scholarly journals Digital Education for Health Professions on Smoking Cessation Management: Systematic Review by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Monika Semwal ◽  
Penny Whiting ◽  
Ram Bajpai ◽  
Shweta Bajpai ◽  
Bhone Myint Kyaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Health Professionals ◽  
Digital Health ◽  
Health Professions ◽  
Primary Objective ◽  
Setup Cost ◽  
Digital Education ◽  
Blended Education ◽  
Smoking Cessation Therapy

BACKGROUND Tobacco smoking, one of the leading causes of preventable death and disease, is associated with 7 million deaths every year. This is estimated to rise to more than 8 million deaths per year by 2030, with 80% occurring in low- and middle-income countries. Digital education, teaching, and learning using digital technologies have the potential to increase educational opportunities, supplement teaching activities, and decrease distance barriers in health professions education. OBJECTIVE The primary objective of this systematic review was to evaluate the effectiveness of digital education compared with various controls in improving learners’ knowledge, skills, attitudes, and satisfaction to deliver smoking cessation therapy. The secondary objectives were to assess patient-related outcomes, change in health professionals’ practice or behavior, self-efficacy or self-rated competence of health professionals in delivering smoking cessation therapy, and cost-effectiveness of the interventions. METHODS We searched 7 electronic databases and 2 trial registers for randomized controlled trials published between January 1990 and August 2017. We used gold standard Cochrane methods to select and extract data and appraise eligible studies. RESULTS A total of 11 studies (number of participants, n=2684) were included in the review. All studies found that digital education was at least as effective as traditional or usual learning. There was some suggestion that blended education results in similar or greater improvements in knowledge (standardized mean difference, SMD=0.19, 95% CI −0.35 to 0.72), skill (SMD=0.58, 95% CI 0.08-1.08), and satisfaction (SMD=0.62, 95% CI 0.12-1.12) compared with digital education or usual learning alone. There was also some evidence for improved attitude (SMD=0.45, 95% CI 0.18-0.72) following digital education compared with usual learning. Only 1 study reported patient outcomes and the setup cost of blended education but did not compare outcomes among groups. There were insufficient data to investigate what components of the digital education interventions were associated with the greatest improvements in learning outcomes. CONCLUSIONS The evidence suggests that digital education is at least as effective as usual learning in improving health professionals’ knowledge and skill for delivering smoking cessation therapy. However, limitations in the evidence base mean that these conclusions should be interpreted with some caution. CLINICALTRIAL PROSPERO CRD42016046815; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=46815

scholarly journals Digital Education for Health Professions on Smoking Cessation Management: Systematic Review by the Digital Health Education Collaboration

10.2196/13000 ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. e13000 ◽  
Author(s):  
Monika Semwal ◽  
Penny Whiting ◽  
Ram Bajpai ◽  
Shweta Bajpai ◽  
Bhone Myint Kyaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Health Education ◽  
Digital Health ◽  
Health Professions ◽  
Digital Education

scholarly journals Digital Problem-Based Learning in Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Lorainne Tudor Car ◽  
Bhone Myint Kyaw ◽  
Gerard Dunleavy ◽  
Neil A Smart ◽  
Monika Semwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Professionals ◽  
Digital Technology ◽  
Digital Health ◽  
Problem Based Learning ◽  
Health Professions ◽  
Pooled Analysis ◽  
Risk Of Bias ◽  
Traditional Learning ◽  
Digital Education

