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      Does online learning work better than offline learning in undergraduate medical education? A systematic review and meta-analysis

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          ABSTRACT

          With the increasing use of technology in education, online learning has become a common teaching method. How effective online learning is for undergraduate medical education remains unknown. This article’s aim is to evaluate whether online learning when compared to offline learning can improve learning outcomes of undergraduate medical students. Five databases and four key journals of medical education were searched using 10 terms and their Boolean combinations during 2000–2017. The extracted articles on undergraduates’ knowledge and skill outcomes were synthesized using a random effects model for the meta-analysis.16 out of 3,700 published articles were identified. The meta-analyses affirmed a statistically significant difference between online and offline learning for knowledge and skill outcomes based on post-test scores (SMD = 0.81; 95% CI: 0.43, 1.20; p < 0.0001; n = 15). The only comparison result based on retention test scores was also statistically significant (SMD = 4.64; 95% CI: 3.19, 6.09; p < 0.00001). The meta-analyses discovered no significant difference when using pre- and post-test score gains (SMD = 3.03; 95% CI: −0.13, 4.13; p = 0.07; n = 3). There is no evidence that offline learning works better. And compared to offline learning, online learning has advantages to enhance undergraduates’ knowledge and skills, therefore, can be considered as a potential method in undergraduate medical teaching.

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          Most cited references38

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          Technology-enhanced simulation for health professions education: a systematic review and meta-analysis.

          Although technology-enhanced simulation has widespread appeal, its effectiveness remains uncertain. A comprehensive synthesis of evidence may inform the use of simulation in health professions education. To summarize the outcomes of technology-enhanced simulation training for health professions learners in comparison with no intervention. Systematic search of MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011. Original research in any language evaluating simulation compared with no intervention for training practicing and student physicians, nurses, dentists, and other health care professionals. Reviewers working in duplicate evaluated quality and abstracted information on learners, instructional design (curricular integration, distributing training over multiple days, feedback, mastery learning, and repetitive practice), and outcomes. We coded skills (performance in a test setting) separately for time, process, and product measures, and similarly classified patient care behaviors. From a pool of 10,903 articles, we identified 609 eligible studies enrolling 35,226 trainees. Of these, 137 were randomized studies, 67 were nonrandomized studies with 2 or more groups, and 405 used a single-group pretest-posttest design. We pooled effect sizes using random effects. Heterogeneity was large (I(2)>50%) in all main analyses. In comparison with no intervention, pooled effect sizes were 1.20 (95% CI, 1.04-1.35) for knowledge outcomes (n = 118 studies), 1.14 (95% CI, 1.03-1.25) for time skills (n = 210), 1.09 (95% CI, 1.03-1.16) for process skills (n = 426), 1.18 (95% CI, 0.98-1.37) for product skills (n = 54), 0.79 (95% CI, 0.47-1.10) for time behaviors (n = 20), 0.81 (95% CI, 0.66-0.96) for other behaviors (n = 50), and 0.50 (95% CI, 0.34-0.66) for direct effects on patients (n = 32). Subgroup analyses revealed no consistent statistically significant interactions between simulation training and instructional design features or study quality. In comparison with no intervention, technology-enhanced simulation training in health professions education is consistently associated with large effects for outcomes of knowledge, skills, and behaviors and moderate effects for patient-related outcomes.
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            Association between funding and quality of published medical education research.

            Methodological shortcomings in medical education research are often attributed to insufficient funding, yet an association between funding and study quality has not been established. To develop and evaluate an instrument for measuring the quality of education research studies and to assess the relationship between funding and study quality. Internal consistency, interrater and intrarater reliability, and criterion validity were determined for a 10-item medical education research study quality instrument (MERSQI). This was applied to 210 medical education research studies published in 13 peer-reviewed journals between September 1, 2002, and December 31, 2003. The amount of funding obtained per study and the publication record of the first author were determined by survey. Study quality as measured by the MERSQI (potential maximum total score, 18; maximum domain score, 3), amount of funding per study, and previous publications by the first author. The mean MERSQI score was 9.95 (SD, 2.34; range, 5-16). Mean domain scores were highest for data analysis (2.58) and lowest for validity (0.69). Intraclass correlation coefficient ranges for interrater and intrarater reliability were 0.72 to 0.98 and 0.78 to 0.998, respectively. Total MERSQI scores were associated with expert quality ratings (Spearman rho, 0.73; 95% confidence interval [CI], 0.56-0.84; P < .001), 3-year citation rate (0.8 increase in score per 10 citations; 95% CI, 0.03-1.30; P = .003), and journal impact factor (1.0 increase in score per 6-unit increase in impact factor; 95% CI, 0.34-1.56; P = .003). In multivariate analysis, MERSQI scores were independently associated with study funding of $20 000 or more (0.95 increase in score; 95% CI, 0.22-1.86; P = .045) and previous medical education publications by the first author (1.07 increase in score per 20 publications; 95% CI, 0.15-2.23; P = .047). The quality of published medical education research is associated with study funding.
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              Student barriers to online learning: A factor analytic study

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                Author and article information

                Journal
                Med Educ Online
                Med Educ Online
                ZMEO
                zmeo20
                Medical Education Online
                Taylor & Francis
                1087-2981
                2019
                17 September 2019
                : 24
                : 1
                : 1666538
                Affiliations
                [a ]Institute of Basic Education Science, Beijing Academy of Educational Sciences , Beijing, China
                [b ]Institute of Medical Education/National center for Health Professions Education Development, Peking University , Beijing, China
                Author notes
                CONTACT Hongbin Wu wuhongbin@ 123456pku.edu.cn Institute of Medical Education/National Center of Health Professions Education Development, Peking University , Beijing 100191, China
                Article
                1666538
                10.1080/10872981.2019.1666538
                6758693
                31526248
                cf1b50ee-cbdd-43aa-9020-92f683e4413c
                © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 March 2019
                : 25 May 2019
                : 05 September 2019
                Page count
                Figures: 7, Tables: 3, References: 45, Pages: 14
                Funding
                Funded by: Peking University 10.13039/501100007937
                Award ID: BMU2017YB005
                This work is funded by a ‘Double First Class’ Discipline Construction in Peking University (BMU2017YB005); Peking University [BMU2017YB005].
                Categories
                Research Article

                Education
                online learning,offline learning,systematic review,meta-analysis,undergraduate medical education (ume)

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