JMIR Publications

ABSTRACT

Background:

There is a pressing need to implement efficient and cost-effective training to address the worldwide shortage of healthcare professionals. Mobile digital education (mLearning) has been mooted as a potential solution to increase the delivery of health professions’ education as it offers the opportunity for wide access at low cost and flexibility with the portability of mobile devices. To better inform policy–making, we need to determine the effectiveness of mLearning.

Objective:

The primary objective of this review is to evaluate the effectiveness of mLearning educational interventions for delivering pre-registration and post-registration health professions’ education

Methods:

We performed a systematic review of the effectiveness of mLearning in health professions’ education using standard Cochrane methodology. We searched seven major bibliographic databases from January 1990 to August 2017, and included randomized controlled trials (RCTs) or cluster RCTs.

Results:

Twenty–nine studies, including 3175 learners, met the inclusion criteria. Twenty-five studies were RCTs and four were cluster RCTs. Interventions consisted of tablet/smartphone applications, personal digital assistants (PDA), basic mobile phones, iPods and mp3 player devices to deliver learning content. Twenty studies assessed knowledge (N=2469) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning over traditional learning for knowledge (SMD = 0.43, 95% CI: 0.05, 0.80, N=11 studies, low quality evidence). There was no difference between blended learning and traditional learning for knowledge (SMD = 0.20, 95% CI: -0.47, 0.86, N=6 studies, low quality evidence). Fourteen studies assessed skills (N=1097) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning (SMD = 1.12, 95% CI: 0.56, 1.69, N=5 studies, moderate quality evidence) and blended learning (SMD = 1.06, 95% CI: 0.09, 2.03, N=7 studies, low quality evidence) over traditional learning for skills. Five and four studies, assessed attitudes (N=440) and satisfaction (N=327), respectively, with inconclusive findings reported for each outcome. The risk of bias was judged as “high” in 16 studies.

Conclusions:

The evidence base suggests that mLearning is as effective as traditional learning or possibly more so. Whilst acknowledging the heterogeneity among the studies, this synthesis provides encouraging early evidence to strengthen efforts aimed at expanding health professionals’ education using mobile devices in order to help tackle the global shortage of healthcare workers.