Blended Learning in Healthcare Education: An Overview and Overarching Meta-analysis of Systematic Reviews

Andrew Lockey, Andrew Bland, John Stephenson, Janet Bray, Felicity Astin

Research output: Contribution to journalReview articlepeer-review


Introduction: Blended learning is an educational approach that integrates face-to-face with online instruction. This overview of existing systematic reviews aims to evaluate the impact of blended learning on educational outcomes in healthcare professional education, identify gaps in the current evidence and direction for future reviews.
Methods: Five databases were searched (1 January 2000 to 14 January 2021) for systematic reviews of blended versus non-blended learning approaches for healthcare education. ‘Flipped classroom’, unpublished studies, abstracts, and study protocols were excluded. The extracted data included details of included reviews, description of populations, and outcomes according to Kirkpatrick levels. A narrative review is presented, along with an overarching meta-analysis, which evaluates a synthesised estimate of the effect of blended learning based on standardised mean differences.
Results: Eleven systematic reviews were included, comprising of 160 primary studies (including 117 randomised controlled trials) from 56 countries with over 18,000 participants. The overall level of evidence was very low quality. An overarching meta-analysis of 93 studies addressing knowledge acquisition favoured blended over non-blended learning methods [standardised mean difference 0.768 (95% CI 0.594 to 0.941); p<0.001]. None of the reviews identified an adverse effect on other educational outcomes.
Discussion: Blended learning may be superior to traditional teaching approaches in improving knowledge acquisition. We recommend further research to describe the relative benefits of blended learning in each individual context and identify which elements of instructional design are beneficial for each outcome. Finally, we recommend the use of clear and consistent terminology in reported studies.
Original languageEnglish
JournalJournal of Continuing Education in the Health Professions
Publication statusAccepted/In press - 22 Jun 2022


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