copsey, Hall, Davies, & Lamb, 2017), entry-level educators can help make this content delivery format familiar and workable for future practitioners.…”