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Digital learning for healthcare professional education: is mobile learning effective?

Gerard Dunleavy

Research Associate in Population Health

Centre for Population Health Sciences, Lee Kong Chian School of Medicine

The Fourth Global Forum on Human Resources for Health

16th November 2017

Overview

• Background

• Objective

• Methodology

• Results

• Conclusion

Background - the problem

Background - the problem

2030

Source: Liu et al, 2017

Background – a possible solution

‘mLearning’, any intervention using handheld,

mobile devices to deliver

educational content

Low cost

Portability

High accessibility

…in order to

extend the reach of learning and

teaching beyond physical space

and distance

Mobile devices, ubiquitous to modern life…

Examples of mLearning

Objective

• To evaluate the effect of mobile learning(mLearning) interventions on healthcare professional(HCP) education

– knowledge

– skills

– attitudes

– satisfaction

• Participants: Undergraduate and registered HCPs.

• Intervention: mLearning interventions, blended learning.

• Control: Traditional learning.

• Outcomes: Knowledge, skills, attitude, satisfaction.

Can the inadequacy of HCP training be

addressed through mLearning?

MEDLINE, Embase, the Cochrane Central

Register of Controlled Trials (CENTRAL),

PsychINFO, ERIC, CINAHL and Web of Science

Core Collection.] and clinical trial registries

(ClinicalTrial.gov, and WHO ICTRP) from

January 1990 to August 2017

Synthesis the evidence

4

Methodology

Results – Prisma Flow Chart

USA (14),

South Korea (2), UK (2), Australia(1),

Canada(1), Germany(1), The

Netherlands(1), New Zealand(1),

Singapore(1), Spain(1), Switzerland(1),

Taiwan (1).

China(1), Iran(1), Kenya(1), Turkey(1)

Results – Description of the studies

Results – Description of the studies

N = 2,631 participants31 RCTs – all published

since 2006

16

13

2

0 5 10 15 20

Undergraduate

Post-

registration

Mixed

participants

Number of studies

Type of HCPs

mLearning vs Traditional learning 18

Blended vs Traditional learning 13

0

2

4

6

8

10

12

14

16

18

Tablet/Smartphone PDA Basic mobile phone iPod/mp3 player

No

. o

f st

ud

ies

Types of mLearning

0

5

10

15

20

2006-2009 2010-2013 2014- August 2017

TREND BY YEAR OF PUBLICATION

No. of studies

Results

Knowledge

vs

Skills

6 studies

(n=1,484)

3 studies

(n=1,165)

4 studies

(n=339)

1 study

(n=32)

Attitude

2 studies

(n=116)

1 study

(n=64)

Satisfaction

1 study

(n=87)

1 study

(n=33)

Knowledge Skills

1 study

(n=49)

4 studies

(n=276)

6 studies

(n=300)

2 studies

(n=32)

vs+

1 study

(n=35)

Result: Cost comparison

mLearning Traditional learning

No. of participants 243 236

Intervention Text messages One-day workshop

Cost of delivery per health

worker (USD)$

0.32 89.96

Baseline knowledge score

mean(SD)

0.33 (0.12) 0.34 (0.13)

A 280-fold difference per person.

Source: Chen, 2014

Post-intervention knowledge

score mean(SD)

0.46 (0.16) 0.31 (0.11)

Conclusions

• mLearning is a promising alternative to traditional learning for educating HCPs

• There is a need for methodologically robust research, employing validated and standardized outcome measurement tools

• Studies should also assess cost-effectiveness, patient related outcomes and potential adverse/unintended effects of mLearning

Thank you

Acknowledgements

LKC School of Medicine (Singapore) Asst Prof Lorainne Tudor Car

Dr Gloria Law

Dr Shoko Dauwels

Assoc Prof Nabil Zary

Karolinska Institutet (Sweden) Mr Sokratis Nifakos

Université catholique de Louvain (Belgium) Dr Charoula K Nikolaou

This research is supported by the Lee Kong Chian School of Medicine, Nanyang

Technological University eLearning grant.

Any questions?

For further info,

contact Gerard Dunleavy gerard.dunleavy@ntu.edu.sg

or Asst Prof Lorainne Tudor-Car (corresponding author) lorainne.tudor.car@ntu.edu.sg

Appendix

Results

Knowledge Skills Attitudes Satisfaction

Number of studies 9 6 3 3

Number of participants 1112 411 152 199

Direction of effect

Favors mLearning

No Difference

Favors Control

Incomparable outcome data

3 studies

6 studies

0 studies

0 studies

4 studies

1 study

0 studies

1 study

1 study

2 studies

0 studies

0 studies

1 study

1 studies

0 studies

1 studies

mLearning vs traditional learning

Quality of evidence was downgraded to ‘very low’.

Results

Knowledge Skills Attitude Satisfaction

Number of studies 6 9 2 1

Number of participants 345 618 93 111

Direction of effect

Favors blended learning

No Difference

Favors Control

Incomplete outcome data

3 studies

2 studies

1 study

0 studies

6 studies

1 studies

0 studies

2 studies

0 studies

1 study

0 studies

1 study

0 studies

0 studies

0 studies

1 study

Blended learning vs traditional learning

Quality of evidence was downgraded to ‘very low’.

Results – Knowledge

Results - Skills

Time to successfully complete a skills task

Results – Attitude and Satisfaction

Attitude

Satisfaction

Search Terms in Search Strategy

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• Education • Professional education, Predental, Premedical, Health Occupations, Distance education,

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Search Terms in Search Strategy

• Intervention• Computer-Assisted Instruction, Internet, Computer Simulation, Patient Simulation,

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