Paper - The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review

As I work on my research proposal this paper (in press) is a very useful and timely reference...


Abstract - Background

The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal program of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes.

Sinclair et al. refer to:

"One suitable framework that is congruent with e-learning research is Kirkpatrick’s four levels of evaluation." (p.53).

I have taken the rest of the paragraph and mapped the stated levels to Hodges' model:

individual
|
INTERPERSONAL : SCIENCES
humanistic ---------------------------------------  mechanistic
SOCIOLOGY : POLITICAL
|
group

Level two pertains to learning and the evaluation of knowledge.	Kirkpatrick’s model is hierarchically based with level one relating to student reaction and how well the learner is satisfied with the education program.
Level three expands on this and considers whether the education has influenced behavior. In the context of this review, behavior change is any practice that is intrinsically linked with the outcomes of the e-learning program undertaken.	Finally, level four evaluates the impact on outcomes such as cost benefit or quality improvements.

The author's continue: "The majority of e-learning research has focused on participant experience and knowledge acquisition, outcomes that correspond with the first two levels of Kirkpatrick’s model. To date, few studies have examined the effectiveness of internet-based e-learning programs on HCP [health care profession] behavior, which aligns with Level 3 of Kirkpatrick’s model (p.54)."

Peter M. Sinclair, Ashly Kable, Tracy Levett-Jones, Debbie Booth, The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review, International Journal of Nursing Studies, Available online 4 February 2016, ISSN 0020-7489, http://dx.doi.org/10.1016/j.ijnurstu.2016.01.011
(http://www.sciencedirect.com/science/article/pii/S0020748916000122) 

Keywords: e-learning; Systematic Review; Education; Information Communication Technology; Health Care Professional