JMIR Publications

ABSTRACT

Background:

Reducing childhood morbidity and mortality is challenging, particularly in countries with a shortage of qualified healthcare workers. The lack of trainers makes it difficult to provide the necessary continuous education on pediatrics. Digital education has the potential to deliver medical education to a large audience, limiting the number of trainers needed.

Objective:

To evaluate whether digital education can replace standard or traditional learning to improve health professionals’ knowledge, skills, attitudes, satisfaction and behavior change in the field of pediatrics.

Methods:

We carried out a systematic review of the literature by following the Cochrane methodology. We searched seven major electronic databases from January 1990 to August 2017. No language restrictions were applied. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We included individually or cluster randomized controlled trials that compared digital education with traditional learning, no intervention, or other forms of digital education.

Results:

Twenty studies (1382 participants) were included. Participants included pediatricians, physicians, nurses, and midwives. A variety of digital education technologies were assessed including high fidelity mannequins (6 studies), computer-based education (12 studies), mobile learning (1 study), and virtual reality (1 study). The majority of the included studies reported that digital education was either as effective as or more effective than the control intervention for outcomes including skill, knowledge, attitude and satisfaction. High fidelity mannequins were associated with greater post-intervention skill scores compared to low fidelity mannequins (SMD = 0.64, 95% CI: 0.16, 1.12). One study reported physicians’ change in practicing behavior and found similar effects between offline plus online digital education and no intervention. The only study to assess impact on patient outcome found no difference between intervention and control groups. None of the included studies reported adverse/untoward effect or economic outcomes of the digital education intervention.

Conclusions:

Digital education for post-registration health professions education in pediatrics is at least as effective as traditional learning and more effective than no learning. High fidelity mannequins were found to be more effective at improving learners’ skills than traditional learning with low fidelity mannequins. Computer-based offline/online digital education was better than no intervention for knowledge and skill outcomes and as good as traditional face-to-face learning. This review highlights evidence gaps calling for more methodological rigorous randomized controlled trials on the topic.