# Effectiveness of E‐Learning in Undergraduate ENT Education: A Mixed‐Methods Systematic Review

## TL;DR

E-learning improves knowledge and confidence in undergraduate ENT education but has limited impact on practical skills.

## Contribution

A mixed-methods systematic review evaluating e-learning's effectiveness in undergraduate ENT education.

## Key findings

- Knowledge scores improved by 26.8% with e-learning.
- Confidence consistently improved across studies.
- Impact on practical skills was variable and limited.

## 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.

E‐learning in undergraduate ear, nose, and throat education was evaluated in a mixed‐methods systematic review of 29 studies. Pooled analysis showed a modest knowledge gain of 26.8%, variable effects on skills, and consistent improvements in learner confidence. These findings support e‐learning as a useful adjunct, rather than a standalone replacement, for clinical teaching.