JMIR Publications

ABSTRACT

Background:

e-Learning is rapidly growing as an alternative way of delivering education in nursing. Two contexts regarding the use of e-learning in nursing are discussed in the literature: 1) education among nursing students and 2) nurses’ continuing education in a life-long learning perspective. A previous systematic review of systematic reviews on e-learning for nursing and health professional students in an academic context has been published previously, but no such reviews exist regarding e-learning for registered nurses in a continuing education context.

Objective:

We aimed to systematically summarize the qualitative and quantitative evidence regarding the effects of e-learning on nursing care among nurses in a continuing education context.

Methods:

We conducted a systematic review of systematic qualitative, quantitative and mixed studies reviews, searching in four bibliographic databases. The eligibility criteria were formulated using the PICOS (population, interventions, comparisons, outcomes, study design) format. Included population was registered nurses. e-Learning interventions were included, compared with face-to-face, any other e-learning interventions and blended learning. The outcomes of interest derived from two models: nursing sensitive indicators from the Nursing Care Performance Framework (e.g., teaching, collaboration) and the levels of evaluation from the Kirkpatrick Model (reaction, learning, behavior and results).

Results:

We identified a total of 12,906 records. We retrieved 222 full-text papers for detailed evaluation, from which 22 systematic reviews published between 2008 and 2018 met the eligibility criteria. The effects of e-learning on nursing care were grouped under Kirkpatrick’s levels of evaluation: 1) Nurse reactions with e-learning; 2) Nurse learning; 3) Behavior; 4) Results. Level 2, nurse learning, was divided into these three subthemes: knowledge, skills, and attitude/self-efficacy. Level 4, results, was divided into patient outcomes and costs. Most of the outcomes were reported in a positive way. For instance, nurses were satisfied with the use of e-learning and they improved their knowledge. The most common topic covered by the e-learning interventions was medication calculation, preparation and administration.

Conclusions:

The effects of e-learning are mainly reported in terms of nurse reactions, knowledge and skills, i.e., the two first levels of the Kirkpatrick Model. The effectiveness of e-learning interventions for nurses in a continuing education context remains unknown regarding how the learning can be transferred to change practice and affect patient outcomes. Further scientific, methodological, theoretical and practice-based breakthroughs are needed in the fast-growing field of e-learning in nursing education, especially in a life-learning perspective. Clinical Trial: Trial Registration: PROSPERO International Prospective Register of Systematic Reviews: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=50714