SynthesisBMJ open2019
Efficacy of adaptive e-learning for health professionals and students: a systematic review and meta-analysis.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
65 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Motivation Theories and Constructs in Experimental Studies of Online Instruction: Systematic Review and Directed Content Analysis.JMIR medical education · 2025Pooled it
- Effects of implementation strategies on nursing practice and patient outcomes: a comprehensive systematic review and meta-analysis.Implementation science : IS · 2024Pooled it
- Learning Outcomes of e-Learning in Psychotherapy Training and Comparison With Conventional Training Methods: Systematic Review.Journal of medical Internet research · 2024Pooled it
- What works in radiology education for medical students: a systematic review and meta-analysis.BMC medical education · 2024Pooled it
- Evidence for continuing professional development standards for regulated health practitioners in Australia: a systematic review.Human resources for health · 2023Pooled it
- A Meta-Analysis of the Effect of Paper Versus Digital Reading on Reading Comprehension in Health Professional Education.American journal of pharmaceutical education · 2021Pooled it
- Effectiveness of blended learning in pharmacy education: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Preparing for obstetric anaesthesia-An educational randomised controlled trial comparing e-learning to written course material.Acta anaesthesiologica Scandinavica · 2023Trial
- Effectiveness of Life Goal Framing to Motivate Medical Students During Online Learning: A Randomized Controlled Trial.Perspectives on medical education · 2023Trial
- Evaluation of Adaptive Feedback in a Smartphone-Based Game on Health Care Providers' Learning Gain: Randomized Controlled Trial.Journal of medical Internet research · 2020Trial
- Web-Based Physiotherapy Resources for Bronchiectasis: Evaluation of Content, Quality, and Implementation Evidence.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2026Article
- Attitudes Toward and Preconditions for Digital Game-Based Learning Among Public Health and Health Sciences Students: Cross-Sectional Online Survey Study.JMIR medical education · 2026Article
- Train-the-Trainer Evaluation of Technology-Enhanced Learning in Preservice Midwifery Education in Nigeria: Qualitative Descriptive Study.JMIR nursing · 2026Article
- Understanding implementation contexts and determinants of e-learning for global health security competency-based training in LMICs.npj health systems · 2026Article
- AI Methods for Implementation Science (AIM-IS): developing a framework, toolkit, and reporting standard for the responsible use of AI in implementation practice and research.Implementation science : IS · 2026Article
- Developing occupational therapy and physiotherapy clinical support workers in their role in supporting student education.The British journal of occupational therapy · 2026Article
- Variability-Adaptive IV insertion training with dual haptic feedback in mixed reality.Medical & biological engineering & computing · 2026Article
- Advancing Healthcare Provision to Autistic Clients: A Systematic Review of Autism Focused Digitally Delivered Professional Education Programs (DDPE) for the Health Workforce.Journal of autism and developmental disorders · 2026Article
- Facilitators and Barriers to Adoption of Mobile Learning Technologies in Undergraduate Health Professional Education in Clinical Environments: A Scoping Review.Journal of medical systems · 2026Article
- Visual cueing and adaptive learning for teaching thyroid eye disease diagnostic assessment to ophthalmology residents.Frontiers in medicine · 2026Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectiveAlthough adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding the efficacy of AEEs in improving knowledge, skills and clinical behaviour in health professionals and students.
designSystematic review and meta-analysis. DATA SOURCES: CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science from the first year of records to February 2019. ELIGIBILITY CRITERIA: Controlled studies that evaluated the effect of an AEE on knowledge, skills or clinical behaviour in health professionals or students. SCREENING, DATA EXTRACTION AND SYNTHESIS: Two authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. AEEs were reviewed with regard to their topic, theoretical framework and adaptivity process. Studies were included in the meta-analysis if they had a non-adaptive e-learning environment control group and had no missing data. Effect sizes (ES) were pooled using a random effects model.
resultsFrom a pool of 10 569 articles, we included 21 eligible studies enrolling 3684 health professionals and students. Clinical topics were mostly related to diagnostic testing, theoretical frameworks were varied and the adaptivity process was characterised by five subdomains: method, goals, timing, factors and types. The pooled ES was 0.70 for knowledge (95% CI -0.08 to 1.49; p.08) and 1.19 for skills (95% CI 0.59 to 1.79; p<0.00001). Risk of bias was generally high. Heterogeneity was large in all analyses.
conclusionsAEEs appear particularly effective in improving skills in health professionals and students. The adaptivity process within AEEs may be more beneficial for learning skills rather than factual knowledge, which generates less cognitive load. Future research should report more clearly on the design and adaptivity process of AEEs, and target higher-level outcomes, such as clinical behaviour. PROSPERO REGISTRATION NUMBER: CRD42017065585.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.