From: Effective in-service training design and delivery: evidence from an integrative literature review
Citation | Study design | Participants | Intervention | Key findings |
---|---|---|---|---|
Aki E et al. 2010 | Systematic review: five articles reviewed to determine the effectiveness of educational gaming on learning | Mostly medical students | Technique: educational games | Findings in three of the five RCTs suggested but did not confirm a positive effect of the games on medical students’ knowledge. |
Media: multiple | ||||
Frequency: NR | ||||
Blaya J et al. 2010 | Systematic review: 45 articles included for review, only three related to POC support, included qualitative and quantitative data | Nurses in developing countries | Technique: didactic vs POC | POC findings: studies were weak but indicated knowledge improved and increased rapport in trusting personal judgment. |
Media: computer-based vs live | ||||
Frequency: NR | ||||
Bruppacher H et al. 2010 | Prospective, single-blinded RCT to determine if simulation or interactive techniques are better for teaching weaning a patient from anaesthesia | Anaesthesiology trainees, post-graduate year 4 | Technique: simulation vs interactive | The simulation group scored significantly higher than the seminar group at both post-test and retention test. Clinical decision-making/psychomotor skills can be acquired via simulation. |
I = 10, C = 10 | Media: live | |||
Country: China | Frequency: single | |||
Intervention group received simulation-based training; control group received an interactive seminar. | ||||
Daniels K et al. 2010 | Prospective RCT to determine if simulation is more effective than didactic in obstetric emergency management | Residents and labour and delivery nurses | Technique: simulation vs interactive | Simulation-trained teams had superior performance scores when tested in a labour and delivery drill. In an academic training programme, didactic and simulation-trained groups showed equal results on written test scores. |
I = 16, C = 16 | Media: live | |||
Country: USA | Frequency: single | |||
Intervention group received simulation-based training; control group received an interactive seminar. | ||||
De Lorenzo R and Abbott C 2004 | RCT to determine if the adult learning model improves student learning in terms of cognitive performance and perception of proficiency in military medic training | Army medic students | Technique: interactive vs didactic | The adult learning model offered only a modest improvement in cognitive evaluation scores over traditional teaching. Additionally, students in the traditional teaching model assessed themselves as proficient more frequently than instructors, whereas instructor and student perception of proficiency were more closely matched in the adult learning model. |
n = 150, I = 81, C = 69 | Media: live | |||
Country: USA | Frequency: single | |||
Intervention group emphasized the principles of adult learning including small group interactive approach, self-directed study, multimedia didactics and intensive integrated practice of psychomotor skills; control group received a traditional, lecture-based course. | ||||
Harder BN 2010 | Systematic review: 23 articles reviewed to evaluate the use of clinical simulation in health care education | Health professionals | Technique: simulation | Inconclusive evidence about the use of simulation due to a low number of studies. However, the use of simulation, as opposed to other education and training methods (motor skills laboratory sessions with task trainers, computer-based instruction and lecture classes), increased students’ clinical skills in the majority of studies. |
Media: multiple | ||||
Frequency: single | ||||
Herbert C et al. 2004 | RCT to assess the impact of individualized feedback and live, interactive group education on prescriptive practices | Physicians | Technique: audit and feedback vs interactive plus audit and feedback vs interactive session only vs nothing | Increase in prescribing preference for correct drug class in module and “prescribing portraits” (graphic comparisons between individual, group and evidence based prescribing practices) group. Evidence-based educational interventions combining personalized prescribing feedback with interactive group discussion can lead to modest but meaningful changes in physician prescribing. |
I1 = 48, audit and feedback only; I2 = 47, interactive module only; I3 = 49, interactive plus audit and feedback; C = 56, nothing | Media: live | |||
4,394 charts reviewed | Frequency: single | |||
Country: Canada | ||||
Issenberg S et al. 2005 | Systematic review: 109 studies reviewed to determine the use of high-fidelity medical simulations that lead to most effective learning | Health professionals | Technique: simulation | The weight of the best available evidence suggests that high-fidelity medical simulations facilitate learning under the right conditions. These conditions include: providing feedback, repetitive practice, curriculum integration, range of difficulty, multiple learning strategies, capture clinical variation, controlled environment, individualized learning, defined outcomes and simulator validity. |
