Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland.
J Med Internet Res. 2024 Jul 29;26:e54473. doi: 10.2196/54473.
Mental disorders pose a major public health problem in most western countries. The demand for services for common mental health disorders has been on the rise despite the widespread accessibility of medication. Especially, the supply and demand for evidence-based psychotherapy do not align. Large-scale increase of modern psychotherapy is difficult with current methods of training which are often expensive, time consuming, and dependent on a small number of top-level professionals as trainers. E-learning has been proposed to enhance psychotherapy training accessibility, quality, and scalability.
This systematic review aims to provide an overview of the current evidence regarding e-learning in psychotherapy training. In particular, the review examines the usability, acceptability, and learning outcomes associated with e-learning. Learning outcomes are assessed in different modalities including trainee experiences, knowledge acquisition, skill acquisition, and application of trained content in daily practice. Furthermore, the equivalence of web-based training and conventional training methods is evaluated.
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search from Ovid, MEDLINE, PsycINFO, and Scopus databases between 2008 and June 2022 was conducted. Inclusion criteria required studies to describe e-learning systems for psychotherapy training and assess acceptability, feasibility, or learning outcomes. The risk of bias was evaluated for both randomized and nonrandomized studies. Learning outcomes were categorized using the Kirkpatrick model. Effect sizes comparing e-learning and traditional methods were calculated.
The search yielded 3380 publications, of which 34 fulfilled the inclusion criteria. Positive learning outcomes are generally associated with various e-learning programs in psychotherapy training including trainee satisfaction, knowledge, and skill acquisition, and in application of trained content in clinical practice. Learning outcomes generally show equivalence between e-learning and conventional training methods. The overall effect size, indicating this disparity, was 0.01, suggesting no significant difference. This literature displays a high level of heterogeneity in e-learning solutions and assessment methods.
e-Learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to e-learning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in blended settings supported by activating learning methods are presented. However, due to the heterogeneity and limitations in the existing literature, further research is necessary to replicate these findings and to establish global standards for e-learning, as well as for the assessment of training outcomes in psychotherapy education. Research is especially needed on the effects of training on patient outcomes and optimal ways to combine e-learning and conventional training methods in blended learning settings.
精神障碍在大多数西方国家是一个主要的公共卫生问题。尽管药物治疗广泛普及，但常见精神健康障碍的服务需求仍在不断增加。特别是，基于证据的心理治疗的供需不匹配。由于目前的培训方法通常昂贵、耗时且依赖少数顶尖专业人员作为培训师，因此大规模增加现代心理治疗是困难的。电子学习已被提议用于增强心理治疗培训的可及性、质量和可扩展性。
本系统评价旨在概述当前关于心理治疗培训中电子学习的证据。特别是，该评价检查了电子学习的可用性、可接受性和学习成果。学习成果通过包括受训者经验、知识获取、技能获取以及将培训内容应用于日常实践在内的不同模式进行评估。此外，还评估了基于网络的培训与传统培训方法的等效性。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，在 2008 年至 2022 年 6 月期间，对 Ovid、MEDLINE、PsycINFO 和 Scopus 数据库进行了搜索。纳入标准要求研究描述心理治疗培训的电子学习系统，并评估可接受性、可行性或学习成果。对随机和非随机研究都进行了偏倚风险评估。使用柯克帕特里克模型对学习成果进行分类。计算了电子学习与传统方法比较的效应量。
搜索结果产生了 3380 篇出版物，其中 34 篇符合纳入标准。在心理治疗培训中，各种电子学习计划通常与积极的学习成果相关，包括受训者满意度、知识和技能获取，以及将培训内容应用于临床实践中。学习成果通常在电子学习和传统培训方法之间显示出等效性。表明这种差异的总体效应量为 0.01，表明没有显著差异。该文献显示电子学习解决方案和评估方法的高度异质性。
电子学习似乎有很大的潜力通过增加获取途径、可扩展性和成本效益来增强心理治疗培训，同时在学习成果方面保持质量。结果与一般健康教育中与电子学习相关的发现一致，在这种情况下，电子学习作为一种教学法与开展以学习者为中心的实践的机会相关联。提出了在混合环境中开展基于电子学习的心理治疗培训计划的建议，同时支持激活学习方法。但是，由于现有文献的异质性和局限性，需要进一步研究来复制这些发现，并为电子学习以及心理治疗教育中培训成果的评估建立全球标准。特别需要研究培训对患者结果的影响，以及在混合学习环境中结合电子学习和传统培训方法的最佳方式。
