Table 3.

Frequency and direction of outcomes.

Levels of evaluation from the Kirkpatrick model and subthemes			Number of documented outcomes from primary studies and direction of the effect
			Negative	No effect	Positive	Total
1. Nurse reactions with e-learning (n=11 SRsa)
	Total		7	0	27	34
	General		0	0	9	9
	Anonymity		0	0	1	1
	Authentic scenario		0	0	1	1
	Computer and internet experience		1	0	0	1
	Confidence in e-learning		0	0	1	1
	Content		0	0	1	1
	Discussion		0	0	1	1
	Information sharing		1	0	0	1
	Interactions		2	0	2	4
	Learners' experience		0	0	1	1
	Overall satisfaction		0	0	1	1
	Person-centered approach		0	0	1	1
	Satisfaction with interactive case studies		0	0	2	2
	Scope of reflection		0	0	1	1
	Sense of belonging		0	0	1	1
	Technical support		0	0	1	1
	Technology characteristics		3	0	3	6
2. Nurse learning (n=18 SRs)
	Total		3	10	40	53
	Knowledge (n=13 SRs)
		Total	1	5	18	24
		General	0	3	6	9
		Acute Physiology and Chronic Health Evaluation III scoring system	0	0	1	1
		Arterial blood gas interpretation	0	0	1	1
		Assessment (ability of neurological function)	0	0	1	1
		Assessment (general)	0	0	1	1
		Emergency preparedness	0	0	1	1
		Hospital quality	0	0	1	1
		Intravenous injections	0	0	2	2
		Medication administration	0	0	1	1
		Medication calculation	1	0	1	2
		Neonatal care	0	0	1	1
		Pain, physical and psychological symptoms, and loss	0	1	0	1
		Palliative care	0	1	1	2
	Attitude and self-efficacy (n=3 SRs)
		Total	0	0	4	4
		Confidence postintervention	0	0	1	1
		Perceived effectiveness of e-learning	0	0	1	1
		Personal and professional development	0	0	1	1
		Stress in nurse-patient relationship	0	0	1	1
		Self-efficacy (general)	0	0	1	1
	Skills (n=10 SRs)
		Total	2	5	18	25
		General	0	0	4	4
		Assessment (depression)	0	0	1	1
		Cannulation	1	0	0	1
		Cardiopulmonary resuscitation-defibrillation	1	0	0	1
		Care practice changes	0	0	1	1
		Child abuse detection	0	0	1	1
		Communication	0	0	1	1
		Critical appraisal of research literature	0	1	1	2
		Emergency preparedness skills performance	0	0	1	1
		Intravenous injections	0	1	0	1
		Medication preparation and administration	0	3	3	6
		Motivational interviewing	0	0	1	1
		Monitoring	0	0	1	1
		Neonatal care	0	0	1	1
		Universal precautions-related behaviors	0	0	1	1
		Scheduling activities	0	0	1	1
3. Behavior (change in practice) (n=0 SRs)			0	0	0	0
4. Results (n=2 SRs)
	Total		0	0	1	1
	Patient outcomes (n=1 SR)
		Nurses’ perceptions of care for older adults	0	0	1	1
	Cost (n=2 SRs)		0	0	2	2
Total			10	10	70	90

^aSR: systematic review.