Effects of Smartphone-Based Mobile Learning in Nursing Education: A Systematic Review and Meta-analysis

Purpose: A systematic review and meta-analysis was conducted to evaluate the effects of smartphone-based mobile learning for nurses and nursing students. Methods: Electronic literature search of PubMed, Cochrane Library, Embase, SCOPUS, Web of Science, ProQuest Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Educational Resource Information Center (ERIC) was conducted. Two authors independently reviewed empirical studies for inclusion and extracted the design, sample size, intervention method, outcome variables, and statistical values of them. Methodological quality was assessed using Cochrane collaboration risk of bias tool. To estimate the effect size, meta-analysis was performed using R meta program. Results: Authors identified 11 randomized or nonrandomized controlled trials of a total of 3,419 studies. Overall effect sizes by random-effects model was large [Hedges'g (g) = 1.12, 95% confidence interval (CI) 0.72-1.52], with learning attitude (g = 1.69), skills (g = 1.41), knowledge (g = 1.47), and confidence in performance (g = 1.54). For heterogeneity, subgroup analyses using meta-analysis of variance were performed, but no significant difference was found. Finally, a funnel plot and Egger's regression test along with trim-and-fill analysis and fail-safe N were conducted to check for publication bias, but no significant bias was detected. Conclusion: Smartphone-based mobile learning had significantly positive influence on nursing students' knowledge, skills, confidence in performance, and learning attitude. Smartphone-based mobile learning may be an alternative or supportive method for better education in nursing fields. (C) 2019 Korean Society of Nursing Science, Published by Elsevier Korea LLC.