Exploring the use of asynchronous online discussion in health care education: A literature review
Section snippets
Introduction & background
Several systematic reviews on e-learning for the health professions show that it is just as effective as classroom learning (e.g. Cook et al., 2008, Lewis et al., 2005). The question now is to ascertain which components of e-learning can lead to greater effectiveness. Cook et al. (2010a) have succeeded in this quest to some extent with a systematic review comparing different e-learning methods for health professionals. They concluded that the most effective are those that include interactivity,
Methods
Although the gold standard for reviews is to consider only randomised controlled trials (RCTs), these appear to be rare within educational research. It is difficult to undertake RCTs in education due to both practical and ethical issues, particularly meeting student expectations/demands (Campbell, Gibsen, Hall, Richards, & Callery, 2008). Therefore, this present review includes quasi-experimental studies as well as all types of qualitative research and mixed method studies.
Results
The 14 selected studies consisted of six qualitative, five quantitative (four quasi-experimental and one observational) and three using a mixed methods approach. They were found from a wide variety of sources mostly from the US, UK and Canada. Seven (50%) were focused on practicing professionals, and seven focused on undergraduates of which four were on practice placement. There was an even mix of nursing (5) medical (5) and other health professions (6).
Discussion
All studies in the review had positive outcomes in terms of demonstrating learning through AOD, although they were all were small except for Plack et al.'s (2008) study. All the quantitative results relevant to the review research question were significant except for Markewitz's (2007) study.
The majority of studies in this review (12/14) used e-moderated AOD, all with positive learning outcomes of varying degrees. At first, this appears to be a similar result to Johnson's review,6
Conclusion
Many factors/options have emerged that may have an effect on learning (Table 4) but the heterogeneity of study design, type of intervention and measure of learning, makes it difficult to generalise these findings. Whilst the overall results are positive, the lack of controls (i.e. AOD without the intervention) and the general small increases in learning mean that the results in terms of effectiveness are not particularly robust. However, there are numerous implications for future research,
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