Impact of e-learning on nurses' and student nurses knowledge, skills, and satisfaction: a systematic review and meta-analysis.

OBJECTIVE To review the impact of e-learning on nurses' and nursing student's knowledge, skills and satisfaction related to e-learning. DESIGN We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) to assess the impact of e-learning on nurses' and nursing student's knowledge, skills and satisfaction. Electronic databases including MEDLINE (1948-2010), CINAHL (1981-2010), Psychinfo (1967-2010) and Eric (1966-2010) were searched in May 2010 and again in December 2010. All RCT studies evaluating the effectiveness of e-learning and differentiating between traditional learning methods among nurses were included. DATA EXTRACTION AND QUALITY ASSESSMENT Data was extracted related to the purpose of the trial, sample, measurements used, index test results and reference standard. An extraction tool developed for Cochrane reviews was used. Methodological quality of eligible trials was assessed. DATA SYNTHESIS 11 trials were eligible for inclusion in the analysis. RESULTS We identified 11 randomized controlled trials including a total of 2491 nurses and student nurses'. First, the random effect size for four studies showed some improvement associated with e-learning compared to traditional techniques on knowledge. However, the difference was not statistically significant (p=0.39, MD 0.44, 95% CI -0.57 to 1.46). Second, one study reported a slight impact on e-learning on skills, but the difference was not statistically significant, either (p=0.13, MD 0.03, 95% CI -0.09 to 0.69). And third, no results on nurses or student nurses' satisfaction could be reported as the statistical data from three possible studies were not available. CONCLUSION Overall, there was no statistical difference between groups in e-learning and traditional learning relating to nurses' or student nurses' knowledge, skills and satisfaction. E-learning can, however, offer an alternative method of education. In future, more studies following the CONSORT and QUOROM statements are needed to evaluate the effects of these interventions.