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Internet-Based Learning in the Health Professions: A Meta-analysis
Abstract
CONTEXT: The increasing use of Internet-based learning in health professions education may be informed by a timely, comprehensive synthesis of evidence of effectiveness. OBJECTIVES: To summarize the effect of Internet-based instruction for health professions learners compared with no intervention and with non-Internet interventions. DATA SOURCES: Systematic search of MEDLINE, Scopus, CINAHL, EMBASE, ERIC, TimeLit, Web of Science, Dissertation Abstracts, and the University of Toronto Research and Development Resource Base from 1990 through 2007. STUDY SELECTION: Studies in any language quantifying the association of Internet-based instruction and educational outcomes for practicing and student physicians, nurses, pharmacists, dentists, and other health care professionals compared with a no-intervention or non-Internet control group or a preintervention assessment. DATA EXTRACTION: Two reviewers independently evaluated study quality and abstracted information including characteristics of learners, learning setting, and intervention (including level of interactivity, practice exercises, online discussion, and duration). DATA SYNTHESIS: There were 201 eligible studies. Heterogeneity in results across studies was large (I(2) > or = 79%) in all analyses. Effect sizes were pooled using a random effects model. The pooled effect size in comparison to no intervention favored Internet-based interventions and was 1.00 (95% confidence interval [CI], 0.90-1.10; P < .001; n = 126 studies) for knowledge outcomes, 0.85 (95% CI, 0.49-1.20; P < .001; n = 16) for skills, and 0.82 (95% CI, 0.63-1.02; P < .001; n = 32) for learner behaviors and patient effects. Compared with non-Internet formats, the pooled effect sizes (positive numbers favoring Internet) were 0.10 (95% CI, -0.12 to 0.32; P = .37; n = 43) for satisfaction, 0.12 (95% CI, 0.003 to 0.24; P = .045; n = 63) for knowledge, 0.09 (95% CI, -0.26 to 0.44; P = .61; n = 12) for skills, and 0.51 (95% CI, -0.24 to 1.25; P = .18; n = 6) for behaviors or patient effects. No important treatment-subgroup interactions were identified. CONCLUSIONS: Internet-based learning is associated with large positive effects compared with no intervention. In contrast, effects compared with non-Internet instructional methods are heterogeneous and generally small, suggesting effectiveness similar to traditional methods. Future research should directly compare different Internet-based interventions.
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Metadata
- Authors
- Cook, D. A., Levinson, A. J., Garside, S., Dupras, D. M., Erwin, P. J., & Montori, V. M.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2008-09-10
- Volume
- 300
- Issue
- 10
- Pages
- 1181
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2040168896
- Cited by
- 1,498
- References
- 12
- FWCI
- 53.00
- Type
- journal article
- Language
- en
- Open access
- closed
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