Comparing the Effectiveness of Webinars and Participatory learning on essential newborn care (ENBC) in the class room in terms of acquisition of knowledge and skills of student nurses: a randomized controlled trial

Effectiveness synchronous e-learning in nursing education: A meta-analysis and subgroup analysis

AIM

This study aimed to identify the best available evidence of the effects of synchronous e-learning in nursing education through a meta-analysis and to compare mean effect sizes between study subgroups.

BACKGROUND

With the rapid development of synchronous e-learning, adequate preparation is essential, as the formulation of effective educational strategies is crucial for learners' success. However, rather than focusing solely on using technology to implement e-learning, instructors should design education programs that meet learning objectives while considering appropriate technologies and types of interactions.

DESIGN

A meta-analysis and a subgroup analysis were conducted.

METHODS

English and Chinese databases including PubMed, Embase, CINAHL, Web of Science, Cochrane Library and China National Knowledge Infrastructure were searched for relevant articles published between the inception of these databases through May 2023. The search included the establishment of these databases up until May 2023. Using a search strategy, we identified 3273 potentially relevant articles. Ten primary studies were included in the final analysis. We used random effect models to synthesize effect size (ES) and accommodate heterogeneity for the main effect. Sub-group analyses were conducted to analyze the variations in effect size to investigate possible causes of heterogeneity.

RESULTS

We found synchronous e-learning to be more effective compared with the control groups, with a pooled random-effects standardized mean difference of 0.51, which is a medium effect size. Regarding learning outcomes, the effect size of reactions to learning (ES = 0.91, confidence interval [CI] = 0.14, 1.67) was higher than that of the psychomotor domain (ES = 0.57, CI = 0.17, 0.98), cognitive domain (ES = 0.63, CI = 0.11, 1.15) and affective domain (ES = 0.40, CI = 0.03, 0.76). In terms of interaction types and study characteristics were more effective if the studies included learner-learner interaction (ES = 0.83, CI = 0.36, 1.29), developed regions (ES = 0.55, CI = 0.17, 0.94), undergraduate nursing students (ES = 0.56, CI = 0.32, 0.80), no randomization (ES = 0.75, CI = 0.40, 1.10) and funding support (ES = 0.78, CI = 0.41, 1.16).

CONCLUSIONS

Well-designed synchronous e-learning courses should consider learners' motivations and self-directed learning abilities by providing diverse learning resources and environments. Nurse educators should develop synchronous e-learning teaching strategies that include peer interaction. The affective domain of learning in synchronous e-learning needs to be developed and considered in future research.

Outcomes of Implementing a Webinar-Based Strategy to Improve Spinal Cord Injury Knowledge and Community Building: Convergent Mixed Methods Study

BACKGROUND

COVID-19 disrupted services received by persons with spinal cord injury (SCI) worldwide. The International Disability Alliance declared the need for a disability-inclusive response to the COVID-19 crisis, as decreased access to health care services for individuals living with varying levels of function was unacceptable. As a result, an SCI community in Canada created a novel webinar-based strategy aimed at improving access to self-management information for people living with SCI and other stakeholders. However, although telehealth practices have previously been used effectively in SCI management and rehabilitation, little to no scholarship has investigated the outcomes of implementing a webinar-based telehealth strategy in this population.

OBJECTIVE

This study aims to understand the outcomes of implementing the webinar series. Specifically, the authors aimed to determine the reach of the series; understand its impact on social connectedness, perceptions of disability, and overall quality of interactions among persons with SCI, their families, service providers, and the public at large; and explore the long-term sustainability of the initiative.

METHODS

The authors implemented a community-based participatory strategy to define a convergent mixed methods design to triangulate qualitative and quantitative data collected simultaneously. Quantitative methods included pop-up questions administered during the live webinars, surveys administered following webinars, and an analysis of YouTube analytics. Qualitative methods included semistructured interviews with persons with SCI and health care providers who attended at least one webinar. The results were integrated, following methods adapted from Creswell and Clark.

RESULTS

A total of 234 individuals attended at least 1 of the 6 webinars that took place during the 6-month study period. In total, 13.2% (31/234) of the participants completed the postwebinar survey, and 23% (7/31) participated in the semistructured interviews. The reach of the webinar series was mainly to persons with SCI, followed by health professionals, with most of them living in urban areas. The topics sexuality and research were the most viewed on YouTube. The knowledge disseminated during the webinars was mainly perceived as valid and useful, related to the fact that the presentation format involved people with lived experience and clinical experts. The webinars did not necessarily help build a new extended community of people involved in SCI but helped strengthen the existing community of people with SCI in Alberta. The webinar positively influenced the perceptions of normality and disability regarding people with SCI. The webinar format was perceived as highly usable and accessible.

