Fontaine M and team has conducted a study to systematically identify, appraise and synthesise the evidence regarding the efficacy of adaptive e-learning environments (AEEs) in improving knowledge, skills and clinical behavior in health professionals and students.
It was a first systematic review and meta-analysis to evaluate the efficacy of AEEs in health professionals and students. The study included the controlled studies or primary research articles reporting the assessment of an AEE with health professionals, students, trainees and residents in any discipline. Two authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. They reviewed AEEs with regard to their topic, theoretical framework and adaptivity process. Using random effects model, effect sizes (ES) were pooled up.
From a pool of 10,569 articles, 21 studies were included enrolling 3684 health professionals and students. Out of 21 studies, 17 of which assessed an AEE versus another educational intervention (large-group classroom instruction, Non-adaptive e-learning environments (NEE) or paper-based learning), and 4 of which assessed 2 AEEs with design variations head-to-head. Clinical topics were related to diagnostic testing, theoretical frameworks were varied and the adaptivity process included five subdomains, such as method, goals, timing, factors and types. The study revealed that the pooled ES for knowledge was 0.70 (95% CI −0.08 to 1.49; p.08) and for skills, it was 1.19 (95% CI 0.59 to 1.79; p<0.00001). There was high risk of bias and heterogeneity was also large.
The study concluded that AEEs are more effective in improving skills in health professionals and students. The adaptivity process within AEEs may be more beneficial for learning skills rather than factual knowledge.
Fontaine G, Cossette S, Maheu-Cadotte M, et al. Efficacy of adaptive e-learning for health professionals and students: a systematic review and meta-analysis. BMJ Open 2019; 9:e025252.