Prof Lockey: Consultant in Emergency Medicine, Calderdale and Huddersfield NHS Trust, United Kingdom and Visiting Professor of Emergency Medicine, University of Huddersfield, United Kingdom. Dr. Bland: Senior Lecturer in Adult Nursing, University of Huddersfield, United Kingdom. Dr. Stephenson: Senior Lecturer in Health/Biomedical Statistics, University of Huddersfield, United Kingdom. Dr. Bray: Associate Professor and Heart Foundation Fellow, Monash University, Melbourne, Australia and Adjunct Associate Professor, Curtin University, Perth, Australia. Prof Astin: Professor of Nursing, University of Huddersfield, United Kingdom and Professor of Nursing, Calderdale and Huddersfield NHS Trust, United Kingdom.
J Contin Educ Health Prof. 2022 Oct 1;42(4):256-264. doi: 10.1097/CEH.0000000000000455. Epub 2022 Sep 5.
Blended learning is an educational approach that integrates face-to-face with online instruction. This overview of existing systematic reviews aims to evaluate the impact of blended learning on educational outcomes in health care professional education, identify gaps in the current evidence, and direction for future reviews.
Five databases were searched (January 1, 2000 to January 14, 2021) for systematic reviews of blended versus nonblended learning approaches for health care education. "Flipped classroom", unpublished studies, abstracts, and study protocols were excluded. The extracted data included details of included reviews, description of populations, and outcomes according to Kirkpatrick levels. A narrative review is presented, along with an overarching meta-analysis, which evaluates a synthesized estimate of the effect of blended learning based on standardized mean differences.
Eleven systematic reviews were included, comprising of 160 primary studies (including 117 randomized controlled trials) from 56 countries with over 18,000 participants. The overall level of evidence was very low quality. An overarching meta-analysis of 93 studies addressing knowledge acquisition favored blended over nonblended learning methods (standardized mean difference 0.768 [95% confidence interval 0.594-0.941]; P < .001). None of the reviews identified an adverse effect on other educational outcomes.
Blended learning may be superior to traditional teaching approaches in improving knowledge acquisition. We recommend further research to describe the relative benefits of blended learning in each individual context and identify which elements of instructional design are beneficial for each outcome. Finally, we recommend the use of clear and consistent terminology in reported studies.
混合式学习是一种将面对面教学与在线教学相结合的教育方法。本综述旨在评估混合式学习对医疗保健专业教育的教育成果的影响，确定当前证据中的差距，并为未来的综述指明方向。
从五个数据库（2000 年 1 月 1 日至 2021 年 1 月 14 日）中搜索了混合式与非混合式学习方法在医疗保健教育中的系统评价。排除了“翻转课堂”、未发表的研究、摘要和研究方案。提取的数据包括纳入综述的详细信息、人群描述以及根据柯克帕特里克水平的结果。呈现了一个叙述性综述，并进行了总体荟萃分析，该分析根据标准化均数差评估了混合式学习效果的综合估计。
纳入了 11 项系统评价，其中包括来自 56 个国家的 160 项初级研究（包括 117 项随机对照试验），涉及超过 18000 名参与者。总体证据水平为极低质量。对 93 项研究（涉及知识获取）的总体荟萃分析表明，混合式学习优于非混合式学习方法（标准化均数差 0.768 [95%置信区间 0.594-0.941]；P <.001）。没有一项综述发现混合式学习对其他教育结果有不利影响。
混合式学习在提高知识获取方面可能优于传统教学方法。我们建议进一步研究描述混合式学习在每个具体环境中的相对优势，并确定教学设计的哪些要素对每个结果有益。最后，我们建议在报告的研究中使用清晰一致的术语。