CONCLUSIONS

The webinar series was associated with improved participant knowledge of what is possible to achieve after an SCI and their perceptions of disability. The long-term implementation of this initiative is feasible, but further considerations to increase its reach to rural areas and ensure the integration of diverse individuals should be taken.

Evaluating Evidences of Effectiveness in Web-Based Nursing Education Program

Background

Web-based education programs are essential in every field of learning, and in nursing coursework, they can contribute towards behavioral development. It is found that emerging approach of web-based nursing programs is overpowering the traditional education methods and provides flexibility in learning and training programs. Therefore, it is considered as a promising medium of learning which can take over the traditional methods because of its effectiveness.

Objective

A systematic review and meta-analysis was performed for analysis of efficiency and effectiveness of web-based nursing education. This study is aimed at evaluating the evidences which evaluate the effectiveness of the web-based nursing education programs. Material and Methods. Studies were selected from 2008 to 2020 available from various global databases like PubMed, Embase, CINAHL, ProQuest, and Cochrane Library.

Results

Five studies were selected for analysis where the results demonstrated no significant difference in the effectiveness of use of web-based nursing educational programs.

Conclusion

More evidences are required for supporting the efficiency and effectiveness of use of web-based programs for nursing education. Hence, more research is required for evaluating the length of nursing education, evaluating practice-based clinical aspects like success ratio for outcomes of study, type of patients handled, and severity of cases handled for better outcomes.

Comparative evaluation of webinar, powerpoint presentation and lecture as oral health educational interventions among school children: a randomized controlled trial

The study compared the effectiveness of three teaching methods on the oral health status of high school children. The study population of 791 school children selected from three different schools was randomly allocated to one of three intervention groups: (i) Webinar group (Online presentation)-260 subjects, (ii) Face to Face lecture using PowerPoint presentation (F2F PP group)-261 subjects and (iii) Control group (Only lecture)-270 subjects. Subjects from the Webinar group and F2F PP group received oral health education at an interval of 15 days starting from baseline. Subjects from the control group received oral health education only at baseline. Oral Hygiene Index (OHI) and Gingival Index (GI) were measured at baseline, at 1 month, 2 months' and 3 months' interval. OHI and GI showed a significant reduction (P = 0.001) in the Webinar group and F2F PP group; However, in the control group, OHI and GI reduced from baseline till second month and showed an increase at 3 months' interval. F2F PP group showed a maximum reduction in OHI and GI followed by the Webinar group. It can be concluded that F2F PowerPoint-based oral health education was most effective followed by the webinar method.

Synchronous distance education vs traditional education for health science students: A systematic review and meta-analysis

CONTEXT

Synchronous distance education (SDE) has been widely used for health science students in recent years. This study examined the effectiveness and acceptance of SDE compared with traditional education for health science students and explored the potential moderators that could impact the pooled results.

METHODS

A systematic review and meta-analysis was conducted of randomised controlled trials (RCTs) from January 2000 to March 2020 searched on nine electronic databases, including Web of Science, PubMed, Cochrane Library, Scopus, EMBASE, CINAHL, ERIC, PsycINFO, and ProQuest Dissertations and Theses. The outcomes measured were knowledge, skills with objective assessments and overall satisfaction with subjective evaluations. The pooled results were calculated using random-model effects, and moderators were explored through meta-regression.

RESULTS

A total of seven RCTs with 594 participants were included. At the post-test level, the pooled effect size of knowledge acquisitions (SMD 0.12, 95% CI -0.07-0.32) showed insignificant difference between the SDE and traditional education groups (P = .207), with low heterogeneity (I²  = 17.6%). Subgroup analyses observed no factors that significantly impacted the pooled results of knowledge acquisition at the post-test levels (P for interaction > 0.05). Knowledge gains from pretest to post-test in SDE groups also did not differ significantly between groups (SMD 0.15, 95% CI -0.22-0.53; P = .428). The pooled effect size of skills (SMD 0.02, 95% CI -0.24-0.28; P = .735) was similarly insignificant. The pooled effect size of overall satisfaction (SMD 0.60, 95% CI 0.38-0.83; P < .001) significantly favoured SDE over traditional education. Incorporating two-group studies without randomisations did not significantly change the overall results of knowledge acquisition at the post-test level (SMD -0.002, 95% CI -0.11-0.10; P = .994), with moderate heterogeneity (I²  = 61.9%).

