Mobile Digital Education for Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

Background: There is a pressing need to implement efficient and
cost-effective training to address the worldwide shortage of health
professionals. Mobile digital education (mLearning) has been mooted
as a potential solution to increase the delivery of health
professions education as it offers the opportunity for wide access
at low cost and flexibility with the portability of mobile devices.
To better inform policy making, we need to determine the
effectiveness of mLearning. Objective: The primary objective of
this review was to evaluate the effectiveness of mLearning
interventions for delivering health professions education in terms
of learners’ knowledge, skills, attitudes, and satisfaction.
Methods: We performed a systematic review of the effectiveness of
mLearning in health professions education using standard Cochrane
methodology. We searched 7 major bibliographic databases from
January 1990 to August 2017 and included randomized controlled
trials (RCTs) or cluster RCTs. Results: A total of 29 studies,
including 3175 learners, met the inclusion criteria. A total of 25
studies were RCTs and 4 were cluster RCTs. Interventions comprised
tablet or smartphone apps, personal digital assistants, basic
mobile phones, iPods, and Moving Picture Experts Group-1 audio
layer 3 player devices to deliver learning content. A total of 20
studies assessed knowledge (n=2469) and compared mLearning or
blended learning to traditional learning or another form of digital
education. The pooled estimate of studies favored mLearning over
traditional learning for knowledge (standardized mean difference
[SMD]=0.43, 95% CI 0.05-0.80, N=11 studies, low-quality evidence).
There was no difference between blended learning and traditional
learning for knowledge (SMD=0.20, 95% CI –0.47 to 0.86, N=6
studies, low-quality evidence). A total of 14 studies assessed
skills (n=1097) and compared mLearning or blended learning to
traditional learning or another form of digital education. The
pooled estimate of studies favored mLearning (SMD=1.12, 95% CI
0.56-1.69, N=5 studies, moderate quality evidence) and blended
learning (SMD=1.06, 95% CI 0.09-2.03, N=7 studies, low-quality
evidence) over traditional learning for skills. A total of 5 and 4
studies assessed attitudes (n=440) and satisfaction (n=327),
respectively, with inconclusive findings reported for each outcome.
The risk of bias was judged as high in 16 studies. Conclusions: The
evidence base suggests that mLearning is as effective as
traditional learning or possibly more so. Although acknowledging
the heterogeneity among the studies, this synthesis provides
encouraging early evidence to strengthen efforts aimed at expanding
health professions education using mobile devices in order to help
tackle the global shortage of health professionals.

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Mobile Digital Education for Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration