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Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis.

ABSTRACT: BACKGROUND:Adaptive e-learning environments (AEEs) can provide tailored instruction by adapting content, navigation, presentation, multimedia, and tools to each user's navigation behavior, individual objectives, knowledge, and preferences. AEEs can have various levels of complexity, ranging from systems using a simple adaptive functionality to systems using artificial intelligence. While AEEs are promising, their effectiveness for the education of health professionals and health professions students remains unclear. OBJECTIVE:The purpose of this systematic review is to assess the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. METHODS:We will follow the Cochrane Collaboration and the Effective Practice and Organisation of Care (EPOC) Group guidelines on systematic review methodology. A systematic search of the literature will be conducted in 6 bibliographic databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed, and Web of Science) using the concepts "adaptive e-learning environments," "health professionals/students," and "effects on knowledge/skills/behavior." We will include randomized and nonrandomized controlled trials, in addition to controlled before-after, interrupted time series, and repeated measures studies published between 2005 and 2017. The title and the abstract of each study followed by a full-text assessment of potentially eligible studies will be independently screened by 2 review authors. Using the EPOC extraction form, 1 review author will conduct data extraction and a second author will validate the data extraction. The methodological quality of included studies will be independently assessed by 2 review authors using the EPOC risk of bias criteria. Included studies will be synthesized by a descriptive analysis. Where appropriate, data will be pooled using meta-analysis by applying the RevMan software version 5.1, considering the heterogeneity of studies. RESULTS:The review is in progress. We plan to submit the results in the beginning of 2018. CONCLUSION:Providing tailored instruction to health professionals and students is a priority in order to optimize learning and clinical outcomes. This systematic review will synthesize the best available evidence regarding the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. It will provide guidance to policy makers, hospital managers, and researchers in terms of AEE development, implementation, and evaluation in health care.

SUBMITTER: Fontaine G

PROVIDER: S-EPMC5517824 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis.

Fontaine Guillaume G Cossette Sylvie S Maheu-Cadotte Marc-André MA Mailhot Tanya T Deschênes Marie-France MF Mathieu-Dupuis Gabrielle G

JMIR research protocols 20170705 7

<h4>Background</h4>Adaptive e-learning environments (AEEs) can provide tailored instruction by adapting content, navigation, presentation, multimedia, and tools to each user's navigation behavior, individual objectives, knowledge, and preferences. AEEs can have various levels of complexity, ranging from systems using a simple adaptive functionality to systems using artificial intelligence. While AEEs are promising, their effectiveness for the education of health professionals and health professi ...[more]

PMID: 28679491

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Project description:OBJECTIVE:Although adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding the efficacy of AEEs in improving knowledge, skills and clinical behaviour in health professionals and students. DESIGN:Systematic review and meta-analysis. DATA SOURCES:CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science from the first year of records to February 2019. ELIGIBILITY CRITERIA:Controlled studies that evaluated the effect of an AEE on knowledge, skills or clinical behaviour in health professionals or students. SCREENING, DATA EXTRACTION AND SYNTHESIS:Two authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. AEEs were reviewed with regard to their topic, theoretical framework and adaptivity process. Studies were included in the meta-analysis if they had a non-adaptive e-learning environment control group and had no missing data. Effect sizes (ES) were pooled using a random effects model. RESULTS:From a pool of 10 569 articles, we included 21 eligible studies enrolling 3684 health professionals and students. Clinical topics were mostly related to diagnostic testing, theoretical frameworks were varied and the adaptivity process was characterised by five subdomains: method, goals, timing, factors and types. The pooled ES was 0.70 for knowledge (95% CI -0.08 to 1.49; p.08) and 1.19 for skills (95% CI 0.59 to 1.79; p<0.00001). Risk of bias was generally high. Heterogeneity was large in all analyses. CONCLUSIONS:AEEs appear particularly 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, which generates less cognitive load. Future research should report more clearly on the design and adaptivity process of AEEs, and target higher-level outcomes, such as clinical behaviour. PROSPERO REGISTRATION NUMBER:CRD42017065585.

