University of Central Lancashire, Preston, UK.
Royal College of Speech & Language Therapists, London, UK.
J Eval Clin Pract. 2024 Sep;30(6):909-935. doi: 10.1111/jep.14001. Epub 2024 May 30.
The primary aim of this systematic review is to assess the effectiveness of evidence-based healthcare (EBHC) educational interventions on healthcare professionals' knowledge, skills, attitudes, behaviour of EBHC, clinical process and care outcomes. A secondary aim of the review is to assess the effects of important pedagogical moderating factors for EBHC educational interventions.
This systematic review used a forward and backward citation search strategy on the Web of Science platform (date of inception to 28 April 2023). Only randomised controlled trials (RCTs) and cluster RCTs which compared EBHC educational interventions for healthcare professionals were included. A random effects meta-analysis was undertaken for EBHC compared with an active and nonactive control for all outcomes.
Sixty-one RCTs were identified which included a total of 5208 healthcare professionals. There was a large effect for EBHC educational interventions compared with waiting list/no treatment/sham control on knowledge (SMD, 2.69; 95% CI, 1.26-4.14, GRADE Low), skills (SMD, 0.88; 95% CI, 0.25-1.73, Very Low Certainty), attitude (SMD, 0.81; 95% CI, 0.16-1.47, Very Low Certainty) and behaviour of EBHC (SMD, 0.82; 95% CI, 0.25-1.40, Very Low Certainty). Over time the effect of EBHC educational interventions substantially decreased with no evidence of effect at 6 months for any outcome except behaviour (SMD,1.72; 95% CI, 0.74-2.71, Low Certainty). There was some evidence that blended learning, active learning and consistency in the individual delivering the intervention may be important positive moderating factors.
These findings suggest that EBHC educational interventions may have a large short-term effect on improving healthcare professionals' knowledge, skills, attitude and behaviour of EBHC. These effects may be longer-lasting regarding EBHC behaviour. In terms of pedagogy, blended learning, active learning, and consistency of the individual delivering the intervention may be important positive moderating factors.
本系统评价的主要目的是评估基于证据的医疗保健（EBHC）教育干预措施对医疗保健专业人员的知识、技能、态度、EBHC 行为、临床流程和护理结果的有效性。本研究的次要目的是评估 EBHC 教育干预措施的重要教学调节因素的效果。
本系统评价采用 Web of Science 平台的向前和向后引文搜索策略（起始日期至 2023 年 4 月 28 日）。仅纳入比较医疗保健专业人员 EBHC 教育干预措施的随机对照试验（RCT）和集群 RCT。对于所有结局，采用随机效应荟萃分析比较 EBHC 与积极对照和非活跃对照。
确定了 61 项 RCT，共纳入 5208 名医疗保健专业人员。与等待名单/无治疗/假对照相比，EBHC 教育干预措施在知识（SMD，2.69；95%CI，1.26-4.14，GRADE 低）、技能（SMD，0.88；95%CI，0.25-1.73，非常低确定性）、态度（SMD，0.81；95%CI，0.16-1.47，非常低确定性）和 EBHC 行为（SMD，0.82；95%CI，0.25-1.40，非常低确定性）方面具有较大的效果。随着时间的推移，EBHC 教育干预措施的效果大大降低，除行为外（SMD，1.72；95%CI，0.74-2.71，低确定性），任何结局在 6 个月时均无效果证据。有一些证据表明，混合学习、主动学习和实施干预的个体的一致性可能是重要的积极调节因素。
这些发现表明，EBHC 教育干预措施可能在短期内对提高医疗保健专业人员的知识、技能、态度和 EBHC 行为产生较大影响。关于 EBHC 行为，这些效果可能更持久。在教学方面，混合学习、主动学习和实施干预的个体的一致性可能是重要的积极调节因素。