Media: multiple | ||||
Frequency: both single and multiple | ||||
Lamb D 2007 | Literature review: nine articles reviewed to determine effectiveness of experiential (focused on simulations) learning | Health professionals | Technique: simulation | None of the studies showed conclusively that simulated learning improves patient outcome; however, evidence suggests human patient simulators to be advantageous over other modalities. They have been proven to be at least as effective as traditional teaching by didactic methods. Both human patient simulators (models) and computer-simulations may be effective. |
Media: multiple | ||||
Frequency: both single and multiple | ||||
Laprise R et al. 2009 | Cluster randomized trial of 122 general practitioners to determine if chart audits and feedback reminders after a CME event lead to better adherence to clinical guidelines | General practitioners | Technique: audit and feedback plus interactive vs interactive only | This study demonstrated significantly improved adherence in the intervention group using chart audits vs CME alone. The magnitude of the difference observed between the two groups in absolute pre-post intervention change is consistent with previous studies on the effectiveness of chart prompting in preventive care. |
n = 122, I = 61, C = 61 | Media: live | |||
Chart audit of 2,344 consenting patient charts | Frequency: single vs multiple | |||
Country: Canada | Intervention group and control group received the same CME intervention, a 2-hour live, interactive workshop. The intervention group also received six monthly follow-up visits from a nurse that included chart screening, audits and feedback, and a print-based checklist distribution and print summary of expert recommendations. | |||
Lin C et al. 2010 | RCT to determine if peer-tutored, PBL is preferable to didactic-based instruction for teaching nursing ethics | Nursing students | Technique: PBL vs didactic | Peer-tutored, PBL was shown to be more effective than conventional lecture-type teaching. Peer-tutored, PBL has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints. |
I = 72, C = 70 | Media: live | |||
Country: Taiwan | Frequency: single | |||
Intervention group received PBL technique; control group received didactic-based instruction. | ||||
McGaghie W et al. 2009a | Systematic review: nine of the JHU EPC systematic review articles reviewed to determine the effectiveness of simulation methods in medical education outside of CME | Health professionals | Technique: simulation | Due to a low number of studies, evidence on simulation methods is inconclusive. However, the direction of evidence points to the effectiveness of simulation training, especially for psychomotor and communication skills. Data analysis revealed a highly significant 'dose-response’ relationship among practice and achievement, with more practice producing higher outcome gains. |
Media: multiple | ||||
Frequency: both single and multiple | ||||
Merien A et al. 2010 | Systematic review: eight articles reviewed to determine the effectiveness of team-based training for obstetric care | Health professionals | Technique: team-based | Due to a low number of studies, evidence on teamwork training in simulation is inconclusive. However, introduction of multidisciplinary teamwork training with integrated acute obstetric training interventions in a simulation setting is potentially effective in the prevention of errors, thus improving patient safety in acute obstetric emergencies. |
Media: live | ||||
Frequency: NR | ||||
Murad MH et al. 2010 | Systematic review: 59 articles (enrolled 8,011 learners) reviewed to determine effectiveness of self-directed learning | Health professionals | Technique: self-directed | Moderate-quality evidence suggests that self-directed learning in health professions education is associated with moderate improvement in the knowledge domain compared with traditional teaching methods, and may be as effective in the skills and attitudes domains. |
Media: multiple | ||||
Frequency: NR | ||||
Perry M et al. 2011 | Systematic review: six articles representing five studies were reviewed to determine the effect of educational interventions in primary dementia care | Health professionals | Technique: multiple | Interactive workshops and decision support systems led to increased detection rates. Evidence shows moderate improvements in knowledge and techniques that required active participation tended to improve detection rates. |
Media: multiple | ||||
Frequency: both single and multiple | ||||
Reynolds A et al. 2010 | RCT to compare students’ knowledge using either simulation or didactic lecture | Midwifery students | Technique: simulation vs didactic | A significantly higher short-term reinforcement of knowledge and greater learner satisfaction was obtained using simulation-based training compared to image-based lectures when teaching routine management of normal delivery and resolution of shoulder dystocia to midwives in training. |