BACKGROUND The use of digital education in problem-based learning, or digital problem-based learning (DPBL), is increasingly employed in health professions education. DPBL includes purely digitally delivered as well as blended problem-based learning, wherein digital and face-to-face learning are combined. OBJECTIVE The aim of this review is to evaluate the effectiveness of DPBL in improving health professionals’ knowledge, skills, attitudes, and satisfaction. METHODS We used the gold-standard Cochrane methods to conduct a systematic review of randomized controlled trials (RCTs). We included studies that compared the effectiveness of DPBL with traditional learning methods or other forms of digital education in improving health professionals’ knowledge, skills, attitudes, and satisfaction. Two authors independently screened studies, extracted data, and assessed the risk of bias. We contacted study authors for additional information, if necessary. We used the random-effects model in the meta-analyses. RESULTS Nine RCTs involving 890 preregistration health professionals were included. Digital technology was mostly employed for presentation of problems. In three studies, PBL was delivered fully online. Digital technology modalities spanned online learning, offline learning, virtual reality, and virtual patients. The control groups consisted of traditional PBL and traditional learning. The pooled analysis of seven studies comparing the effect of DPBL and traditional PBL reported little or no difference in postintervention knowledge outcomes (standardized mean difference [SMD] 0.19, 95% CI 0.00-0.38). The pooled analysis of three studies comparing the effect of DPBL to traditional learning on postintervention knowledge outcomes favored DPBL (SMD 0.67, 95% CI 0.14-1.19). For skill development, the pooled analysis of two studies comparing DPBL to traditional PBL favored DPBL (SMD 0.30, 95% CI 0.07-0.54). Findings on attitudes and satisfaction outcomes were mixed. The included studies mostly had an unclear risk of bias. CONCLUSIONS Our findings suggest that DPBL is as effective as traditional PBL and more effective than traditional learning in improving knowledge. DPBL may be more effective than traditional learning or traditional PBL in improving skills. Further studies should evaluate the use of digital technology for the delivery of other PBL components as well as PBL overall.

scholarly journals Mobile Digital Education for Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

10.2196/12937 ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e12937 ◽  
Author(s):  
Gerard Dunleavy ◽  
Charoula Konstantia Nikolaou ◽  
Sokratis Nifakos ◽  
Rifat Atun ◽  
Gloria Chun Yi Law ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Education ◽  
Digital Health ◽  
Meta Analysis ◽  
Health Professions ◽  
Digital Education

scholarly journals Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Bhone Myint Kyaw ◽  
Nakul Saxena ◽  
Pawel Posadzki ◽  
Jitka Vseteckova ◽  
Charoula Konstantia Nikolaou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Clinical Practice ◽  
Health Professionals ◽  
Cognitive Skills ◽  
Meta Analysis ◽  
Health Professions ◽  
Risk Of Bias ◽  
Traditional Learning ◽  
Digital Education

BACKGROUND Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. OBJECTIVE The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. METHODS We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. RESULTS A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals’ cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. CONCLUSIONS We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.

scholarly journals Offline Digital Education for Postregistration Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Pawel Posadzki ◽  
Malgorzata M Bala ◽  
Bhone Myint Kyaw ◽  
Monika Semwal ◽  
Ushashree Divakar ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Health Professions ◽  
Computer Assisted ◽  
Unintended Effects ◽  
Digital Education ◽  
Mental Health Therapists ◽  
Traditional Training

BACKGROUND The shortage and disproportionate distribution of health care workers worldwide is further aggravated by the inadequacy of training programs, difficulties in implementing conventional curricula, deficiencies in learning infrastructure, or a lack of essential equipment. Offline digital education has the potential to improve the quality of health professions education. OBJECTIVE The primary objective of this systematic review was to evaluate the effectiveness of offline digital education compared with various controls in improving learners’ knowledge, skills, attitudes, satisfaction, and patient-related outcomes. The secondary objectives were (1) to assess the cost-effectiveness of the interventions and (2) to assess adverse effects of the interventions on patients and learners. METHODS We searched 7 electronic databases and 2 trial registries for randomized controlled trials published between January 1990 and August 2017. We used Cochrane systematic review methods. RESULTS A total of 27 trials involving 4618 individuals were included in this systematic review. Meta-analyses found that compared with no intervention, offline digital education (CD-ROM) may increase knowledge in nurses (standardized mean difference [SMD]=1.88; 95% CI 1.14 to 2.62; participants=300; studies=3; I2=80%; low certainty evidence). A meta-analysis of 2 studies found that compared with no intervention, the effects of offline digital education (computer-assisted training [CAT]) on nurses and physical therapists’ knowledge were uncertain (SMD 0.55; 95% CI –0.39 to 1.50; participants=64; I2=71%; very low certainty evidence). A meta-analysis of 2 studies found that compared with traditional learning, a PowerPoint presentation may improve the knowledge of patient care personnel and pharmacists (SMD 0.76; 95% CI 0.29 to 1.23; participants=167; I2=54%; low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, the effects of computer-assisted training on skills in community (mental health) therapists, nurses, and pharmacists were uncertain (SMD 0.45; 95% CI –0.35 to 1.25; participants=229; I2=88%; very low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, offline digital education may have little effect or no difference on satisfaction scores in nurses and mental health therapists (SMD –0.07; 95% CI –0.42 to 0.28, participants=232; I2=41%; low certainty evidence). A total of 2 studies found that offline digital education may have little or no effect on patient-centered outcomes when compared with blended learning. For skills and attitudes, the results were mixed and inconclusive. None of the studies reported adverse or unintended effects of the interventions. Only 1 study reported costs of interventions. The risk of bias was predominantly unclear and the certainty of the evidence ranged from low to very low. CONCLUSIONS There is some evidence to support the effectiveness of offline digital education in improving learners’ knowledge and insufficient quality and quantity evidence for the other outcomes. Future high-quality studies are needed to increase generalizability and inform use of this modality of education.