CONCLUSIONS

Synchronous distance education was not significantly different from traditional education in effectiveness and had higher satisfaction ratings. Our findings might provide indications for adoptions of online remote education in health science education centres.

Multidisciplinary Tracheostomy Quality Improvement in the COVID-19 Pandemic: Building a Global Learning Community

OBJECTIVES

To report experience with a global multidisciplinary tracheostomy e-learning initiative.

METHODS

An international multidisciplinary panel of experts convened to build a virtual learning community for tracheostomy care, comprising a web-based platform, five distance learning (interactive webinar) sessions, and professional discourse over 12 months. Structured pre- and post-webinar surveys were disseminated to global participants including otolaryngologists, intensivists, nurses, allied health professionals, and patients/caregivers. Data were collected on audio-visual fidelity, demographics, and pre- and post-tutorial assessments regarding experience and skill acquisition. Participants reported confidence levels for NICU, pediatric, adult, and family care, as well as technical skills, communication, learning, assessment, and subdomains.

RESULTS

Participants from 197 institutions in 22 countries engaged in the virtual education platform, including otolaryngologists, speech pathologists, respiratory therapists, specialist nurses, patients, and caregivers. Significant improvements were reported in communication (P < .0001), clinical assessments (P < .0001), and clinical governance (P < .0001), with positive impact on pediatric decannulation (P = .0008), adult decannulation (P = .04), and quality improvement (P < .0001). Respondents reported enhanced readiness to integrate knowledge into practice. Barriers included time zones, internet bandwidth, and perceived difficulty of direct clinical translation of highly technical skills. Participants rated the implementation highly in terms of length, ability for discussion, satisfaction, applicability to professional practice, and expertise of discussants (median scores: 4, 4, 4, 4 and 5 out of 5).

CONCLUSIONS

Virtual learning has dominated the education landscape during COVID-19 pandemic, but few data are available on its effectiveness. This study demonstrated feasibility of virtual learning for disseminating best practices in tracheostomy, engaging a diverse, multidisciplinary audience. Learning of complex technical skills proved a hurdle, however, suggesting need for hands-on experience for technical mastery. While interactive videoconferencing via webinar affords an engaging and scalable strategy for sharing knowledge, further investigation is needed on clinical outcomes to define effective strategies for experiential online learning and virtual in-service simulations.

Evaluation of a multimodal teaching method on essential newborn care among health providers at a tertiary care hospital

Background

There is an unmet need for in-service training of health providers for essential new-born care. This study evaluated the ability of a multi-modal training workshop on new-born care to improve the knowledge and skills of health providers.

Methods

This was an intervention based pre-and post-study on 54 students who attended a two-day workshop on essential new-born care. The teaching used self-directed learning, demonstration, videos, webinars, podcasts, group discussion, role-play and individual feedback. Knowledge was assessed by a set of 25 peer-reviewed multiple-choice questions (MCQs), both pre-and post-test and skills by 3 peer-reviewed and validated objective structured clinical examination (OSCE) stations in the post-test period. Follow-up assessment after 10 months was also done for 30 students.

Results

There was a significant improvement in the knowledge scores on MCQs after the workshop [16.65 ± 1.84 vs 12 ± 2.98, mean difference 4.65, 95%CI (3.85 to 5.44); p value < 0.0001]. The skill scores assessed by the OSCE were 92.35%, 83.50% and 78.86% of the expected scores respectively with a composite OSCE stations score of 83.90% of the expected score (100%). Follow-up assessment after 10 months showed a significant decline in knowledge scores, though skill scores were retained.

Conclusion

An essential new-born care workshop using multi-modal teaching methods resulted in an improvement in knowledge and skill scores among a diverse mix of nurses and doctors. This model of learning was acceptable and can be adapted for future training of health providers. There is a need for regular refresher training to maintain knowledge and skills.

Combining bottleneck analysis and quality improvement as a novel methodology to improve the quality of neonatal care in a northeastern state of India: a feasibility study

Background

The State of Meghalaya, India, has some of the worst newborn health outcomes in the country. State health authorities commissioned an assessment of newborn service delivery to improve services. This study proposes bottleneck analysis (BNA) and quality improvement (QI) methods as a combined method to improve compliance with evidence-based neonatal interventions in newborn health facilities.

