Professional and patient care outcomes of e-learning in healthcare continuing education: A systematic review

Aim: To synthesize evidence on the perceived and objectively measured effectiveness of e-learning for continuing educational purposes among healthcare professionals, with particular attention to professional and patient care-related outcomes Background: E-learning is increasingly used for continuing healthcare education, yet its perceived effectiveness on professional and patient outcomes has not been summarised. Design: Systematic review. Methods: The review protocol was registered in PROSPERO (CRD42024545255) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. MEDLINE-PubMed, CINAHL, Scopus and the Cochrane Library were searched for studies published from January 2016 to June 2024. Eligible studies included quantitative, qualitative and mixed-methods designs, using comparative and non-comparative approaches, assessing e-learning interventions in postgraduate or continuing education for healthcare professionals and reporting professional and/or patient care outcomes. Study quality was appraised using Joanna Briggs Institute tools. Findings were synthesized narratively and organized using the adapted Kirkpatrick/Barr framework. Results: Seventeen studies from 16 countries were included, nine quasi-experimental, six cross-sectional and two randomized trials. E-learning was consistently perceived as effective in improving knowledge, confidence, attitudes and selected skills, while evidence of practice change was less consistent and only partly documented in routine care. However, only four studies examined patient safety, quality of care, satisfaction, or infection outcomes, using heterogeneous indicators and follow-up periods. Conclusions: E-learning appears useful for continuing professional development, especially for improving knowledge, confidence, attitudes, perceived competence and selected skills. However, evidence remains largely self-reported and data on sustained practice change and patient-related outcomes are still limited, heterogeneous and inconsistently measured.