scholarly journals Health Professions Digital Education for Antibiotic Management: A Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

2019 ◽  
Author(s):  
Bhone Myint Kyaw ◽  
Lorainne Tudor Car ◽  
Louise Sandra van Galen ◽  
Michiel A van Agtmael ◽  
Céire E. Costelloe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Education ◽  
Digital Health ◽  
Meta Analysis ◽  
Health Professions ◽  
Digital Education ◽  
Antibiotic Management

scholarly journals Mobile Digital Education for Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Gerard Dunleavy ◽  
Charoula Konstantia Nikolaou ◽  
Sokratis Nifakos ◽  
Rifat Atun ◽  
Gloria Chun Yi Law ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blended Learning ◽  
Mobile Devices ◽  
Health Professionals ◽  
Health Professions ◽  
Health Professions Education ◽  
Personal Digital Assistants ◽  
Traditional Learning ◽  
Digital Education ◽  
Quality Evidence

BACKGROUND There is a pressing need to implement efficient and cost-effective training to address the worldwide shortage of health professionals. Mobile digital education (mLearning) has been mooted as a potential solution to increase the delivery of health professions education as it offers the opportunity for wide access at low cost and flexibility with the portability of mobile devices. To better inform policy making, we need to determine the effectiveness of mLearning. OBJECTIVE The primary objective of this review was to evaluate the effectiveness of mLearning interventions for delivering health professions education in terms of learners’ knowledge, skills, attitudes, and satisfaction. METHODS We performed a systematic review of the effectiveness of mLearning in health professions education using standard Cochrane methodology. We searched 7 major bibliographic databases from January 1990 to August 2017 and included randomized controlled trials (RCTs) or cluster RCTs. RESULTS A total of 29 studies, including 3175 learners, met the inclusion criteria. A total of 25 studies were RCTs and 4 were cluster RCTs. Interventions comprised tablet or smartphone apps, personal digital assistants, basic mobile phones, iPods, and Moving Picture Experts Group-1 audio layer 3 player devices to deliver learning content. A total of 20 studies assessed knowledge (n=2469) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning over traditional learning for knowledge (standardized mean difference [SMD]=0.43, 95% CI 0.05-0.80, N=11 studies, low-quality evidence). There was no difference between blended learning and traditional learning for knowledge (SMD=0.20, 95% CI –0.47 to 0.86, N=6 studies, low-quality evidence). A total of 14 studies assessed skills (n=1097) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning (SMD=1.12, 95% CI 0.56-1.69, N=5 studies, moderate quality evidence) and blended learning (SMD=1.06, 95% CI 0.09-2.03, N=7 studies, low-quality evidence) over traditional learning for skills. A total of 5 and 4 studies assessed attitudes (n=440) and satisfaction (n=327), respectively, with inconclusive findings reported for each outcome. The risk of bias was judged as high in 16 studies. CONCLUSIONS The evidence base suggests that mLearning is as effective as traditional learning or possibly more so. Although acknowledging the heterogeneity among the studies, this synthesis provides encouraging early evidence to strengthen efforts aimed at expanding health professions education using mobile devices in order to help tackle the global shortage of health professionals.

scholarly journals Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2019 ◽  
Author(s):  
Andrzej A Kononowicz ◽  
Luke A Woodham ◽  
Samuel Edelbring ◽  
Natalia Stathakarou ◽  
David Davies ◽  
...  
Keyword(s):  
Systematic Review ◽  
Digital Health ◽  
Health Professions ◽  
Virtual Patient ◽  
Traditional Education ◽  
Health Professions Education ◽  
Virtual Patients ◽  
Patient Simulations ◽  
Digital Education ◽  
Clinical Scenarios

BACKGROUND Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education. OBJECTIVE The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction. METHODS We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models. RESULTS A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI −0.17 to 0.39, I2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence. CONCLUSIONS Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low- and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.

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