Background
Term | Definition |
---|---|
TEDE | A collection of methods that use the application of some form of digital technology for teaching and/or learning in the dementia education context. |
E-learning | Learning via any electronic medium. E-learning refers to the application of information communication technology in its widest sense to support and improve the learning experience. Online and non-networked computer-based learning are subsets of e-learning. |
Online learning | Online learning refers to any e-learning that is conducted online. Internet-based learning and web-based learning are subsets of online learning. The terms are often used interchangeably. |
Computer-based learning | This is a non-networked approach for e-learning that emphasises the use of a computer (or computerised device) as the delivery platform. |
Blended learning | A mixed mode of delivery combining face-to-face learning with e-learning techniques. It is especially relevant to introducing elements of flexibility into traditional courses. |
Aim
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What are the experimental research methods that evaluate technology-enabled dementia education programmes for health and social care practitioners?
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What are the methodological strengths and limitations of experimental studies that evaluate technology-enabled dementia education programmes for health and social care practitioners?
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Are online and non-networked computer-based dementia education programmes beneficial across the outcomes in Kirkpatrick’s model?
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What are the delivery methods, instructional strategies, and modes of information delivery in technology-enabled dementia education programmes for health and social care practitioners?
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What instructional strategies support interactivity (communication and collaboration) in technology-enabled dementia education for health and social care practitioners?
Methods
Protocol
Criteria for considering studies for this review
Eligibility criteria
Classification | Category | Study design | Definition |
---|---|---|---|
Experimental | 1 | Randomised trials | An experimental study in which individuals or groups are allocated to different interventions using methods that are random. |
Quasi-experimental | 2 | Interrupted time-series designs | A study that uses observation at multiple (at least three) time points before and after an intervention. |
3 | Controlled before-after studies | A study in which observations are made before and after the implementation of an intervention, both in a group that receives the intervention and in a control group that does not. | |
4 | Non-randomised studies | A study in which people are allocated to different interventions using methods that are not random. | |
5 | Before-after studies | A study in which observations are made before and after the implementation of an intervention in the same group of individuals. | |
5 | Repeated measure studies | A before-after study in which there are multiple post-intervention time points at which outcome measurements are made [40]. |
Outcome measures
Level | Outcome | Definition |
---|---|---|
1 | Reaction | This is a measure of how participants feel about aspects of the TEDE programme. It is a measure of learner satisfaction. |
2a | Learning-change in knowledge | This is a measure of knowledge acquired as a result of the TEDE programme. |
2b | Learning-change in skills | This is a measure of the skills acquired as a result of the TEDE programme. |
2c | Learning-change in attitudes | This is a measure of attitudinal change as the result of the TEDE programme. |
3 | Behaviours | This is a measure of the extent to which participants change their behaviours in practice because of the TEDE programme. |
4 | Results | This is a measure of results that occurred because of the TEDE programme. It includes outcomes for service users and other organisational-level outcomes. |
Search methods
Data collection and analysis
Selection of studies
Data extraction
Assessment of methodological quality
Data synthesis
Results
Description of studies
Results of the search
Included studies
Excluded studies
Study designs
Quality assessment of included studies
MMAT
MERSQI
Possible score | Mean (SD) | |
---|---|---|
Study design | 3 | 1.95 (0.6) |
Single group cross‐sectional or single group post-test only | 1 | |
