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BACKGROUND

Spaced digital education applies digital tools to deliver educational content via multiple, repeated learning sessions separated by prespecified time intervals. Spaced digital education appears to promote acquisition and long-term retention of knowledge, skills, and change in clinical behavior.

OBJECTIVE

The aim of this review was to assess the effectiveness of spaced digital education in improving pre- and postregistration health care professionals' knowledge, skills, attitudes, satisfaction, and change in clinical behavior.

METHODS

This review followed Cochrane's methodology and PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) reporting guidelines. We searched MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses databases from January 1990 to February 2023. We included randomized controlled trials (RCTs), cluster RCTs, and quasi-RCTs comparing spaced digital education with nonspaced education, spaced nondigital education, traditional learning, or no intervention for pre- or postregistration health care professionals. Study selection, data extraction, study quality, and certainty of evidence were assessed by 2 independent reviewers. Meta-analyses were conducted using random effect models.

RESULTS

We included 23 studies evaluating spaced online education (n=17, 74%) or spaced digital simulation (n=6, 26%) interventions. Most studies assessed 1 or 2 outcomes, including knowledge (n=15, 65%), skills (n=9, 39%), attitudes (n=8, 35%), clinical behavior change (n=8, 35%), and satisfaction (n=7, 30%). Most studies had an unclear or a high risk of bias (n=19, 83%). Spaced online education was superior to massed online education for postintervention knowledge (n=9, 39%; standardized mean difference [SMD] 0.32, 95% CI 0.13-0.51, I=66%, moderate certainty of evidence). Spaced online education (n=3, 13%) was superior to massed online education (n=2, 9%) and no intervention (n=1, 4%; SMD 0.67, 95% CI 0.43-0.91, I=5%, moderate certainty of evidence) for postintervention clinical behavior change. Spaced digital simulation was superior to massed simulation for postintervention surgical skills (n=2, 9%; SMD 1.15, 95% CI 0.34-1.96, I=74%, low certainty of evidence). Spaced digital education positively impacted confidence and satisfaction with the intervention.

CONCLUSIONS

Spaced digital education is effective in improving knowledge, particularly in substantially improving surgical skills and promoting clinical behavior change in pre- and postregistration health care professionals. Our findings support the use of spaced digital education interventions in undergraduate and postgraduate health profession education. Trial Registration: PROSPERO CRD42021241969.

TRIAL REGISTRATION

PROSPERO CRD42021241969; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=241969.

BACKGROUND

OBJECTIVE

METHODS

RESULTS

CONCLUSIONS

TRIAL REGISTRATION

PROSPERO CRD42021241969; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=241969.

背景

间隔式数字教育利用数字工具通过多个、重复的学习课程来传递教育内容，这些课程由预先指定的时间间隔隔开。间隔式数字教育似乎可以促进知识、技能的获取和长期保留，以及临床行为的改变。

目的

本综述旨在评估间隔式数字教育在提高预注册和注册后医疗保健专业人员的知识、技能、态度、满意度和临床行为改变方面的有效性。

方法

本综述遵循 Cochrane 的方法学和 PRISMA（系统评价和荟萃分析的首选报告项目）报告指南。我们检索了 MEDLINE、Embase、Web of Science、ERIC、PsycINFO、CINAHL、CENTRAL 和 ProQuest 学位论文和论文数据库，检索时间为 1990 年 1 月至 2023 年 2 月。我们纳入了比较间隔式数字教育与非间隔式教育、间隔式非数字教育、传统学习或无干预对预注册和注册后医疗保健专业人员的效果的随机对照试验（RCT）、集群 RCT 和准 RCT。两名独立评审员进行了研究选择、数据提取、研究质量和证据确定性评估。使用随机效应模型进行了荟萃分析。

结果

我们纳入了 23 项研究，评估了间隔式在线教育（n=17，占 65%）或间隔式数字模拟（n=6，占 26%）干预措施。大多数研究评估了 1 个或 2 个结果，包括知识（n=15，占 65%）、技能（n=9，占 39%）、态度（n=8，占 35%）、临床行为改变（n=8，占 35%）和满意度（n=7，占 30%）。大多数研究的偏倚风险为不明确或高（n=19，占 83%）。间隔式在线教育优于集中式在线教育，在干预后的知识方面（n=9，占 39%；标准化均数差 [SMD] 0.32，95%CI 0.13-0.51，I=66%，中等确定性证据）。间隔式在线教育（n=3，占 13%）优于集中式在线教育（n=2，占 9%）和无干预（n=1，占 4%；SMD 0.67，95%CI 0.43-0.91，I=5%，中等确定性证据），在干预后的临床行为改变方面。间隔式数字模拟在干预后的手术技能方面优于集中式模拟（n=2，占 9%；SMD 1.15，95%CI 0.34-1.96，I=74%，低确定性证据）。间隔式数字教育对干预的信心和满意度产生了积极影响。