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Table 2 Characteristics of the studies

From: Effectiveness of distance learning strategies for continuing professional development (CPD) for rural allied health practitioners: a systematic review

Author, year and country

Design and data collection

Study purpose & participants

CPD topic

Outcome measures

Results

Bailey et al. 2005 [30]

Australia

Service review (audit)

Data collection method NR

AHPs

Evaluate VC as a learning method Rural

Child development

Knowledge and clinical process

VC improved access to professional supports from metropolitan team; networking; knowledge in developmental disability and learning difficulties; enhancement of clinical processes

Bynum et al. 2010 [31]

USA

Single arm post-test

Self-report Likert scale

Total 44,989 with 3230 AHPs

Evaluate satisfaction with education program using VC Rural

Varied, needs driven

Satisfaction with program length, presentation, effectiveness & convenience of technology. Satisfaction with impact on patient care

Rural participants reported highest satisfaction with technology convenience (p < 0.01), predictors of program satisfaction were program year, male (p < 0.01), African American (p < 0.01), healthcare discipline (nursing), community size (smallest) and travel mileage from originating site.

Women (p < 0.01), Hispanics (p < 0.01) and dental professionals (p < 0.01) recorded greater increases in knowledge, and needs match.

Multiple regression showed combined variables of program year, gender, ethnicity, healthcare discipline, home community size, and travel mileage to training site were significant predictors of program satisfaction, accounting for 5% of the variance (R2 = 0.05, p < 0.01). The strongest single predictor of satisfaction was program year

Dennis et al. 2010 [32] USA

Longitudinal cohort

Self-reported pre-and post-Likert scale and end-of-year reflections

132 AHPs

Evaluate learning from VC structured discussions

Rural

Needs based journal club - critical appraisal

Critical appraisal skills; access to research and implementation

Access to research pre-to post 2006 to 2009 change of 3.10 to 3.88; critical appraisal skills change of 2.80 to 3.76; implementation change of 3.09 to 3.98

DuBose et al. 1997 [27]

USA

Cross sectional cohort

Examination and satisfaction evaluation (5 point Likert scale)

31 medical sonographers

Evaluate education program comparing VC and FTF

Rural and metro

Sonographic anatomy

Knowledge by rural versus classroom; overall; level of experience of participants & satisfaction

Students in remote sites did as well as those in classroom (p > 0.05), more years of experience had a small significant effect (p < 0.05, R2 = 0.42); satisfaction evaluation was generally good (mean 3.7, range 4.9 to 2.7). However, significant difference in satisfaction between rural and classroom (p < 0.05) with rural indicating feelings of isolation from other students and instructor.

Ducat et al.

2014 [20]

Australia

Descriptive Qualitative

Semi-structured interviews

42 AHPs

Evaluate education program using blended delivery (TC, VC, FTF)

Rural and remote

8 domains in line with the Allied Health Capability framework

Enablers and barriers

Barriers: Competing time demands; clinical work takes precedence; difficulty accessing the equipment for VC participation.

Enablers: Access to VC was cost effective; no need for travel; efficiencies with staff time.

Evans & Sachs 2000 [28]

USA

Cross sectional cohort

Pre-and post-knowledge assessment with follow-up survey

378 sonographers

Evaluate a TC with an expert panel

Rural and urban

Ultrasound equipment developments

Satisfaction; relevance; knowledge

Overall satisfaction mean 4.5 (SD 0.60); relevance mean 4.55 (SD 0.61); between groups (managers and radiologic technologists) difference in satisfaction (p = 0.02) and relevance (p = 0.01); no gender differences in satisfaction p = 0.72 or relevance p = 0.94; satisfaction and relevance were correlated p < 0.001; knowledge scores improved from 85% to 95%

Fahey et al. 2003 [38]

Australia

Cross sectional cohort

Post session evaluation, surveys and interviews

38 AHPs

Evaluate 12 session VC program

Rural

Child psychological development

Knowledge; changes to practice; satisfaction with technology

Questionnaires: 80% felt the sessions were informative and self-report practice change would occur; 86% comfortable with technology; 12% discomfort; several stated ‘nothing replaces person in the room’. 80% rated online medium as excellent or very good, 1% unsatisfactory / poor. Acceptance consistently high from session 5 onward.

Interviews (n = 16): 11 reported gains in knowledge in developmental frameworks and actual change in history taking & assessment; managers reported observed increased ability to spot problems; Networking was valued.

