Study finds that eLearning is likely as effective as traditional methods for training health professionals, but barriers to adoption remain.

Students learn as well or better through eLearning than they do through traditional teaching, according to a report released last month by the Imperial College of London. Commissioned by the WHO, the report provides extensive evidence to guide the adoption of innovative, technology-enabled models into health professional education.

eLearning, the use of electronic media and devices in education, is already used by some universities to support traditional campus-based teaching or enable distance learning. The report concludes that eLearning is likely to be as effective as traditional methods for training health professionals.

Wider use of eLearning might help address the need to train more health workers across the globe. According to a 2013 WHO report, the world is short 7.2 million healthcare professionals, and the figure is growing.

The WHO estimates that by 2030, there will be a shortage of 12.9 million health workers globally. Of the countries with shortages, 36 of the 57 are in Africa.

This shortage of health professionals limits the number of teachers and lecturers for different aspects of health professional education, from bedside teaching to health science education. Health professional educational institutions worldwide are thus seeking to innovate in order to increase the accessibility of their courses and make the most of the limited teaching pool.

Dr. Josip Car, from the School of Public Health at Imperial College London said:

"eLearning programs could potentially help address the shortage of healthcare workers by enabling greater access to education, especially in the developing world where the need for more health professionals is greatest.”

eLearning Offers Increased Flexibility and Accessibility, but Can Be More Isolating and Time Consuming than Traditional Learning

The Imperial team, led by Dr. Car, carried out a systematic review of the scientific literature to evaluate the effectiveness of eLearning for undergraduate health professional education. Dr. Car and colleagues reviewed 108 studies, conducting separate analyses for online learning that required an Internet connection, offline computer-based learning delivered using CD-ROMs or USB sticks, and a combination of online and offline learning.

The most common advantages of eLearning cited in the literature review were:

  • Increased accessibility and flexibility
  • Improved student-teacher contact (especially outside of traditional office hours)
  • Personalized learning
  • Increased discussions with peers
  • Lower costs

Online, self-paced learning was thought to encourage a deeper understanding of the material, as online learners are active participants rather than passive recipients of knowledge. Computerized learning also allows non-traditional students to participate when and where it is convenient for them, whether they live on a rural farm and commuting is an issue, or are raising a family.

The most common disadvantages of eLearning, according to the literature review, are that it can:

  • Be more time consuming
  • Lead to feelings of isolation
  • Lack in-depth discussion
  • Inhibit students from gaining interpersonal communication skills without group meetings and face-to-face interactions.

Students indicated a preference for face-to-face discussions with their professors and tutors if they had questions about assignments or course materials.

The authors suggest that combining eLearning with traditional teaching might be more suitable for healthcare training than courses that rely fully on eLearning because of the need to acquire practical skills. Students felt that eLearning was a useful supplement rather that a replacement for traditional education settings.

Barriers to Adoption

The development of eLearning courses, like all disruptive innovation, does not happen in a bubble. There are cultural, political, social, and economic considerations—such as the availability of computers and broadband connectivity.

“There are still barriers that need to be overcome, such as access to computers, internet connections, and learning resources, and this could be helped by facilitating investments in ICT,” according to Dr. Car. “Universities should encourage the development of eLearning curricula and use online resources to reach out to students internationally."

The successful implementation of an eLearning curriculum necessitates that both teachers and students have the hardware and software to run the programs. Additionally, eLearning requires faculty engagement, professional development, and student training. Perhaps most difficult in remote areas and developing countries is finding secure, high speed Internet access.

The Imperial review discusses the slow adoption of computerized teaching in nursing programs in Brazil compared to North America, and the importance of government policy in the adoption of interventions.

Dr. Rifat Atun, from Harvard University’s School of Health, and a visiting professor at the Imperial College of London said:

“Even when there is evidence on the benefits of an intervention, the prevailing political economy and socio-cultural norms will influence the desirability of the adoption and assimilation of the intervention.”

Jenn Lonzer has a B.A. in English from Cleveland State University and an M.A. in Health Communication from Johns Hopkins University. Passionate about access to care and social justice issues, Jenn writes on global digital health developments, research, and trends. Follow Jenn on Twitter @jnnprater3.