Single group pre-test and post-test | 1.5 | |
Nonrandomised, 2 groups | 2 | |
Randomised controlled trial | 3 | |
Sampling | ||
Institutions studied | 1.5 | 1.05 (0.5) |
1 | 0.5 | |
2 | 1 | |
3 | 1.5 | |
Response rate, % | 1.5 | 1.31 (0.4) |
Not applicable | 0 | |
< 50 or not reported | 0.5 | |
50–74 | 1 | |
> 75 | 1.5 | |
Type of data | 3 | 2.33 (0.9) |
Assessment by participants | 1 | |
Objective measurement | 3 | |
Validity of evaluation instrument | ||
Internal structure | 1 | 0.52 (0.5) |
Not applicable | 0 | |
Not reported | 0 | |
Reported | 1 | |
Content | 1 | 0.52 (0.5) |
Not applicable | 0 | |
Not reported | 0 | |
Reported | 1 | |
Relationships to other variables | 1 | 0.05 (0.2) |
Not applicable | 0 | |
Not reported | 0 | |
Reported | 1 | |
Data analysis | ||
Appropriateness of analysis | 1 | 1.00 (0.0) |
Inappropriate for study design or type of data | 0 | |
Appropriate for study design and type of data | 1 | |
Complexity of analysis | 2 | 1.95 (0.2) |
Descriptive analysis only | 1 | |
Beyond descriptive analysis | 2 | |
Outcomes | 3 | 1.69 (0.4) |
Satisfaction, attitudes, perceptions, opinions, general facts | 1 | |
Knowledge, skills | 1.5 | |
Behaviours | 2 | |
Patient/healthcare outcome | 3 | |
Total | 18 | 12.38 (1.6) |
Establishing the effectiveness of TEDE
Online dementia education programmes
Interactivity
Instructional strategies
Mode of information delivery
Assessment
Study | Setting/participants | Programme | Duration | Programme characteristics |
---|---|---|---|---|
Bentley, Kerr et al. 2019 [14] | Primary care International medical graduates and practice nurses | Online interactive educational resource (recognising, diagnosing, and managing dementia in general practice) | 4 modules Total duration: 3 h | Delivery method: fully online Instructional strategy: NS MID: video; external learning resources Interactivity: NS |
Chao, Kaas et al. 2016 [52] | Long-term care Nurses | Advanced Innovative Internet-Based Communication Education Program | 4 modules Total duration NS | Delivery method: blended learning Instructional strategy: case-based MID: video; face-to-face Interactivity: face-to-face discussion; online discussion NOS; online reflective journaling |
Cobbett, Redmond et al. 2016 [53] | Higher education Nursing students | Alzheimer’s disease and other dementias care course: adapted online course | 8 online modules and 1 face-to-facea Module duration: 1 h (with additional 2 h of preparatory work) | Delivery method: fully onlinea Instructional strategy: case-based MID: video; text Interactivity: online discussion (asynchronous) |
De Witt Jansen, Brazil et al. 2018 [54] | Primary and Secondary care, Nursing Home, and Hospice Physicians and nurses | Tele-mentoring to enhance assessment and management of pain in advanced dementia (based on Project ECHO model) | 5 sessions Session duration: 1 h 15 min | Delivery method: fully online Instructional strategy: case-based MID: videoconferencing Interactivity: online discussion (synchronous) |
Helms, Denson et al. 2009 [55] | Higher education Medical students | E-module: Neurology and Dementia: Psychological Aspects of Care (with clerkship materials) | Total duration NS | Delivery method: fully onlineb Instructional strategy: NS MID: video; text; external learning resources Interactivity: NS |
Hobday, Savik, and Gaugler 2010 [57] | Long-term care Direct care workers | Internet-based multimedia education program: dementia training resource | 3 prototype modules Module duration: 1 h | Delivery method: Fully Online Instructional strategy: NS MID: video; text; audio Interactivity: NS |
Hobday et al. 2010 [58] | Long-term care Nurse assistants | Internet-based, interactive, multimedia dementia educational program | 4 modules Module duration: 1 h | Delivery method: fully online Instructional strategy: NS MID: video; text; audio-narration; graphics Interactivity: NS |
Hobday, Gaugler and Mittelman 2017 [56] | Hospital Nursing assistants and allied hospital workers | CARES® dementia-friendly hospital program: online dementia training program | 4 modules Total duration NS | Delivery method: fully online Instructional strategy: case-based MID: video; audio-narrated text; text considers literacy levels; graphics Interactivity: NS |
Irvine, A. B., Bourgeois et al. 2007 [17] | Long-term care Nurse aides | Interactive multimedia program: professional dementia care (managing aggression) | Total duration NS | Delivery method: fully online Instructional strategy: video-modelling MID: video; text considers literacy levels; narration; graphics Interactivity: NS |