Maloney et al. 2011 [33]

Australia

Head-to-head randomised trial

Electronic survey for self-reported (Likert scale) satisfaction and self-reported change in practice, 1 h knowledge test, assignment

166 AHPs (attrition brought the final number to 96)

Compare 1 day FTF workshop including video and written supports with web-based delivery over 4 weeks with discussion boards

Rural and urban

Falls prevention using exercise

Participant reaction; knowledge; change in behaviour

Satisfaction content & relevance no difference (p = 0.75); satisfaction course facilitation & support no difference (p = 0.25); web group spent more time on compulsory & additional learning materials (p = 0.002); knowledge and assignment comparable between web and FTF (p = 0.07, p = 0.61); change in practice same (p = 0.89); difference in practice change between groups: web group changes in motivational interviewing while FTF changed exercise prescription. Both changed in assessment. Comfort with web based learning improved from 24% apprehensive to 80% willing to do another web based program.

Miller et al. 2008 [39]

Canada

Non-equivalent control group design

Self-reported pre-test and post-test and follow up survey for feedback using 5 point Likert scale, yes & no and open ended questions

44 AHPs

Compare 1 day FTF workshop with VC delivered simultaneously

Remote

Training in scoring guidelines for stroke assessment

Effectiveness acceptability & monetary costs

VC performed as well as FTF on pre-post-test of competency in scoring stroke assessment. Significant change in both groups between pre and post test scores p = 0.001) (i.e. learning occurred). 33% of FTF group thought training was excellent compared with 8% in VC group. Satisfaction in mode of participation was the same across both groups - the presence of the VC in the room did seem to impact the experience for the FTF attenders (i.e. reluctant to speak out as wanted to give VC chance to speak). VC was more cost effective

Nipp et al.

2014 [35]

USA

quasi-experimental cohort

Pre-and post-knowledge tests and follow up survey for practice change

28 AHPs

Evaluate 5 continuing education modules delivered online

Rural

Low vision assessment and treatment

Knowledge pre-and post-test; knowledge by years of practice experience

Change in knowledge was significant (p = 0.01). On follow up 73.7% indicated they consistently considered vision when planning treatment; 50% reported often screen for vision now and 15/19 participants now consider environment & vision. However, 63.2% did not use any of the screening assessments covered; 78% reported increase in comfort levels for providing interventions for low vision including increased activity visibility, increased contrast & organisation of work stations.

Ray et al.

2014 [36]

Australia

Cross-sectional cohort

Electronic survey using self-report Likert scales

Total 101, AHPs 20

Evaluate VCs with experts delivered monthly for 16 months

Rural

16 Palliative care (PC) topics

Content usefulness, confidence of palliative care delivery & influence on practice

Content usefulness: significant difference in ratings between AHPs and MDs/students (p = 0.018) and nurses (p = 0.018); AHPs found content less useful than MDs and nurses. Practice location, years of working and number of clients seen were not significant. Confidence: AHP significantly lower confidence in topics than both nurses (p = 0.008) and MDs (p = 0.013); Overall confidence improved mean 0.54 (SD 0.46). Those who had more palliative care clients were more confident but years of experience had no effect. Change in confidence greater in those with no previous education than those with post-grad (p = 0.44) and short course experience (p = .014).

Shade & Barber

2004 [37]

USA

Cohort

Electronic survey after each course

58 AHPs

Evaluate an adaptation of FTF education to online and video courses with peer support discussions

Rural

Individualised gerontology instruction

Knowledge; satisfaction; ease of use; content, usefulness and application

Reported ‘average’ computer skills on program completion; high speed internet was an advantage. Not all course content translated easily to online environment; time consuming to design interactive experiences to compensate for no live facilitator; topics that were time-sensitive took effort to maintain but more static material was easier. Participants working together from a single agency enriched the learning experience and learner interaction.

Steed 2008 [29] USA

Mixed method case series

Electronic survey after experience using Likert scale and open-ended questions

7 OTs

Evaluate second life virtual reality as a learning method

Rural and remote

Cultural competency

Attitudes about clients from a different culture perception of learning environment

4 themes: sense of presence - embodiment as an African American; Sense of co-presence - self in the environment with others; place presence - natural engagement supporting visual and kinaesthetic learning styles; sense of play - learning through fun - authentic and goal oriented.

Warugaba et al. 2016 [34] Rwanda

Cohort study

Electronic survey after the education program

Total 38 completed: 17 were AHPs

Evaluate an adaptation of a massive open online course including FTF support

Rural and remote

Global health

Attendance at in-person classes; use of online forum, number of quizzes taken, time required, opinions whether course helps work and career advancement & learning

10 / 20 completers used online forums, 18 did up to 7 quizzes; 16 course was helpful to work, 18 course contributes to career advancement; 16 spend 2–5 h a week on course. Relationship between attendance at in-person classes and course completion statistically significant (p = 0.013).

  1. Key: AHPs = Allied health practitioners; FTF = face to face; VC = videoconference; TC = teleconference; NR = not reported; MD = Medical Doctor