Table 1.
Summary of findings table: Effects of offline digital education on knowledge, skills, attitudes, and satisfaction. Patient or population: medical students, Settings: university or hospital, Intervention: offline digital education, Comparison: offline digital education versus traditional learning.
| Outcomes | Illustrative comparative risks (95% CI) | Number of participants (number of studies) | Quality of the evidence (GRADEa) | Comments |
| Knowledge: Assessed with multiple-choice questions, questionnaires, essays, quizzes, and practical section (from postintervention to 11-22 months of follow-up) | The mean knowledge score in offline digital education groups was 0.11 SD higher (–0.11 lower to 0.32 higher) | 1717 (19) | Lowb,c,d | The results from seven studies (689 participants) were not added to the meta-analysis due to incomplete or incomparable outcome data. These studies reported mixed findings: four studies (331 participants) favored offline digital education group, two studies reported no difference (289 participants), and one study favored the traditional learning group (69 participants). |
| Skills: Assessed with checklists, Likert-type scales, and questionnaires, (from postintervention to 1-10 months of follow-up) | The mean skills score in the offline digital education groups was 0.5 SD higher (0.25 higher to 0.75 higher) | 415 (4) | Lowb,c,d | The results of two studies (190 participants) were not added to the meta-analysis due to incomplete outcome data. One study (121 participants) favored offline digital education group. The other study (69 participants) reported no difference between the groups immediately postintervention and favored the offline digital education group at 1-month of follow-up. |
| Attitude: Assessed with Likert scale, questionnaires, and surveys (from postintervention to 5 weeks of follow-up) | Not estimable | 493 (5) | Lowb,c,d | One study (54 participants) reported higher postintervention attitude scores in offline digital education compared to traditional learning. We were uncertain about the effect of four studies (439 participants) due to incomplete outcome data. |
| Satisfaction: Assessed with Likert scales, questionnaires, and surveys (postintervention) | Not estimable | 1442 (15) | Lowb,c,d | Two studies (144 participants) favored traditional learning and two studies (103 participants) reported little or no difference between the groups. We were uncertain about the effect of 11 studies (1195 participants) due to incomplete outcome data. |
aGRADE: Grading of Recommendations, Assessment, Development, and Evaluations.
bLow quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
cRated down by one level for study limitations. The risk of bias was unclear for sequence generation and allocation concealment in majority of the studies.
dRated down by one level for inconsistency. The heterogeneity is high with large variations in effect and lack of overlap among CIs.