Irvine, A. Blair, Beaty et al. 2013 [59] | Long-term care Non-direct care staff including nurses | Internet dementia-training program | 5 modules 2 h to complete all modules | Delivery method: fully online Instructional strategy: video-modelling MID: video; text considers literacy levels; narration Interactivity: NS |
Jones, Moyle 2016 [60] | Long-term care Nurses, care workers, and students | Online self-directed e-learning education intervention (based on the sexualities and dementia education resource for health professionals) | 4 modules Module duration: 1 h | Delivery method: fully online Instructional strategy: case-based MID: NS Interactivity: NS |
Kimzey, Mastel-Smith et al. 2016 [61] | Higher education Nursing students | Alzheimer’s disease online module | Total duration NS | Delivery method: fully online Instructional strategy: NS MID: NS Interactivity: NS |
Luconi 2008 [62] | Primary care Family physicians | Early Alzheimer’s disease program: web-based continuing medical education program | 8 modules completed over 6 months | Delivery method: fully online Instructional strategy: case-based; practice-based learning method MID: text; external learning resources Interactivity: online discussions (asynchronous); moderated |
Tomaz, Jose Batista Cisne, Mamede et al. 2015 [66] | Primary care Family physicians | Online PBL: clinical approach for elderly with dementia | 120 h (100 h distance and 20 face-to-face) over 12 weeks | Delivery method: blended learningc Instructional strategy: case-based; PBL MID: video; face-to-face Interactivity: face-to-face discussion; online discussions (synchronous; asynchronous) |
Vollmar, Mayer et al. 2010 [68] | Primary care General practitioners | Online modules: presentation of a dementia guideline | Estimated average activity duration: 83 (15 to 200) min | Delivery method: blended learning Instructional strategy: case-based MID: online NOS Interactivity: face-to-face discussions |
Westmoreland, Counsell et al. 2010 [69] | Higher education Medical residents | Dementia education module within a web-based geriatrics training program | Total duration NS | Delivery method: fully online Instructional strategy: case-based MID: video; text; graphics Interactivity: NS |
Effect of ODE on learner satisfaction
Effect of ODE on knowledge
Study | Setting | Study design | Comparator | Measure | Results |
---|---|---|---|---|---|
Bentley, Kerr et al. 2019 [14] | Practice | Before-after | NA | DKAS | Evidence of effecta |
Chao, Kaas et al. 2016 [52] | Practice | Repeated measures | NA | CKS-C | Evidence of effectb |
Cobbett, Redmond et al. 2016 [53] | HE | Controlled before-after | Did not participate in online training | MCQc | Evidence of effect |
De Witt Jansen, Brazil et al. 2018 [54] | Practice | Before-after | NA | ECHO Questionnaired | Evidence of effect |
Hobday, Savik, and Gaugler 2010 [57] | Practice | Before-after | NA | Knowledge Inventory | Evidence of effect |
Hobday et al. 2010 [58] | Practice | Before-after | NA | Dementia Care Knowledge | Evidence of effect |
Hobday, Gaugler and Mittelman 2017 [56] | Practice | Before-after | NA | Dementia Care Knowledge | Evidence of effect |
Irvine, A. B., Bourgeois et al. 2007 [17] | Practice | Randomised trial | Did not participate in training | VST: knowledge | Evidence of effect |
Irvine, A. Blair, Beaty et al. 2013 [59] | Practice | Before-after | NA | VST: knowledge | Evidence of effecte |
Jones, Moyle 2016 [60] | Practice | Before-after | NA | ASKAS: knowledge | Evidence of effect |
Kimzey, Mastel-Smith et al. 2016 [61] | HE | Controlled before-after | Usual practice; Experiential learning | ADKS | No evidence of effect |
Luconi 2008 [62] | Practice | Repeated measures | NA | MCQ; clinical cases | Partial evidence of effectb (multiple outcome measures) |
Tomaz, Jose Batista Cisne, Mamede et al. 2015 [66] | Practice | Controlled before-after | Did not receive training | Knowledge test | Evidence of effect |
Vollmar, Mayer et al. 2010 [68] | Practice | Randomised trial | Traditional lecture | Knowledge test | No evidence of effect |
Westmoreland, Counsell et al. 2010 [69] | HE | Randomised trial | Paper-based learning | Knowledge test | Evidence of effect |
Effect of ODE on skills
Study | Setting | Study design | Comparator | Measure | Results |
---|---|---|---|---|---|
Chao, Kaas et al. 2016 [52] | Practice | Repeated measures | NA | CCS | Evidence of effecta |
Helms, Denson et al. 2009 [55] | HE | Non-randomised trial | Did not participate in e-module | OSCE clinical note score; OSCE performance | Evidence of effect |