I = 26, C = 24 | Media: live | |||
Country: Portugal | Frequency: single | |||
Intervention group received simulation-based training; control group received didactic lectures with print visuals. | ||||
Smits P et al. 2003 | RCT to compare effectiveness of PBL vs didactic for management of mental health problems | Post-graduate medical trainees | Technique: PBL vs didactic | The study found that both PBL and didactic-based instruction were effective, but had no statistical difference. The PBL programme appeared to be more effective than the lecture-based programme in improving performance, but received less favourable evaluations. |
I = 59, C = 59 | Media: live | |||
Country: the Netherlands | Frequency: single | |||
Intervention group received PBL technique; control group received didactic-based instruction. | ||||
Steadman R et al. 2006 | RCT to determine if simulation is better than PBL for teaching assessment and management skills | 4th year medical students | Technique: simulation vs PBL | Simulation-based teaching was superior to PBL for the acquisition of critical assessment and management skills. |
I = 15, C = 16 | Media: live | |||
Country: USA | Frequency: single | |||
Intervention group received simulation-based teaching; control group received PBL. | ||||
Sturm L et al. 2008 | Systematic review: 11 articles reviewed to determine if skills acquired by simulation-based training transfer to the operative setting | Surgeons | Technique: simulation | Due to limited quality and methodology and a lack of relevant studies, a weak conclusion can be made supporting the transfer of skills developed in simulation to the operative setting. Evidence from one study showed better performance for participants who received simulation-based training before undergoing patient-based assessment than their counterparts who did not receive previous simulation training. |
Media: multiple | ||||
Frequency: both single and multiple | ||||
Werb S and Matear D 2004 | Systematic review: three systematic reviews and nine original research articles reviewed to examine evidence-based clinical teaching and faculty continuing education | Allied health professionals | Technique: PBL | PBL and evidence-based health care interventions were effective in increasing students’ knowledge of medical topics and their ability to search, evaluate and appraise medical literature. Dental students in a PBL curriculum, emphasizing evidence-based practices, scored higher on the National Dentistry Boards, Part I, than students in traditional curricula. |
Media: multiple | ||||
Frequency: both single and multiple | ||||
White M et al. 2004 | RCT to investigate effectiveness of PBL vs didactic for asthma management | Physicians | Technique: PBL vs didactic | There was no significant difference in knowledge gained or satisfaction with the facilitator between the PBL group and the lecture-based group. The PBL group rated the educational value higher than the didactic group. |
I = 23, C = 29 | Media: live | |||
Country: Canada | Frequency: single | |||
Intervention group received PBL technique; control group received didactic-based instruction. | ||||
Young J and Ward J 2002 | Randomized trial to determine the effect of self-directed (distance) learning on knowledge, attitudes and practices related to smoking cessation | Family physicians | Technique: self-directed vs reading | Modest changes from baseline to post-test for both the distance learning group and self-directed group suggest a lack of significant evidence to support a distance or self-directed approach to address changes in practice. |
I = 26, C = 27 | Media: print | |||
Country: Australia | Frequency: single | |||
Intervention group received a self-directed learning module; control group received guidelines only. | ||||
Yuan H et al. 2008 | Systematic review: 10 studies reviewed to determine the evidence to support PBL | Nursing students | Technique: PBL | Inconclusive evidence to support PBL. While several studies showed increased reported self-confidence in ability to make decisions, and several showed increased skills in critical thinking questions from the PBL group, overall findings were inconclusive due to a lack of quality studies. |
Media: multiple | ||||
Frequency: both single and multiple | ||||
Zurovac D et al. 2011 | Cluster RCT at 107 rural health facilities to determine if text-message reminders would improve provider adherence to national malaria treatment guidelines | Health professionals | Technique: reminders | The use of mobile technology showed significant improvement in case management practice for paediatric malaria cases among physicians with repetitive text-message reminders compared to control group. |
119 health workers | Media: mobile phone | |||
Case-management practices were assessed for 2,269 children who needed treatment | Frequency: repetitive | |||
I = 1,157, C = 1,112 | Intervention group received repetitive text messages over a 6-month period; control group received nothing. | |||
Country: Kenya |