Objective

To describe the best evidence on the effectiveness of technology-based learning tools designed to improve knowledge of health care providers about clinical practice guidelines (CPGs).

Methods

We conducted a systematic review, searching MEDLINE, Embase, and CINAHL from inception to July 2018. Included studies investigated the effectiveness of any technology-based learning tools developed to improve knowledge of health care providers about CPGs. We used a 2-phase screening process to determine eligibility. Pairs of reviewers critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network checklist for randomized controlled trials or the National Institutes of Health checklist for pre- and postintervention trials. Evidence from internally valid studies was described using a best-evidence summary. We conducted a sensitivity analysis to determine whether results varied according to methodological quality.

Results

Twenty-five of 8321 articles met our selection criteria. Six studies had a low risk of bias and were included in this review. Spaced education was associated with improvement in knowledge; however, its effectiveness relative to other interventions is unknown. Module-based online educational interventions were associated with improvement in knowledge of CPGs; however, they may not be more effective than paper-based self-learning or in-person workshops. The sensitivity analysis determined that the evidence was similar between the high and low risk of bias studies.

Conclusion

Module-based- and spaced-education interventions may be beneficial for improving health care providers' knowledge of CPGs; however, much of the evidence toward their use is preliminary.

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Author notes

Leslie Verville is a Research Manager - Knowledge Translation at the Centre for Disability Prevention and Rehabilitation at Ontario Tech University (2000 Simcoe Street N, Oshawa, Ontario, L1H 7K4, Canada; leslie.verville@uoit.ca). Pierre Côté is a professor on the Faculty of Health Sciences, director of the Centre for Disability Prevention and Rehabilitation, and Canada research chair in Disability Prevention and Rehabilitation at Ontario Tech University (2000 Simcoe Street N, Oshawa, Ontario, L1H 7K4, Canada; pierre.cote@uoit.ca). Diane Grondin is an associate professor in the Department of Research and Innovation at the Canadian Memorial Chiropractic College (6100 Leslie Street North, Toronto, Ontario, M2H 3J1, Canada; dgrondin@cmcc.ca). Silvano Mior is the director for research partnerships and health policy at the Canadian Memorial Chiropractic College and a scientist at the Centre for Disability Prevention and Rehabilitation at Ontario Tech University (6100 Leslie Street North, Toronto, Ontario, M2H 3J1, Canada; smior@cmcc.ca). Keshini Moodley is a master's degree student at the Centre for Disability Prevention and Rehabilitation at Ontario Tech University (2000 Simcoe Street N, Oshawa, Ontario, L1H 7K4, Canada; keshini.moodley@uoit.ca). Robin Kay is a professor on the Faculty of Education at Ontario Tech University (2000 Simcoe Street N, Oshawa, Ontario, L1H 7K4, Canada; robin.kay@uoit.ca). Anne Taylor-Vaisey is health sciences librarian for the Centre for Disability Prevention and Rehabilitation at Ontario Tech University (2000 Simcoe Street N, Oshawa, Ontario, L1H 7K4, Canada; Anne.TaylorVaisey@uoit.ca).

Concept development: LV, PC, RK. Design: LV, PC, RK. Supervision: LV, PC, RK. Data collection/processing: LV, PC, KM. Analysis/interpretation: LV, PC, DG, SM, RK. Literature search: ATV. Writing: LV, PC. Critical review: LV, PC, DG, SM, KM, RK, ATV.

Supplementary data