Table 1.
Effectiveness of training strategies on the practices of professional healthcare providers
| Strategies tested* | Outcome scale | No of study comparisons (risk of bias: low, moderate, high, very high) | Median MES†, in %-points (IQR; range) | |
| Intervention arm | Reference arm | |||
| Group in-service training | ||||
| Group in-service training | Controls | Percentage | 60 (9, 19, 17, 15) | 7.3‡ (3.6–17.4; –21.3 to 68.1) |
| Group in-service training | Controls | Continuous | 16 (3, 5, 2, 6) | 17.4§ (–2.3 to 28.5; –25.0 to 81.4) |
| Group in-service training plus other strategy components | Other strategy components | Percentage | 13 (6, 3, 4, 0) | 3.7¶ (–0.1 to 5.8; –2.7 to 23.6) |
| Group in-service training plus other strategy components | Other strategy components | Continuous | 4 (1, 1, 2, 0) | –7.3 (–20.6 to 3.6; –25.8 to 6.4) |
| Educational outreach visits | ||||
| Educational outreach visits | Controls | Percentage | 8 (0, 2, 3, 3) | 9.9 (4.3–20.6; 2.8–30.9) |
| Educational outreach visits plus other strategy components | Other strategy components | Percentage | 3 (2, 1, 0, 0) | 21.5 (NA; 5.4–30.7) |
| Group in-service training versus (or combined with) educational outreach visits | ||||
| Group in-service training | Educational outreach visits | Percentage | 1 (0, 0, 1, 0) | 0.8 (NA; NA) |
| Group in-service training plus other strategy components | Educational outreach visits plus other strategy components | Percentage | 2 (2, 0, 0, 0) | –6.4 (NA; –5.8 to –7.0) (ie, both studies favoured educational outreach visits) |
| Group in-service training plus educational outreach visits | Controls | Percentage | 1 (0, 0, 0, 1) | –2.5 (NA; NA) |
| Group in-service training versus (or combined with) self-study in-service training | ||||
| Group in-service training | Self-study in-service training | Percentage | 2 (1, 1, 0, 0) | 9.3 (NA; 4.6–14.0) |
| Group in-service training plus other strategy components | Self-study in-service training plus other strategy components | Percentage | 2 (0, 0, 1, 1) | 2.0 (NA; –1.0 to 5.0) |
| Group in-service training plus self-study in-service training | Controls | Percentage | 1 (0, 0, 1, 0) | 24.0 (NA; NA) |
| Group preservice training | ||||
| Group preservice training | Controls | Percentage | 3 (1, 1, 1, 0) | 16.9 (NA; 15.0–46.7) |
| Peer-to-peer training | ||||
| Peer-to-peer training | Controls | Percentage | 1 (0, 0, 0, 1) | 4.0 (NA; NA) |
| Peer-to-peer training plus group in-service training | Controls | Percentage | 3 (0, 0, 0, 3) | 8.4 (NA; 1.8–66.2) |
| Peer-to-peer training plus group in-service training plus other strategy components | Other strategy components | Percentage | 1 (0, 0, 1, 0) | 25.0 (NA; NA) |
*See boxes 1 and 2 for descriptions of the strategies and the comparisons, respectively.
†Effect sizes calculated as the intervention arm improvement minus reference arm improvement.
‡Among studies with a low or moderate risk of bias, median MES=5.1 %-points (IQR: 2.5–14.0; range: –3.0 to 42.8); median MES for high or very high risk of bias studies=9.7 (IQR: 5.1–19.8; range: –21.3 to 68.1).
§Among studies with a low or moderate risk of bias, median MES=15.1 %-points (IQR: –3.8 to 21.2; range: –25.0 to 81.4); median MES for high or very high risk of bias studies=20.3 (IQR: 1.9–41.4; range: –19.2 to 57.3).
¶Among studies with a low or moderate risk of bias, median MES=4.5 %-points (IQR: 2.1–5.8; range: –2.0 to 23.6); median MES for high or very high risk of bias studies=1.4 (IQR: –1.8 to 5.4; range: –2.7 to 7.0).
MES, median effect size; NA, not applicable; %-points, percentage-points.