Irvine, A. B., Bourgeois et al. 2007 [17] | Practice | Randomised trial | Did not participate in training | Self-efficacy; VST: Self efficacy | Evidence of effect |
Irvine, A. Blair, Beaty et al. 2013 [59] | Practice | Before-after | NA | Self-efficacy; VST: Self efficacy | No evidence of effectb |
Tomaz, Jose Batista Cisne, Mamede et al. 2015 [66] | Practice | Controlled before-after | Did not receive training | DD; MMSE | Evidence of effect |
Effect of ODE on attitudes
Study | Setting | Study design | Comparator | Measure | Results |
---|---|---|---|---|---|
Bentley, Kerr et al. 2019 [14] | Practice | Before-after | NA | GPACS-D | Evidence of effecta |
Chao, Kaas et al. 2016 [52] | Practice | Repeated measures | NA | CSAS-C | No evidence of effectb |
Irvine, A. B., Bourgeois et al. 2007 [17] | Practice | Randomised trial | Did not participate in training | Attitudes; behavioural Intentions | Evidence of effect |
Irvine, A. Blair, Beaty et al. 2013 [59] | Practice | Before-after | NA | Attitudes; behavioural intentions | Partial evidence of effectc (multiple outcome measures) |
Jones, Moyle 2016 [60] | Practice | Before-after | NA | ASKAS: attitude; SAID | Evidence of effect |
Kimzey, Mastel-Smith et al. 2016 [61] | HE | Controlled before-after | Usual practice; experiential learning | DAS | No evidence of effect |
Effect of ODE on behaviours
Study | Setting | Study Design | Comparator | Measure | Results |
---|---|---|---|---|---|
Chao, Kaas et al. 2016 [52] | Practice | Repeated measures | NA | PREAS | Evidence of effecta |
Westmoreland, Counsell et al. 2010 [69] | HE | Randomised trial | Paper-based learning | Chart abstraction; encounter checklist; EOES | Partial evidence of effect (multiple outcome measures) |
Effect of ODE on results
Computer-based dementia education programmes
Study | Setting/participants | Programme | Duration | Programme characteristics |
---|---|---|---|---|
Downs, Turner et al. 2006 [1] | Primary care GP practices | Educational tutorial on CD-ROM | Total duration: NS | Delivery methods: CD-ROM Instructional strategy: case-based MID: electronic book (hypertext indexing system) |
Matsumura, Shinno et al. 2018 [63] | Higher education Medical students | Clinic simulator with virtual patients (alongside conventional learning) | Simulator duration: 0.75 h | Delivery methods: Windows 7 Operating System Instructional strategy: Simulated learning; case-based MID: 3D simulation; text; video |
Rababa, Masha'al 2020 [64] | Higher education Nursing students | Computer-based BPS for pain management in people with dementia | 6 sessions Session duration: 1-h duration | Delivery methods: computer-based Instructional strategy: BPS; case-based MID: NS |
Ruiz, Smith et al. 2006 [65] | Higher education Nursing students | Multimedia training CD-ROM: Alzheimer’s and other Dementias | 7 modules Module duration: 20–30 min | Delivery methods: CD-ROM Instructional strategy: NS MID: video; text; graphics; audio |
Tsai, Kitch et al. 2018 [67] | Long-term care Nursing Assistants and Residents | Computer-based simulation—appropriate level of dressing assistance for people with dementia (with conventional learning) | Simulator duration: 2 h | Delivery methods: tablet device Instructional strategy: simulated learning; video modelling MID: video; text |
Effect of CBDE on learner satisfaction
Effect of CBDE on knowledge
Effect of CBDE on skills
Effect of CBDE on attitudes
Effect of CBDE on behaviours
Effect of CBDE on results
Study | Setting | Study design | Comparator | Outcome | Measure | Results |
---|---|---|---|---|---|---|
Downs, Turner et al. 2006 [1] | Practice | Randomised trial | Workshop; decision support; control (no training intervention) | Behaviours | Detection rates; concordance with guidelines | No evidence of effect |
Matsumura, Shinno et al. 2018 [63] | HE | Controlled before-after | Did not participate in clinic simulator activity | Satisfaction Knowledge | ARCS Knowledge test | Evidence of effect Evidence of effect |
Rababa, Masha'al 2020 [64] | HE | Controlled before-after | Traditional lectures | Skills | CTSAS | Evidence of effect |
Ruiz, Smith et al. 2006 [65] | HE | Before-after | NA | Satisfaction Knowledge Skills Attitudes | PPT Knowledge test Self-efficacy test Attitude test | Evidence of effect Evidence of effect Evidence of effect Evidence of effect |
Tsai, Kitch et al. 2018 [67] | Practice | Controlled before-after | Did not participate in video simulator activity | Behaviours Results | Level of dressing assistance BDPS | No evidence of effect No evidence of effect |