Effects of E-Learning in a Continuing Education Context on Nursing Care: Systematic Review of Systematic Qualitative, Quantitative, and Mixed-Studies Reviews

Abstract

Background E-learning is rapidly growing as an alternative way of delivering education in nursing. Two contexts regarding the use of e-learning in nursing are discussed in the literature: (1) education among nursing students and (2) nurses’ continuing education within a life-long learning perspective. A systematic review of systematic reviews on e-learning for nursing and health professional students in an academic context has been published previously; however, no such review exists regarding e-learning for registered nurses in a continuing education context. Objective We aimed to systematically summarize the qualitative and quantitative evidence regarding the effects of e-learning on nursing care among nurses in a continuing education context. Methods We conducted a systematic review of systematic qualitative, quantitative, and mixed-studies reviews, searching within four bibliographic databases. The eligibility criteria were formulated using the population, interventions, comparisons, outcomes, and study design (PICOS) format. The included population was registered nurses. E-learning interventions were included and compared with face-to-face and any other e-learning interventions, as well as blended learning. The outcomes of interest were derived from two models: nursing-sensitive indicators from the Nursing Care Performance Framework (eg, teaching and collaboration) and the levels of evaluation from the Kirkpatrick model (ie, reaction, learning, behavior, and results). Results We identified a total of 12,906 records. We retrieved 222 full-text papers for detailed evaluation, from which 22 systematic reviews published between 2008 and 2018 met the eligibility criteria. The effects of e-learning on nursing care were grouped under Kirkpatrick’s levels of evaluation: (1) nurse reactions to e-learning, (2) nurse learning, (3) behavior, and (4) results. Level 2, nurse learning, was divided into three subthemes: knowledge, skills, attitude and self-efficacy. Level 4, results, was divided into patient outcomes and costs. Most of the outcomes were reported in a positive way. For instance, nurses were satisfied with the use of e-learning and they improved their knowledge. The most common topics covered by the e-learning interventions were medication calculation, preparation, and administration. Conclusions The effects of e-learning are mainly reported in terms of nurse reactions, knowledge, and skills (ie, the first two levels of the Kirkpatrick model). The effectiveness of e-learning interventions for nurses in a continuing education context remains unknown regarding how the learning can be transferred to change practice and affect patient outcomes. Further scientific, methodological, theoretical, and practice-based breakthroughs are needed in the fast-growing field of e-learning in nursing education, especially in a life-learning perspective. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42016050714; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=50714

Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial

“…The relatively low level of satisfaction displayed by the participants should also be taken into account. Though e-learning modules and serious games usually increase participant satisfaction when compared to more traditional methods [ 27 , 28 ], such an effect could not be found in this study. Disagreement with IPC guidelines might, at least in part, explain why some participants were dissatisfied [ 5 , 29 , 30 ].…”

Teaching the National Institutes of Health Stroke Scale to Paramedics (E-Learning vs Video): Randomized Controlled Trial

“…Previous studies have indeed shown that a greater level of interactivity increases learner engagement while decreasing the attrition rate [ 20 ]. Though other factors such as quality of content, convenience of the technology, and quality of the support received have also been found to increase learner satisfaction [ 21 ], they probably had little influence on this outcome given our study design as these elements were almost identical for both groups.…”

The Relevance of Telemedicine in Continuing Medical Education

“…Several studies have reported a positive experience and increase in physician knowledge following online CME (Kirkpatrick levels 1 and 2), but few studies have examined their effects on practice behavior and patient outcomes (Kirkpatrick levels 3 and 4). 16 – 18 …”