Effects of online professional learning on healthcare professionals' knowledge and skill acquisition. A systematic review and meta-analysis

BackgroundOnline professional learning offers a scalable alternative to traditional face-to-face learning, but there are doubts regarding how well it works and when it works best. This review assessed the effectiveness of online professional learning interventions on healthcare professionals knowledge and skill acquisition. MethodsWe conducted a systematic review and meta-analysis of randomised controlled trials that compared online professional learning against static controls or face-to-face controls. We searched MEDLINE Complete, Scopus, Embase, CENTRAL, and PsycINFO from inception to January 31, 2025. Eligible studies included practising healthcare professionals in any clinical setting that measured knowledge or skill acquisition related to patient care. Data was extracted in duplicate, with disagreements resolved through discussion or by a third reviewer. We used multilevel meta-analyses to estimate the overall effect size and conducted moderation analyses for pre-specified factors. The study protocol was pre-registered on the Open Science Framework (OSF; https://osf.io/46zav). FindingsOf 55,376 records; 171 studies (391 effects, 25,412 participants) met the inclusion criteria. Online learning significantly improved knowledge and skill acquisition compared to static controls (g = 0.93, 95% CI [0.78,1.07], p < 0.001; I{superscript 2} = 89.8%), with larger effects in lower-middle income countries (g = 1.30, 95% CI [0.88, 1.72]) than in high income (g = 0.75, 95% CI [0.63, 0.86]). Online learning also significantly improves outcomes compared to face-to-face instruction (g = 0.45, 95% CI [0.31,0.59], p < 0.001; I{superscript 2} = 85.92%), with larger effects for knowledge outcomes (g = 0.46, 95% CI [0.33, 0.59]) than skills outcomes (g = 0.20, 95% CI [0.04, 0.36]). Effects did not differ significantly by profession, clinician experience, clinical setting, intervention characteristics or the learning design features (all p > 0.05). No studies had low overall risk of bias, and some evidence of publication bias was found. InterpretationFrom this body of evidence, we identified that online learning appears to improve healthcare professionals knowledge and skill acquisition, exceeding traditional teaching methods. Healthcare organisations can be confident implementing or expanding online professional learning to improve knowledge and skill acquisition. FundingNo funding