Learning Outcomes of e-Learning in Psychotherapy Training and Comparison with Conventional Training Methods: Systematic Review

—《医学互联网研究杂志》第26卷：e54473, 2024年7月29日—

<Journal of Medical Internet Research> Volume 26: e54473, Published on July 29, 2024

【摘要】背景：精神障碍是大多数西方国家的主要公共卫生问题。尽管药物广泛可用，但对常见精神障碍服务的需求一直在增加。特别是，循证心理治疗的供需并不一致。目前的培训方法往往昂贵、耗时，而且依赖于少数顶级专业人员作为培训师，因此现代心理治疗的大规模增加是困难的。电子学习已被提出来提高心理治疗培训的可及性、质量和可扩展性。目的：本系统综述旨在概述心理治疗培训中电子学习的当前证据。特别是，本综述考察了与电子学习相关的可用性、可接受性和学习成果。学习成果以不同的方式进行评估，包括受训者体验、知识获取、技能获取和培训内容在日常实践中的应用。此外，还评估了基于网络的培训和传统培训方法的等效性。方法：按照PRISMA（系统评价和荟萃分析的首选报告项目）指南，在2008年至2022年6月期间对Ovid、MEDLINE、PsycINFO和Scopus 数据库进行了搜索。纳入标准要求研究描述心理治疗培训的电子学习系统并评估可接受性、可行性或学习成果。对随机和非随机研究的偏见风险进行了评估。使用Kirkpatrick模型对学习成果进行分类。计算了比较电子学习和传统方法的效应大小。结果：搜索产生了3380篇出版物，其中34篇符合纳入标准。积极的学习成果通常与心理治疗培训中的各种电子学习计划有关，包括受训者的满意度、知识和技能获取以及在临床实践中应用培训内容。学习成果通常显示电子学习和传统培训方法之间的等效性。表明这种差异的总体效应大小为0.01，表明没有显着差异。这些文献显示出电子学习解决方案和评估方法的高度异质性。结论：电子学习似乎具有很好的潜力，可以通过增加访问量、可扩展性和成本效益来增强心理治疗培训，同时保持学习成果的质量。结果与一般健康教育中电子学习的发现一致，其中电子学习作为一种教学法与开展以学习者为中心的实践的机会相关。提出了在激活学习方法支持的混合环境中开展心理治疗培训计划的建议。然而，由于现有文献的异质性和局限性，需要进一步研究来复制这些发现并为电子学习以及心理治疗教育培训结果评估建立全球标准。特别需要研究培训对患者结果的影响以及在混合学习环境中结合电子学习和传统培训方法的最佳方法。

【关键词】心理健康；心理治疗；数字化学习；电子学习；在线健康；心理治疗培训；学习成果

[Abstract] Background: Mental disorders pose a major public health problem in most western countries. The demand for services for common mental health disorders has been on the rise despite the widespread accessibility of medication. Especially, the supply and demand for evidence-based psychotherapy do not align. Large-scale increase of modern psychotherapy is difficult with current methods of training which are often expensive, time consuming, and dependent on a small number of top-level professionals as trainers. E-learning has been proposed to enhance psychotherapy training accessibility, quality, and scalability. Objective: This systematic review aims to provide an overview of the current evidence regarding e-learning in psychotherapy training. In particular, the review examines the usability, acceptability, and learning outcomes associated with e-learning. Learning outcomes are assessed in different modalities including trainee experiences, knowledge acquisition, skill acquisition, and application of trained content in daily practice. Furthermore, the equivalence of web-based training and conventional training methods is evaluated. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search from Ovid, MEDLINE, PsycINFO, and Scopus databases between 2008 and June 2022 was conducted. Inclusion criteria required studies to describe e-learning systems for psychotherapy training and assess acceptability, feasibility, or learning outcomes. The risk of bias was evaluated for both randomized and nonrandomized studies. Learning outcomes were categorized using the Kirkpatrick model. Effect sizes comparing e-learning and traditional methods were calculated. Results: The search yielded 3380 publications, of which 34 fulfilled the inclusion criteria. Positive learning outcomes are generally associated with various e-learning programs in psychotherapy training including trainee satisfaction, knowledge, and skill acquisition, and in application of trained content in clinical practice. Learning outcomes generally show equivalence between e-learning and conventional training methods. The overall effect size, indicating this disparity, was 0.01, suggesting no significant difference. This literature displays a high level of heterogeneity in e-learning solutions and assessment methods. Conclusions: e-Learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to e-learning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in blended settings supported by activating learning methods are presented. However, due to the heterogeneity and limitations in the existing literature, further research is necessary to replicate these findings and to establish global standards for e-learning, as well as for the assessment of training outcomes in psychotherapy education. Research is especially needed on the effects of training on patient outcomes and optimal ways to combine e-learning and conventional training methods in blended learning settings.

[Key words] mental health; psychotherapy; digital learning; e-learning; online health; psychotherapy training; learning outcome

论文原文：Kasperi Mikkonen, Eeva-Eerika Helminen, Samuli I Saarni, and   Suoma E Saarni (2024). Learning Outcomes of e-Learning in Psychotherapy Training and Comparison with Conventional Training Methods: Systematic Review. Journal of Medical Internet Research. Vol 26, 2024. Published on 29 July.

https://doi.org/10.2196/54473

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