“…One study could be described as excellent, 46 six as good, 14,33,36,39,41,43 thirteen as fair 31,32,34,35,38,40,42,44,[48][49][50][51][52] and three as poor 37,45,47 based on the Downs and Black score. 26 There was sufficient data presented in n=9 studies to be combined in a meta-analysis, which showed a significant improvement in knowledge after the online learning (standard mean difference 1.39; 95% CI = 0.96, 1.83; pvalue <0.01; I²=91%), 31,32,34,36,39,43,44,47,51 although the high I 2 value suggests heterogeneity in the analysis (Figure 2). All but one study included in the meta-analysis were rated fair or good quality studies.…”