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Meta-Analysis
. 2020 Aug 10;22(8):e16504.
doi: 10.2196/16504.

Blended Learning Compared to Traditional Learning in Medical Education: Systematic Review and Meta-Analysis

Alexandre Vallée  1 , Jacques Blacher  1 , Alain Cariou  2 , Emmanuel Sorbets  1
Affiliations
Meta-Analysis

Blended Learning Compared to Traditional Learning in Medical Education: Systematic Review and Meta-Analysis

Alexandre Vallée et al. J Med Internet Res. .

Abstract

Background: Blended learning, which combines face-to-face learning and e-learning, has grown rapidly to be commonly used in education. Nevertheless, the effectiveness of this learning approach has not been completely quantitatively synthesized and evaluated using knowledge outcomes in health education.

Objective: The aim of this study was to assess the effectiveness of blended learning compared to that of traditional learning in health education.

Methods: We performed a systematic review of blended learning in health education in MEDLINE from January 1990 to July 2019. We independently selected studies, extracted data, assessed risk of bias, and compared overall blended learning versus traditional learning, offline blended learning versus traditional learning, online blended learning versus traditional learning, digital blended learning versus traditional learning, computer-aided instruction blended learning versus traditional learning, and virtual patient blended learning versus traditional learning. All pooled analyses were based on random-effect models, and the I2 statistic was used to quantify heterogeneity across studies.

Results: A total of 56 studies (N=9943 participants) assessing several types of learning support in blended learning met our inclusion criteria; 3 studies investigated offline support, 7 studies investigated digital support, 34 studies investigated online support, 8 studies investigated computer-assisted instruction support, and 5 studies used virtual patient support for blended learning. The pooled analysis comparing all blended learning to traditional learning showed significantly better knowledge outcomes for blended learning (standardized mean difference 1.07, 95% CI 0.85 to 1.28, I2=94.3%). Similar results were observed for online (standardized mean difference 0.73, 95% CI 0.60 to 0.86, I2=94.9%), computer-assisted instruction (standardized mean difference 1.13, 95% CI 0.47 to 1.79, I2=78.0%), and virtual patient (standardized mean difference 0.62, 95% CI 0.18 to 1.06, I2=78.4%) learning support, but results for offline learning support (standardized mean difference 0.08, 95% CI -0.63 to 0.79, I2=87.9%) and digital learning support (standardized mean difference 0.04, 95% CI -0.45 to 0.52, I2=93.4%) were not significant.

Conclusions: From this review, blended learning demonstrated consistently better effects on knowledge outcomes when compared with traditional learning in health education. Further studies are needed to confirm these results and to explore the utility of different design variants of blended learning.

Keywords: blended learning; computer-aided instruction; meta-analysis; online learning; traditional learning; virtual patients.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Forest plot of blended learning to traditional learning comparison for knowledge outcomes. df: degree of freedom; CI: confidence interval; SMD: standard mean difference.
Figure 3
Figure 3
Funnel plot of blended learning versus traditional learning.
Figure 4
Figure 4
Forest plot of offline blended learning to traditional learning comparison for knowledge outcomes. df: degree of freedom; CI: confidence interval.
Figure 5
Figure 5
Forest plot of online blended learning to traditional learning comparison for knowledge outcomes. df: degree of freedom; CI: confidence interval; SMD: standard mean difference.
Figure 6
Figure 6
Forest plot of digital blended learning to traditional learning comparison for knowledge outcomes. df: degree of freedom; CI: confidence interval.
Figure 7
Figure 7
Forest plot of computer-assisted instruction blended learning to traditional learning comparison for knowledge outcomes. df: degree of freedom; CI: confidence interval.
Figure 8
Figure 8
Forest plot of virtual patient blended learning to traditional learning comparison for knowledge outcomes. df: degree of freedom; CI: confidence interval.
Figure 9
Figure 9
Forest plot of blended learning to traditional learning comparison for knowledge outcomes for medical students. df: degree of freedom; CI: confidence interval.
Figure 10
Figure 10
Forest plot of blended learning to traditional learning comparison for knowledge outcomes for nurses as students. df: degree of freedom; CI: confidence interval.
Figure 11
Figure 11
Forest plot of blended learning to traditional learning comparison for knowledge outcomes for dentistry students. df: degree of freedom; CI: confidence interval.
Figure 12
Figure 12
Risk of bias summary (+ low risk of bias; - high risk of bias; ? unclear risk of bias).
See this image and copyright information in PMC

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