Voutilainen Ari, Saaranen Terhi, Sormunen Marjorita
Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1C, Kuopio, Finland.
Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1C, Kuopio, Finland.
Nurse Educ Today. 2017 Mar;50:97-103. doi: 10.1016/j.nedt.2016.12.020. Epub 2016 Dec 22.
By and large, in health professions training, the direction of the effect of e-learning, positive or negative, strongly depends on the learning outcome in question as well as on learning methods which e-learning is compared to. In nursing education, meta-analytically generated knowledge regarding the comparisons between conventional and e-learning is scarce.
The aim of this review is to discover the size of the effect of e-learning on learning outcomes in nursing education and to assess the quality of studies in which e-learning has been compared to conventional learning.
A systematic search of six electronic databases, PubMed, Ovid MEDLINE®, CINAHL (EBSCOhost), Cochrane Library, PsycINFO, and ERIC, was conducted in order to identify relevant peer-reviewed English language articles published between 2011 and 2015. The quality of the studies included as well as the risk of bias in each study was assessed. A random-effects meta-analysis was performed to generate a pooled mean difference in the learning outcome.
Altogether, 10 studies were eligible for the quality assessment and meta-analysis. Nine studies were evaluated as good quality studies, but not without a risk of bias. Performance bias caused a high risk in nearly all the studies. In the meta-analysis, an e-learning method resulted in test scores that were, on average, five points higher than a conventional method on a 0-100 scale. Heterogeneity between the studies was very large.
The size and direction of the effect of a learning method on learning outcomes appeared to be strongly situational. We suggest that meta-regressions should be performed instead of basic meta-analyses in order to reveal factors that cause variation in the learning outcomes of nursing education. It might be necessary to perform separate meta-analyses between e-learning interventions aimed at improving nursing knowledge and those aimed at improving nursing skills.
总体而言，在卫生专业培训中，电子学习效果的方向，无论是积极的还是消极的，很大程度上取决于所讨论的学习成果以及与之比较的学习方法。在护理教育中，关于传统学习与电子学习比较的元分析所产生的知识很少。
本综述的目的是发现电子学习对护理教育学习成果的影响大小，并评估将电子学习与传统学习进行比较的研究质量。
对六个电子数据库进行系统检索，包括PubMed、Ovid MEDLINE®、CINAHL（EBSCOhost）、Cochrane图书馆、PsycINFO和ERIC，以识别2011年至2015年期间发表的相关同行评审英文文章。评估了纳入研究的质量以及每项研究中的偏倚风险。进行随机效应元分析以得出学习成果的合并平均差异。
共有10项研究符合质量评估和元分析的条件。9项研究被评估为高质量研究，但并非没有偏倚风险。表现偏倚在几乎所有研究中都造成了高风险。在元分析中，电子学习方法导致的测试分数在0至100分的量表上平均比传统方法高5分。研究之间的异质性非常大。
学习方法对学习成果的影响大小和方向似乎强烈依赖于具体情境。我们建议应进行元回归分析而非基本的元分析，以揭示导致护理教育学习成果差异的因素。可能有必要针对旨在提高护理知识的电子学习干预措施和旨在提高护理技能的电子学习干预措施分别进行元分析。
