Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland.
Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
BMJ Evid Based Med. 2024 Jul 23;29(4):229-238. doi: 10.1136/bmjebm-2023-112647.
The objectives of this study are to assess reporting of evidence-based healthcare (EBHC) e-learning interventions using the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) checklist and explore factors associated with compliant reporting.
Methodological cross-sectional study.
Based on the criteria used in an earlier systematic review, we included studies comparing EBHC e-learning and any other form of EBHC training or no EBHC training. We searched Medline, Embase, ERIC, CINAHL, CENTRAL, SCOPUS, Web of Knowledge, PsycInfo, ProQuest and Best Evidence Medical Education up to 4 January 2023. Screening of titles, abstracts, full-text articles and data extraction was done independently by two authors. For each study, we assessed adherence to each of the 17 GREET items and extracted information on possible predictors. Adequacy of reporting for each item of the GREET checklist was judged with yes (provided complete information), no (provided no information), unclear (when insufficient information was provided), or not applicable, when the item was clearly of no relevance to the intervention described (such as for item 8-details about the instructors-in the studies which used electronic, self-paced intervention, without any tutoring). Studies' adherence to the GREET checklist was presented as percentages and absolute numbers. We performed univariate analysis to assess the association of potential adherence predictors with the GREET checklist. We summarised results descriptively.
We included 40 studies, the majority of which assessed e-learning or blended learning and mostly involved medical and other healthcare students. None of the studies fully reported all the GREET items. Overall, the median number of GREET items met (received yes) per study was 8 and third quartile (Q3) of GREET items met per study was 9 (min. 4 max. 14). When we used Q3 of the number of items met as cut-off point, adherence to the GREET reporting checklist was poor with 7 out of 40 studies (17.5%) reporting items of the checklist on acceptable level (adhered to at least 10 items out of 17). None of the studies reported on all 17 GREET items. For 3 items, 80% of included studies well reported information (received yes for these items): item 1 (brief description of intervention), item 4 (evidence-based practice content) and item 6 (educational strategies). Items for which 50% of included studies reported complete information (received yes for these items) included: item 9 (modes of delivery), item 11 (schedule) and 12 (time spent on learning). The items for which 70% or more of included studies did not provide information (received no for these items) included: item 7 (incentives) and item 13 (adaptations; for both items 70% of studies received no for them), item 14 (modifications of educational interventions-95% of studies received no for this item), item 16 (any processes to determine whether the materials and the educational strategies used in the educational intervention were delivered as originally planned-93% of studies received no for this item) and 17 (intervention delivery according to schedule-100% of studies received no for this item). Studies published after September 2016 showed slight improvements in nine reporting items. In the logistic regression models, using the cut-off point of Q3 (10 points or above) the odds of acceptable adherence to GREET guidelines were 7.5 times higher if adherence to other guideline (Consolidated Standards of Reporting Trials, Strengthening the Reporting of Observational Studies in Epidemiology, etc) was reported for a given study type (p=0.039), also higher number of study authors increased the odds of adherence to GREET guidance by 18% (p=0.037).
Studies assessing educational interventions on EBHC e-learning still poorly adhere to the GREET checklist. Using other reporting guidelines increased the odds of better GREET reporting. Journals should call for the use of appropriate use of reporting guidelines of future studies on teaching EBHC to increase transparency of reporting, decrease unnecessary research duplication and facilitate uptake of research evidence or result.
The Open Science Framework (https://doi.org/10.17605/OSF.IO/V86FR).
本研究旨在使用循证实践教育干预和教学指南（GREET）清单评估证据为基础的医疗保健（EBHC）电子学习干预措施的报告情况，并探讨与合规报告相关的因素。
方法学的横断面研究。
根据早期系统评价中使用的标准，我们纳入了比较 EBHC 电子学习与任何其他形式的 EBHC 培训或无 EBHC 培训的研究。我们检索了 Medline、Embase、ERIC、CINAHL、CENTRAL、SCOPUS、Web of Knowledge、PsycInfo、ProQuest 和最佳证据医学教育数据库，截至 2023 年 1 月 4 日。两名作者独立进行了标题、摘要、全文文章和数据提取的筛选。对于每项研究，我们评估了对 17 项 GREET 条目的每项遵守情况，并提取了可能的预测因素的信息。对 GREET 清单中每项条目的报告充分性进行了判断，分为“是（提供完整信息）”、“否（未提供信息）”、“不明确（提供的信息不足）”或“不适用（对于描述的干预措施明显不相关的项目，例如项目 8-关于指导者的详细信息-在使用电子、自主学习的干预措施且没有任何辅导的研究中）”。研究对 GREET 清单的遵守情况以百分比和绝对数字表示。我们进行了单变量分析，以评估潜在的遵守预测因素与 GREET 清单的关联。我们对结果进行了描述性总结。
我们纳入了 40 项研究，其中大多数评估了电子学习或混合学习，主要涉及医学和其他医疗保健学生。没有一项研究完全报告了所有 GREET 项目。总体而言，每个研究符合 GREET 项目的中位数为 8 项，第三四分位数（Q3）为 9 项（最小 4 项，最大 14 项）。当我们使用符合 Q3 数量的项目作为截止点时，GREET 报告清单的遵守情况较差，40 项研究中有 7 项（17.5%）报告了清单项目处于可接受水平（遵守了 17 项中的至少 10 项）。没有一项研究报告了所有 17 项 GREET 项目。有 3 项，80%的纳入研究很好地报告了信息（这些项目收到了“是”）：项目 1（干预措施的简要描述）、项目 4（循证实践内容）和项目 6（教育策略）。有 50%的纳入研究报告了完整信息的项目包括：项目 9（交付模式）、项目 11（时间表）和项目 12（学习时间）。有 70%或更多纳入研究没有提供信息的项目包括：项目 7（激励措施）和项目 13（适应性；对于这两个项目，70%的研究收到了“否”）、项目 14（教育干预措施的修改-95%的研究收到了“否”）、项目 16（任何确定是否按照原始计划交付教育干预措施和教育策略的过程-93%的研究收到了“否”）和项目 17（根据时间表交付干预措施-100%的研究收到了“否”）。2016 年 9 月以后发表的研究在九个报告项目中有了略微的改进。在逻辑回归模型中，使用 Q3（10 分或以上）的截止点，如果给定研究类型报告了对其他指南（临床试验统一标准、观察性研究强化报告标准等）的遵守情况，则符合 GREET 指南的可能性增加了 7.5 倍（p=0.039），另外，研究作者的数量增加了 18%，符合 GREET 指导的可能性（p=0.037）。
评估 EBHC 电子学习教育干预措施的研究仍然不符合 GREET 清单的要求。使用其他报告指南增加了更好地报告 GREET 的可能性。期刊应呼吁未来关于教授 EBHC 的研究使用适当的报告指南，以提高报告的透明度，减少不必要的研究重复，并促进研究证据或结果的采用。