Methods

An adapted Every Newborn BNA tool was applied to collect data on barriers to providing quality care in five district hospitals. Subsequently, health workers were coached to use QI methodology to overcome identified bottlenecks. Data from QI projects were analysed using run charts.

Results

BNA revealed that interventions directed toward basic newborn care and special newborn care facilities needed attention. Facilities that undertook QI projects showed an improvement in neonates having early initiation of breastfeeding within the first hour of birth, from 64% to a peak of 94% in one facility and from 75% to 91% in another. Skin-to-skin contact increased from 49% to a peak of 78% and is sustained at 58%. Improved performance has been sustained in some facilities.

Conclusions

The combination of BNA and QI is a successful method for identifying and overcoming bottlenecks in newborn care in resource-limited settings.

Evaluating Web-Based Nursing Education's Effects: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis investigated whether using web-based nursing educational programs increases a participant's knowledge and clinical performance. We performed a meta-analysis of studies published between January 2000 and July 2016 and identified through RISS, CINAHL, ProQuest Central, Embase, the Cochrane Library, and PubMed. Eleven studies were eligible for inclusion in this analysis. The results of the meta-analysis demonstrated significant differences not only for the overall effect but also specifically for blended programs and short (2 weeks or 4 weeks) intervention periods. To present more evidence supporting the effectiveness of web-based nursing educational programs, further research is warranted.

Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions

BACKGROUND

An estimated two-thirds of the world's 2.7 million newborn deaths could be prevented with quality care at birth and during the postnatal period. Basic Newborn Care (BNC) is part of the solution and includes hygienic birth and newborn care practices including cord care, thermal care, and early and exclusive breastfeeding. Timely provision of resuscitation if needed is also critical to newborn survival. This paper describes health system barriers to BNC and neonatal resuscitation and proposes solutions to scale up evidence-based strategies.

METHODS

The maternal and newborn bottleneck analysis tool was applied by 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops engaged technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks" that hinder the scale up of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for BNC and neonatal resuscitation.

RESULTS

Eleven of the 12 countries provided grading data. Overall, bottlenecks were graded more severely for resuscitation. The most severely graded bottlenecks for BNC were health workforce (8 of 11 countries), health financing (9 out of 11) and service delivery (7 out of 9); and for neonatal resuscitation, workforce (9 out of 10), essential commodities (9 out of 10) and service delivery (8 out of 10). Country teams from Africa graded bottlenecks overall more severely. Improving workforce performance, availability of essential commodities, and well-integrated health service delivery were the key solutions proposed.

CONCLUSIONS

BNC was perceived to have the least health system challenges among the seven maternal and newborn intervention packages assessed. Although neonatal resuscitation bottlenecks were graded more severe than for BNC, similarities particularly in the workforce and service delivery building blocks highlight the inextricable link between the two interventions and the need to equip birth attendants with requisite skills and commodities to assess and care for every newborn. Solutions highlighted by country teams include ensuring more investment to improve workforce performance and distribution, especially numbers of skilled birth attendants, incentives for placement in challenging settings, and skills-based training particularly for neonatal resuscitation.

Webinar software: a tool for developing more effective lectures (online or in-person)

PURPOSE

To describe the use of online seminars (webinars) to improve learning experience for medical residents and fostering critical thinking.

MATERIALS AND METHODS

Sixty-one online seminars (webinars) for residents were developed from April 2012 to February 2013. Residents attended the lectures in the same room as the presenter or from distant locations. Residents interacted with the presenter using their personal computers, tablets, or smartphones. They were able to ask questions and answer the instructor's multiple choice or open-ended questions. The lecture dynamics consisted of: (1) The presentation of a clinical case by an expert on the clinical topic; (2) the instructor asked open-ended and multiple-choice questions about the problem-resolution process; (3) participants responded questions individually; (4) participants received feedback on their answers; (5) a brief conference was given on the learning objectives and the content, also fostering interactive participation; (6) lectures were complemented with work documents.

RESULTS

This method allowed for exploration of learning of scientific knowledge and the acquisition of other medical competences (such as patient care, interpersonal and communication skills, and professionalism). The question-and-answer activity and immediate feedback gave attendees the chance to participate actively in the conference, reflect on the topic, correct conceptual errors, and exercise critical thinking. All these factors are necessary for learning.

CONCLUSIONS

This modality, which facilitates interaction, active participation, and immediate feedback, could allow learners to acquire knowledge more effectively.