| E‐learning versus traditional learning for health professionals |
| Patient or population: licensed health professionals (doctors, nurses and allied health professionals fully licensed to practice without supervision) Settings: postgraduate education in any setting Intervention: e‐learning (any intervention in which clinical content is distributed primarily by the Internet, Extranet or Intranet) Comparison: traditional learning (any intervention not distributed through the media mentioned above) |
| Patient outcomes Follow‐up: 12 months | E‐learning may make lead to little or no difference between the groups in proportion of patients with LDL cholesterol < 100 mg/dL (adjusted difference 4.0% (95% CI −0.3 to 7.9; 6399 patients) or glycated haemoglobin level < 8% (adjusted difference 4.6%, 95% CI −1.5 to 9.8; 3114 patients) | 168 primary care clinics; 847 health professionals (1 study) | ⊕⊕⊝⊝
Lowa | — |
| Health professionals' behaviours Follow‐up: 3‐12 months | E‐learning may make little or no difference between the groups in terms of screening for dyslipidaemia (OR 0.90, 95% CI 0.77 to 1.06, 6027 patients) or treatment for dyslipidaemia (OR 1.15, 95% CI 0.89 to 1.48; 5491 patients) | 950 health professionals (2 studies) | ⊕⊕⊝⊝
Lowb | Studies reported multiple outcomes without specifying the primary outcome: to assess consistency, we explored 3 other possible combinations between the 2 study indicators. |
| Health professionals' skills Follow‐up: 0‐12 weeks | We are uncertain whether e‐learning improves or reduces health professionals' skills (SMD 0.03, 95% CI −0.25 to 0.31, I2 = 61%, 201 participants, 12 weeks' follow‐up). | 2912 health professionals (6 studies) | ⊕⊝⊝⊝ Very lowc | The results from the largest trial and 2 more trials, favouring traditional learning (2640 participants), and from one trial favouring e‐learning could not be included in the meta‐analysis. The meta‐analysis included 2 trials studying different professional skills (drug dose calculation and accuracy in pressure ulcers classification). |
| Health professionals' knowledge Any follow‐up: 0‐12 weeks | E‐learning may make little or no difference in health professionals' knowledge: 8 trials provided data to the meta‐analysis (SMD 0.04, 95% CI ‐0.03 to 0.11, I2 = 47%, 3082 participants). | 3236 health professionals (11 studies) | ⊕⊕⊝⊝
Lowd | 3 additional studies (154 participants) reported this outcome but no data were available for pooling. |
| CI: confidence interval; LDL: low‐density lipoprotein; OR: odds ratio; SD: standard deviation; SMD: standardised mean difference. *We interpreted SMDs using the following rules suggested by Higgins 2011a: < 0.40 represents a small effect size; 0.40 to 0.70, a moderate effect size; and > 0.70, a large effect size. |
| GRADE Working Group grades of evidence:
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are uncertain about the estimate. |