Project description:IntroductionEuropean societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds.Materials and methodsA phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal.Results5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice.ConclusionThe participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities.

Project description:BackgroundIn Brazil, as in most countries nowadays, there is a pursuit for healthcare quality improvement and sustainability in public and private systems. Healthcare professionals' perceptions, knowledge and attitudes determine evidence-based practice (EBP), which remain uncertain among Brazilian practitioners. A standardised national instrument whose wide use will identify gaps and flaws in establishing an EBP could contribute to an effective resources allocation from health professionals willing to use an EBP.ObjectivesTo present a study protocol on the development and validation of an instrument to measure Brazilian healthcare professionals' behaviour, skills, self-efficacy, knowledge and attitudes towards EBP.MethodsThis is a validation study with Brazilian healthcare professionals to develop a valid and reliable questionnaire, including selection of domains and formulation of questions. Construct and content validity will be assess by a panel of experts, with data collection and analysis following a Delphi-like methodology. Further, a pilot survey will be accomplished with a representative sample of different healthcare professionals from all main Brazilian regions. An exploratory factor analysis and a confirmatory factor analysis will be conducted afterwards. The ratio of χ2 and df (χ2/df), comparative fit index, goodness of fit index and root mean square error of approximation will be used for assessing the model fit. In addition, the reliability of the instrument will be estimated by test-retest reproducibility and Cronbach's alpha coefficient (α).Ethics and disseminationThis study has received ethical approval from the Pharmaceutical Sciences Faculty of the São Paulo State University (1.425.808). The use among a wide national sample is expected to promote an extensive view of evidence-based decision-making, identifying the knowledge gaps in this area. Study findings will be circulated to healthcare professionals and scientists in the field through the publication in peer-reviewed journals and conference presentations.

Project description:BACKGROUND:The composition of habitual diets is associated with adverse or protective effects on aspects of health. Consequently, UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is e-Learning, the use of interactive electronic media to facilitate teaching and learning on a range of issues, including diet and health. The aims of this systematic review are to determine the effectiveness and cost-effectiveness of adaptive e-Learning for improving dietary behaviours. METHODS/DESIGN:The research will consist of a systematic review and a cost-effectiveness analysis. Studies will be considered for the review if they are randomised controlled trials, involving participants aged 13 or over, which evaluate the effectiveness or efficacy of interactive software programmes for improving dietary behaviour. Primary outcome measures will be those related to dietary behaviours, including estimated intakes of energy, nutrients and dietary fibre, or the estimated number of servings per day of foods or food groups. Secondary outcome measures will be objective clinical measures that are likely to respond to changes in dietary behaviours, such as anthropometry or blood biochemistry. Knowledge, self-efficacy, intention and emotion will be examined as mediators of dietary behaviour change in order to explore potential mechanisms of action. Databases will be searched using a comprehensive four-part search strategy, and the results exported to a bibliographic database. Two review authors will independently screen results to identify potentially eligible studies, and will independently extract data from included studies, with any discrepancies at each stage settled by a third author. Standardised forms and criteria will be used.A descriptive analysis of included studies will describe study design, participants, the intervention, and outcomes. Statistical analyses appropriate to the data extracted, and an economic evaluation using a cost-utility analysis, will be undertaken if sufficient data exist, and effective components of successful interventions will be investigated. DISCUSSION:This review aims to provide comprehensive evidence of the effectiveness and cost-effectiveness of adaptive e-Learning interventions for dietary behaviour change, and explore potential psychological mechanisms of action and the effective components of effective interventions. This can inform policy makers and healthcare commissioners in deciding whether e-Learning should be part of a comprehensive response to the improvement of dietary behaviour for health, and if so which components should be present for interventions to be effective.

Dataset Information

Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis.

Publications

Effectiveness of Adaptive E-Learning Environments on Knowledge, Competence, and Behavior in Health Professionals and Students: Protocol for a Systematic Review and Meta-Analysis.

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