Online technology use in physiotherapy teaching and learning: a systematic review of effectiveness and users’ perceptions

Mącznik et al. BMC Medical Education (2015) 15:160 DOI 10.1186/s12909-015-0429-8 RESEARCH ARTICLE Open Access Online technology use in physiotherapy teaching and learning: a systematic review of effectiveness and users’ perceptions Aleksandra K. Mącznik*, Daniel Cury Ribeiro and G. David Baxter Abstract Background: The use of online technologies in health professionals’ education, including physiotherapy, has been advocated as effective and well-accepted tools for enhancing student learning. The aim of this study was to critically review the effectiveness, and user perceptions of online technology for physiotherapy teaching and learning. Methods: Following databases were systematically searched on the 31st of August 2013 for articles describing implementation of online technologies into physiotherapy teaching and learning: ERIC, CINAHL, Web of Science, Academic search complete, ProQuest Nursing and Allied Health Source, Medline, Embase, and Scopus. No language, design or publishing date restrictions were imposed. Risk of bias was assessed using the 2011 Mixed Methods Appraisal Tool checklist (MMAT). Results: A total of 4133 articles were retrieved; 22 articles met the inclusion criteria and were accepted for final analysis: 15 on the effectiveness of technology, and 14 on users’ perceptions. Included studies used three designs: case study (14 articles), controlled trial (3), and randomized controlled trial (5). Studies investigated both pre-registration physiotherapy students (1523) and physiotherapy professionals (171). The quality of studies ranged from 67 to 100 % on the MMAT checklist which can be considered moderate to excellent. More than half of the studies (68 %) received scores greater than 80 %. Studies typically investigated websites and discussion boards. The websites are effective in enhancing practical skills performance, and discussion boards in knowledge acquisition, as well as in development of critical and reflective thinking. Students’ perceptions of the use of websites were mostly positive, providing students with entertaining, easy accessible resources. Perceived barriers to the use of websites included difficulties with internet connection, insufficiently interactive material, or personal preference for paper-based materials. Discussion boards were perceived as deepening students’ thinking and facilitating reflection, allowing for learning from multiple perspectives, and providing easy communication and support. Conclusions: The results of this review suggest that online technologies (i.e., websites and discussion boards) have many benefits to offer for physiotherapy teaching and learning; There was minimal evidence of barriers for the use of online technologies, however, addressing the identified ones could enhance adherence to use of online technologies in health professionals’ education. * Correspondence: Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Otago, New Zealand © 2015 Mącznik et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Mącznik et al. BMC Medical Education (2015) 15:160 Background Online technologies can be defined as any service and communication tools available on or utilising the internet including social networks, web-based resources and discussion boards. Online technologies have become an indispensable part of students and academics’ life in higher education, influencing strategies for learning [1–3]. Students in the health professions seem to access the internet daily, as part of which they are engaged in diverse online activities, focused mainly around social media platforms [4]. The rapid evolution of web-based information platforms, and social media in particular, has made the internet the primary source of information for many health professions students [5], meaning that medical textbooks and paper-based materials are no longer the main source of knowledge for student learning. Such embracing of online technologies into health professionals’ education is considered as inevitable and desired by some authors [2, 6], but more recently others advise caution and moderation [7, 8]. It is therefore important and timely to review and critically appraise the evidence from the empirical studies. The broader incorporation of online technology into health professionals’ education is increasingly advocated, with claimed benefits including incorporation of quality content, support of life-long learning, flexibility of access, enrichment and personalisation of learner experience, and improved communication networks [9–11]. However, the use of online technologies as teaching tools has shown mixed results (benefits or no difference to traditional methods in facilitating knowledge or skills acquisition) in health professionals’ education. Previous reviews have focused on the use of technology in dental [11], medical [12], nursing education [13], and also for health professions’ faculty development [14]. To date however, there is a lack of reviews focusing on the use of online technology in physiotherapy education, and reviews conducted on mixed health professionals groups frequently do not include physiotherapy studies [15, 16]. Therefore a systematic review of the outcomes of online technology use in physiotherapy teaching was indicated to inform conclusions about their usefulness. The aim of this study was twofold. First, we aimed to assess current evidence for the effectiveness of technology in physiotherapy teaching and learning in enhancing students’ skills and knowledge. Second, we aimed to summarize perceptions of physiotherapy students (or professionals) on the use of online technology. The research questions were: 1. What is the effectiveness of technology on teaching and learning in physiotherapy in respect to student learning outcomes (i.e., students’ grades)? Page 2 of 12 2. What are the users’ perceptions (physiotherapy students and professionals) of benefits and barriers for use of technology in physiotherapy teaching and learning? Method PRISMA guidelines were used to design and report this systematic review [17]. Eligibility criteria Articles published in peer-reviewed journals describing implementation of any online technology for teaching and learning in physiotherapy (Am: physical therapy) were included in this review. Articles could present designs such as case study (CS), controlled trial (CT), or randomised cont (...truncated)