The Effectiveness of Blended Learning in Health Professions: Systematic Review and Meta-Analysis

Abstract

BackgroundBlended learning, defined as the combination of traditional face-to-face learning and asynchronous or synchronous e-learning, has grown rapidly and is now widely used in education. Concerns about the effectiveness of blended learning have led to an increasing number of studies on this topic. However, there has yet to be a quantitative synthesis evaluating the effectiveness of blended learning on knowledge acquisition in health professions.ObjectiveWe aimed to assess the effectiveness of blended learning for health professional learners compared with no intervention and with nonblended learning. We also aimed to explore factors that could explain differences in learning effects across study designs, participants, country socioeconomic status, intervention durations, randomization, and quality score for each of these questions.MethodsWe conducted a search of citations in Medline, CINAHL, Science Direct, Ovid Embase, Web of Science, CENTRAL, and ERIC through September 2014. Studies in any language that compared blended learning with no intervention or nonblended learning among health professional learners and assessed knowledge acquisition were included. Two reviewers independently evaluated study quality and abstracted information including characteristics of learners and intervention (study design, exercises, interactivity, peer discussion, and outcome assessment).ResultsWe identified 56 eligible articles. Heterogeneity across studies was large (I2 ≥93.3) in all analyses. For studies comparing knowledge gained from blended learning versus no intervention, the pooled effect size was 1.40 (95% CI 1.04-1.77; P<.001; n=20 interventions) with no significant publication bias, and exclusion of any single study did not change the overall result. For studies comparing blended learning with nonblended learning (pure e-learning or pure traditional face-to-face learning), the pooled effect size was 0.81 (95% CI 0.57-1.05; P<.001; n=56 interventions), and exclusion of any single study did not change the overall result. Although significant publication bias was found, the trim and fill method showed that the effect size changed to 0.26 (95% CI -0.01 to 0.54) after adjustment. In the subgroup analyses, pre-posttest study design, presence of exercises, and objective outcome assessment yielded larger effect sizes.ConclusionsBlended learning appears to have a consistent positive effect in comparison with no intervention, and to be more effective than or at least as effective as nonblended instruction for knowledge acquisition in health professions. Due to the large heterogeneity, the conclusion should be treated with caution.

Learnings and challenges to deploy an interprofessional and independent medical education programme to a new audience

“…However, in a large but sparsely populated country like Australia, a blended approach to learning is more financially viable and can be as effective as the traditional face-to-face modes. Blended learning has also consistently shown effectiveness in knowledge acquisition compared with no intervention at all [26,27]. It has demonstrated improvements in learning outcomes in graduate studies where curricula are based on adult learning theory [8,9,28,29].…”

Functional and structural impact of the loss of the leucine-rich repeat protein LRIT1 in the mouse retina.

“…Taken together, the literature on online learning some of which specifically investigate SoftChalks either demonstrated no difference (14,(35)(36)(37)(38)(39) or a positive significant difference (10,32-34,39) on student outcomes and perceptions. These studies support that online approaches at the least do not harm student learning.…”

“…This leftward shift activates voltage-dependent calcium channels, resulting in photoreceptor depolarization. Although the ephaptic mechanism has been shown to shift the calcium activation currents in turtles (36), newts (37), salamanders (38), goldfish (39), zebrafish (40,41), and mice (42), it is unclear if it alone can explain the changes in cone activating calcium currents (43).…”

“…Another study analyzed third-year medical students (n=147) in traditional versus blended courses in evidence-based medicine concluding no significant difference in outcomes (38). A meta-analysis of blended learning studies in the health professions compared 1) blended learning to no intervention or 2) blended and nonblended learning (39). They found that blended learning has either no effect or a positive effect when compared to no intervention or non-blended learning.…”

“…They found that blended learning has either no effect or a positive effect when compared to no intervention or non-blended learning. Half of the studies examined in their meta-analysis examined medical student performance (39).…”