Effectiveness of E-Learning in Undergraduate ENT Education: A Mixed-Methods Systematic Review.

Abstract

Ear, nose and throat (ENT) is often underrepresented in undergraduate medical curricula. E-learning has emerged as a promising strategy to address this gap. This mixed-methods systematic review aimed to evaluate the effectiveness of e-learning in undergraduate ENT education. MEDLINE, Embase, Education Research Complete, and Web of Science were searched. The PRISMA guidelines were followed. Quantitative data were synthesized with a meta-analysis of normalized gain scores to assess knowledge improvement. Qualitative findings were analyzed using thematic synthesis. Due to substantial heterogeneity, a narrative synthesis was performed for skills and confidence. Twenty-nine studies fulfilled the inclusion criteria. Knowledge scores improved by 26.8% (95% CI 23.7%-30.0%, n = 13), which was considered low gain. Skill improvement was variable (n = 6), while confidence consistently improved (n = 5). Thematic synthesis identified four themes: (1) multimedia resources, (2) learner autonomy and self-directed engagement, (3) technical barriers, and (4) blended learning models. Knowledge and learner confidence improved with e-learning. However, its impact on practical skills was limited. These findings support the integration of e-learning as a complementary adjunct to clinical teaching.