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eLearning for health professionals: how effective is it?

6 February 2015

eLearning for health professionals: how effective is it?

We increasingly rely on technology in our everyday lives; computers, emails, iPads, smart phones, Sat Navs…a whole host of devices that 20 years ago we functioned perfectly well without, and now most of us could barely go a day without them. It was only a matter of time, then, that we started to receive our education in the same fashion – and it’s no bad thing, as a new report has found.

Recent figures released by the World Health Organisation (WHO) have revealed that the world is short of 7.2 million healthcare professionals, and that figure is growing. According to WHO, a shortage of qualified health workers in rural areas is common in both developed and developing countries, and in most developing countries, more than half of their populations live in rural areas. Globally, rural areas are served by only 38 per cent of the total nursing workforce and by less than 25 per cent of the total physician workforce.

WHO says that countries with lower relative need have the highest numbers of health workers, while those with the greatest burden of disease have a much smaller health workforce. The health worker crisis is at its worst in sub–Saharan Africa and Asia. Studies have shown that countries in this region are facing a double burden of both infectious and non–communicable diseases, and they lack the funds, technology, infrastructure and trained health workers needed to provide basic health care service.

To address this shortage, eLearning is increasingly being adopted in health professionals’ education. eLearning can be entirely driven by technology, or be a mix of the traditional and fully computer–based methodologies (blended learning). Many universities use it to support traditional campus-based teaching or enable distance learning, and dental professionals don’t need to look far to find online courses and webinars for that all-important CPD.

The benefits of eLearning are numerous; it can work around your schedule (perfect for those who wish to continue working while getting their education); you can learn at your own pace with the ability to stop, pause and rewind when you didn’t catch what was said or didn’t fully understand it; and you can do it all whilst sat at home in your pyjamas. But is it effective and can you receive as good an education as you would in a traditional setting?

One new report has looked into just that – the effectiveness of eLearning for undergraduate health professional education – and actually found that students acquire knowledge and skills through eLearning as well as or better than they do through traditional teaching. This result may or may not surprise you, depending on your view of technology (are you a lover or a hater?), but it does have big implications for how health professionals learn across the globe, and could mean an end to this shortage. After all, if what is holding somebody back from becoming a health professional is location, time and needing to continue to work while they learn, then these obstacles are soon eradicated with eLearning. This is especially true in the developing world where the need for more health professionals is greatest.

Commissioned by WHO, the report involved a review carried out by a team of researchers at Imperial College London of 108 studies, to evaluate the effectiveness of eLearning for undergraduate health professional education, and to inform policy-making.

Fifty nine studies, including 6,750 students enrolled in medicine, dentistry, nursing, physical therapy and pharmacy studies, met the inclusion criteria.

In the review, the researchers found that 29 per cent of the studies showed significantly higher knowledge gains; 40 per cent of the studies showed significantly greater skill acquisition; 67 per cent of the studies showed no difference in attitude; and 14 per cent of the studies showed higher satisfaction with online eLearning than traditional learning.

Overall, the researchers say that the evidence from the studies indicates that eLearning is equivalent to and perhaps even more effective than traditional learning in terms of knowledge and skills gained.

The authors of the report told Smile-on News: “The findings of the report suggest that eLearning could be equivalent to traditional forms of learning in regard to knowledge and skill acquisition in health education. This information is crucial for policy makers and educators who are forming future education.

“eLearning allows learners to  address their own learning needs, offers ease of access and accessibility and can be particularly useful in remote geographical locations.”

So it works as a learning tool, but what about the cost? Quite often with technology comes expense, but this review has actually found that eLearning could result in significant cost-efficiency. Buzzell et al. (2002) mentioned that in the future many experts would be involved in content generation for their respective disciplines and that content could be shared online among their disciplines. Thus the online content development and delivery would not need the involvement of many faculty at all stages of content development and in turn educational institutions would be cost efficient. Stain et al. (2005) mentioned that the costs of setting up videoconferencing were comparable to the costs of live lectures after an initial hardware investment of less than US$10,000.

Stewart et al. (2011) cited a paper saying that reduction of instructor training time, labour costs and institutional infrastructure could result in significant cost–efficiency, while Toumas et al. (2009) mentioned that using the Internet leads to “reduced costs in terms of tutor–led workshops and is more efficient, enabling more complex topics to be covered in workshops”.

Dr Josip Car, from the School of Public Health at Imperial College London said:  “eLearning programmes could potentially help address the shortage of healthcare workers by enabling greater access to education, especially in the developing world the need for more health professionals is greatest.

“There are still barriers that need to be overcome, such as access to computers, internet connections, and learning resources, and this could be helped by facilitating investments in ICT. Universities should encourage the development of eLearning curricula and use online resources to reach out to students internationally.”

The authors suggest that combining eLearning with traditional teaching might be more suitable for healthcare training than courses that rely fully on eLearning because of the need to acquire practical skills. Also, some studies in the report found that eLearning is associated with feelings of isolation, a lack of student-teacher interaction and that it sometimes results in the lack of in-depth discussion.

The authors say that on the back of this report, policy makers should encourage adoption and the development of eLearning programs, as they could be useful in training health care professionals in countries with acute health care worker shortage, without substantial investments. They also say that although implementing these technologies would involve some initial start-up cost, the potential for the return on investment is high in terms of health gains and lives saved.

To view the report, click here. To find out more about Healthcare Learning: Smile-on's range of eLearning for healthcare professionals, click here.


Buzzell PR, Chamberlain VM, Pintauro SJ. The effectiveness of web–based, multimedia tutorials for teaching methods of human body composition analysis. Adv Physiol Educ. 2002;26:21-9. Medline:11850324

Stain SC, Mitchell M, Belue R, Mosley V, Wherry S, Adams CZ, et al. Objective assessment of videoconferenced lectures in a surgical clerkship. Am J Surg. 2005;189:81-4. Medline:15701498 doi:10.1016/j.amjsurg.2004.04.012

Stewart A, Inglis G, Jardine L, Koorts P, Davies MW. A randomised controlled trial of blended learning to improve the newborn examination skills of medical students. Arch Dis Child Fetal Neonatal Ed. 2013;98:F141-4. Medline:22684155 doi:10.1136/archdischild-2011-301252

Toumas M, Basheti IA, Bosnic–Anticevich SZ. Comparison of small–group training with self–directed internet–based training in inhaler techniques. Am J Pharm Educ. 2009;73:85. Medline:19777100 doi:10.5688/aj730585


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