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. 2019 Aug 28;9(8):e025252. doi: 10.1136/bmjopen-2018-025252

Table 2.

Characteristics of adaptive e-learning environments

First author, year Clinical topic(s) Theoretical framework(s) Platform Adaptivity subdomains
Adaptivity method Adaptivity goals Adaptivity timing Adaptivity factors Adaptivity types
Casebeer, 2003 Chlamydia screening Transtheoretical model of change, problem-based learning, situated learning theory NR Designed adaptivity To increase learning effectiveness (knowledge, skills). Throughout the training, after case-based and practice-based questions. User answers to questions
  • Content

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Cook,
2008
Diabetes, hyperlipidaemia, asthma, depression NR NR Designed adaptivity To increase learning efficiency (knowledge gain divided by learning time). After each case-based question in each module (17 to 21 times/module). User knowledge
  • Content

  • Navigation

Crowley, 2007 Dermopathology, subepidermal vesicular dermatitis Cognitive tutoring SlideTutor Algorithmic adaptivity To increase learning gains, metacognitive gains and diagnostic performance. At the beginning of each case. User actions: results of problem-solving tasks; requests for help
  • Content

  • Navigation

  • Presentation

  • Multimedia

  • Tools

Crowley, 2010 Dermopathology, melanoma Cognitive tutoring SlideTutor Algorithmic adaptivity To improve reporting performance and diagnostic accuracy. At the beginning of each case. User actions: results of problem-solving tasks; reporting tasks; requests for help
  • Content

  • Navigation

  • Presentation

  • Multimedia

  • Tools

de Ruijter, 2018 Smoking cessation counselling I-Change Model Computer-tailored e-learning programme Designed adaptivity To modify behavioural predictors and behaviour. At the beginning of the training. Demographics, behavioural predictors, behaviour
  • Content

El Saadawi, 2008 Dermopathology, melanoma Cognitive tutoring Report tutor Algorithmic adaptivity To teach how to correctly identify and document all relevant prognostic factors in the diagnostic report. At the beginning of each case. User actions, report features
  • Content

  • Navigation

  • Presentation

  • Multimedia

El Saadawi, 2010 Dermopathology Cognitive tutoring SlideTutor Algorithmic adaptivity To facilitate transfer of performance gains to real world tasks that do not provide direct feedback on intermediate steps. During intermediate problem-solving steps. User actions: results of problem-solving tasks; reporting tasks; requests for help
  • Content

  • Navigation

  • Presentation

  • Multimedia

Feyzi-Begnagh, 2014 Dermopathology, nodular and diffuse dermatitis Cognitive tutoring, theories of self-regulated learning SlideTutor Algorithmic adaptivity To improve metacognitive and learning gains during problem-solving. During each case or immediately after each case. User actions: results of problem-solving tasks; reporting tasks; requests for help
  • Content

  • Navigation

  • Presentation

  • Multimedia

  • Tools

Hayes-Roth, 2010 Brief intervention training in alcohol abuse Guided mastery STAR workshop NR To improve attitudes and skills. During clinical cases. User scores, user-generated dialogue
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Lee,
2017
Treatment of atrial fibrillation NR Learning assessment platform Designed adaptivity To increase learning effectiveness (knowledge, competence, confidence and practice). After learning gaps identified in the first session. Learning gaps in relation to objectives
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Micheel, 2017 Oncology Learning style frameworks Learning-style tailored educational platform Designed adaptivity To increase learning effectiveness (knowledge). After assessing the learning style. Learning style
  • Presentation

  • Multimedia

  • Tools

Morente, 2013 Pressure ulcer evaluation NR ePULab Designed adaptivity To increase learning effectiveness (knowledge, skills). Each pressure ulcer evaluation. User skills
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Munoz, 2010 Management of childhood illness Learning styles framework SIAS-ITS Designed adaptivity To increase learning effectiveness and efficiency. At the beginning of the training. User knowledge, user learning style
  • Content

  • Tools

Romito, 2016 Transoesophageal echocardiography Perceptual learning TOE PALM Algorithmic adaptivity To improve response accuracy and response time. After each clinical case. User response accuracy, user response time
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  • Multimedia

Samulski, 2017 Cytopathology, pap test, squamous lesions, glandular lesions NR Smart
Sparrow
Designed adaptivity To improve learning effectiveness. During intermediate problem-solving steps. User knowledge
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Thai,
2015
Electrocardiography Perceptual learning theory, adaptive response-time-based algorithm PALM Algorithmic adaptivity To improve perceptual classification learning effectiveness and efficiency. After each user response. User response accuracy, user response time
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  • Presentation

  • Multimedia

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Van Es, 2015 Diagnostic cytopathology, gynaecology, fine needle aspiration, exfoliative fluid NR Smart
Sparrow
Designed adaptivity To improve learning effectiveness. During intermediate problem-solving steps. User responses
  • Content

  • Navigation

  • Presentation

  • Multimedia

Van Es, 2016 Diagnostic cytopathology,; gynaecology, fine needle aspiration, exfoliative fluid NR Smart
Sparrow
Designed adaptivity To improve learning effectiveness. During intermediate problem-solving steps. User responses
  • Content

  • Navigation

  • Presentation

  • Multimedia

  • Tools

Wong, 2015 Diagnostic imaging, chest X-rays, computed tomography scans Cognitive load theory Smart
Sparrow
Designed adaptivity To improve learning effectiveness. During intermediate problem-solving steps. User responses
  • Content

Wong, 2017 Fetal heart rate interpretation Perceptual learning PALM Algorithmic adaptivity To improve response accuracy and response time. After each clinical case. User response accuracy, user response time
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  • Navigation

  • Multimedia

Woo, 2006 Haemodynamics, baroreceptor reflex NR CIRCSIM tutor Algorithmic adaptivity To improve knowledge related to problem-solving tasks. After each user response. User knowledge, user responses
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  • Navigation

  • Tools

ePULab, electronic pressure ulcer lab; NR, not reported; PALM, perceptual adaptive learning module.; SIAS-ITS, SIAS intelligent tutoring system; TOE PALM, transoesophageal echocardiography perceptual adaptive learning module.