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Int J Nurs Stud. 2020 Apr;104:103512. doi: 10.1016/j.ijnurstu.2019.103512. Epub 2019 Dec 26.

Digital health professions education on chronic wound management: A systematic review.

Author information

1
Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore. Electronic address: mart0020@e.ntu.edu.sg.
2
Laboratory of Molecular and Vascular Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Level 3, Singapore 636921, Singapore. Electronic address: NATA0041@e.ntu.edu.sg.
3
Laboratory of Muscle and Cardiac Biophysics, Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Level 3, Singapore 636921, Singapore. Electronic address: KAST0008@e.ntu.edu.sg.
4
Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Institute of Health and Biomedical Innovation, Queensland University of Technology, 149 Victoria Park Rd, Kelvin Grove, Queensland 4059, Australia.
5
Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore. Electronic address: bhone.mk@ntu.edu.sg.
6
Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road Level 18, Singapore 308232, Singapore; Department of Primary Care and Public Health, School of Public Health, Imperial College London, The Reynolds Building, St Dunstan's Road, London W6 8RP, UK. Electronic address: lorainne.tudor.car@ntu.edu.sg.

Abstract

BACKGROUND:

Continuing education is crucial for healthcare professionals to keep up with research but attending classroom lectures is a major barrier. Chronic wound management is increasingly relevant for continuous professional training. Digital education offers learning tailored to individual needs and could be an effective alternative to healthcare professionals' training. However, the effectiveness of digital education for chronic wound management training has not been explored.

OBJECTIVES:

To assess the effectiveness of digital education in improving healthcare professionals' knowledge, attitudes, practical skills and behaviour change on chronic wound management, and their satisfaction with the intervention.

DESIGN:

This systematic review follows Cochrane methodology and is one of a series of reviews on the use of digital education for health professions education. Protocol registration: PROSPERO CRD42018109971 DATA SOURCES: Searches were conducted in MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses Database.

REVIEW METHODS:

We included randomised control trials, cluster randomised control trials and quasi-randomised control trials comparing digital or blended education with traditional learning, no intervention or other forms of digital or blended education for pre- or post-registration healthcare professionals in chronic wound management. A narrative summary of findings is presented.

RESULTS:

Seven studies (1,404 participants) were included. All studies investigated interventions for nursing students or professionals working in hospitals or community settings, and all but one study focused on pressure ulcers. Five studies (935 participants) assessed post-intervention knowledge, and indicated that digital education was more effective than no intervention, while blended learning was superior to exclusive digital education. Three studies (543 participants) assessed post-intervention skills and reported mixed results. One study (140 participants) compared post-intervention behaviour change and satisfaction with blended and online digital education, and reported no difference in behaviour between the groups, and higher satisfaction with blended education. For knowledge retention up to six months, digital education was more effective than no intervention, while blended learning was superior to digital education. The risk of bias in included studies was mostly high or unclear.

CONCLUSIONS:

Digital education on chronic wound management appears to be less effective than blended education and more effective than no intervention in improving knowledge among nurses and nursing students. Data for other outcomes is scarce and inconclusive. Future studies should assess participants' skills, attitudes, satisfaction and behaviour change; cost-effectiveness and potential untoward effects of digital education, compare digital education to other learning modalities and include other healthcare professionals in diverse clinical settings.

KEYWORDS:

Chronic wounds; Continuous medical education; Digital education; E-learning; Healthcare professionals; Nurses; Pressure ulcers; Systematic review; Venous leg ulcers

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