Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/83522
Title: Health professions digital education on clinical practice guidelines: a systematic review by Digital Health Education collaboration
Authors: Tudor Car, Lorainne
Soong, Aijia
Kyaw, Bhone Myint
Chua, Kee Leng
Low-Beer, Naomi
Majeed, Azeem
Keywords: Science::Medicine
Clinical Practice Guidelines
Health Professions Education
Issue Date: 2019
Source: Tudor Car, L., Soong, A., Kyaw, B. M., Chua, K. L., Low-Beer, N., & Majeed, A. (2019). Health professions digital education on clinical practice guidelines: a systematic review by Digital Health Education collaboration. BMC Medicine, 17(1), 139-. doi:10.1186/s12916-019-1370-1
Series/Report no.: BMC Medicine
Abstract: Background:Clinical practice guidelines are an important source of information, designed to help clinicians integrate research evidence into their clinical practice. Digital education is increasingly used for clinical practice guideline dissemination and adoption. Our aim was to evaluate the effectiveness of digital education in improving the adoption of clinical practice guidelines. Methods:We performed a systematic review and searched seven electronic databases from January 1990 to September 2018. Two reviewers independently screened studies, extracted data and assessed risk of bias. We included studies in any language evaluating the effectiveness of digital education on clinical practice guidelines compared to other forms of education or no intervention in healthcare professionals. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to assess the quality of the body of evidence. Results:Seventeen trials involving 2382 participants were included. The included studies were diverse with a largely unclear or high risk of bias. They mostly focused on physicians, evaluated computer-based interventions with limited interactivity and measured participants’ knowledge and behaviour. With regard to knowledge, studies comparing the effect of digital education with no intervention showed a moderate, statistically significant difference in favour of digital education intervention (SMD = 0.85, 95% CI 0.16, 1.54; I2 = 83%, n = 3, moderate quality of evidence). Studies comparing the effect of digital education with traditional learning on knowledge showed a small, statistically non-significant difference in favour of digital education (SMD = 0.23, 95% CI − 0.12, 0.59; I2 = 34%, n = 3, moderate quality of evidence). Three studies measured participants’ skills and reported mixed results. Of four studies measuring satisfaction, three studies favoured digital education over traditional learning. Of nine studies evaluating healthcare professionals’ behaviour change, only one study comparing email-delivered, spaced education intervention to no intervention reported improvement in the intervention group. Of three studies reporting patient outcomes, only one study comparing email-delivered, spaced education games to non-interactive online resources reported modest improvement in the intervention group. The quality of evidence for outcomes other than knowledge was mostly judged as low due to risk of bias, imprecision and/or inconsistency. Conclusions:Health professions digital education on clinical practice guidelines is at least as effective as traditional learning and more effective than no intervention in terms of knowledge. Most studies report little or no difference in healthcare professionals’ behaviours and patient outcomes. The only intervention shown to improve healthcare professionals’ behaviour and modestly patient outcomes was email-delivered, spaced education. Future research should evaluate interactive, simulation-based and spaced forms of digital education and report on outcomes such as skills, behaviour, patient outcomes and cost.
URI: https://hdl.handle.net/10356/83522
http://hdl.handle.net/10220/49764
DOI: http://dx.doi.org/10.1186/s12916-019-1370-1
Rights: © 2019 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
metadata.item.grantfulltext: open
metadata.item.fulltext: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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