title: Systematic review of e-learning for surgical training.
abstract: BACKGROUND
  Internet and software-based platforms (e-learning) have gained popularity as teaching tools in medical education. Despite widespread use, there is limited evidence to support their effectiveness for surgical training. This study sought to evaluate the effectiveness of e-learning as a teaching tool compared with no intervention and other methods of surgical training.
  
  
  METHODS
  A systematic literature search of bibliographical databases was performed up to August 2015. Studies were included if they were RCTs assessing the effectiveness of an e-learning platform for teaching any surgical skill, compared with no intervention or another method of training.
  
  
  RESULTS
  From 4704 studies screened, 87 were included with 7871 participants enrolled, comprising medical students (52 studies), trainees (51 studies), qualified surgeons (2 studies) and nurses (6 studies). E-learning tools were used for teaching cognitive (71 studies), psychomotor (36 studies) and non-technical (8 studies) skills. Tool features included multimedia (84 studies), interactive learning (60 studies), feedback (27 studies), assessment (26 studies), virtual patients (22 studies), virtual reality environment (11 studies), spaced education (7 studies), community discussions (2 studies) and gaming (2 studies). Overall, e-learning showed either greater or similar effectiveness compared with both no intervention (29 and 4 studies respectively) and non-e-learning interventions (29 and 22 studies respectively).
  
  
  CONCLUSIONS
  Despite significant heterogeneity amongst platforms, e-learning is at least as effective as other methods of training.
authors.affiliation: Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium. heidi.maertens@ugent.be.
authors.forename: H
authors.initials: H
authors.lastname: Maertens
authors.affiliation: Department of Surgery, McGill University, Montreal, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Madani
authors.affiliation: Montreal General Hospital Medical Library, McGill University Health Centre, Montreal, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Landry
authors.affiliation: Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Vermassen
authors.affiliation: Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Van Herzeele
authors.affiliation: Department of Surgery, McGill University, Montreal, Canada.|Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine, McGill University, Montreal, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Aggarwal
mesh_terms: D002983:Clinical Competence / Q000592:standards; D020375:Education, Distance / Q000379:methods*; D004501:Education, Medical / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D020407:Internet; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D013663:Teaching