Choosing Wisely: Face-to-Face and Web-Based Instructional Methods for Continuing Education

by Megan Davis, Pharm.D., PGY1 Pharmacy Practice Resident, Magnolia Regional Health Center

Continuing education programs play an important role in a pharmacist’s development. Healthcare practitioners should be self-directed learners and continuing education (CE) provides them with a way to keep their knowledge and skills current. Moreover, CE is required by law to order to maintain professional licensure. CE programs are offered through a variety of methods. Two of the most common are face-to-face and web-based methods. Web-based instruction uses the Internet as the primary method of information delivery.¹ Many terms are used interchangeably to describe web-based learning. These include online learning, computer-assisted learning, and e-learning. For the purpose of this essay, web-based learning is defined as learning that does not take place in a live environment, that is, the instruction and learning are happening at different times (asynchronous delivery). Face-to-face learning, on the other hand, is live interaction that occurs in-person between a learner and a teacher — that is, the instruction and learning are occurring at the same time and in the same place. The problem with these methods, however, is that neither is very effective in terms of behavior change.²

The effectiveness of continuing education is typically assessed in terms of learner reactions and satisfaction, sometimes by testing for knowledge changes, but rarely are patient outcomes or changes in practice measured. For example, knowledge can be measured via pre-test and post-test scores. But a change in knowledge may not lead to practice change and improved patient outcomes. None-the-less, while there is some debate about how effective CE is, healthcare practitioners should understand the advantages and disadvantages of the face-to-face and web-based methods.²

Potential Advantages and Limitations of Face-to-Face Instruction

Face-to-face learners have the opportunity to perform and practice techniques while receiving feedback and guidance from the instructor. In today’s world, I realize the popularity of platforms such as YouTube, where the audience is able to learn how to do just about any task by watching tutorial videos. However, I argue that this web-based instruction is not as effective as learning how to perform the activity in-person with feedback from an instructor. Face-to-face instruction can provide the learner with real-time, on-the-spot feedback, whereas non-live web-based instruction does not.

When learners and instructors meet face-to-face, it’s an opportunity network and connect with others in your profession. This initial forming of relationships is easier in a face-to-face environment where one is able to connect with others between sessions, during breaks, or at dinner. Pharmacy, like nursing and medicine, is a small world and connecting and building relationships is best accomplished through face-to-face interactions and continuing education that takes place at local, regional, and national meetings.³ In my personal experience, I have made countless lasting relationships by attending face-to-face continuing education programs. Social media platforms, which are web-based, do allow for continued connection once the face-to-face interaction has occurred, but I do not believe that it can replace the initial contact, conversations, and networking that face-to-face allows.

However, face-to-face instruction typically does not take into account the individual’s learning preferences. As we know, learning is not a one size fits all format. In web-based instruction, the learner can seek out different instructional methods (readings, videos, podcasts) — one’s that are most conducive to their learning style. In face-to-face instruction, the learner can’t select the instructional method — the instructor chooses. 

Also, live instruction generally does not evaluate learning using a valid assessment at the conclusion of the education. Credit is awarded based on attendance. By not assessing improvements in knowledge or skill, it difficult to assess whether any learning has occurred. Some live programs incorporate audience response (aka clicker-type) questions throughout the program, but answering these questions correctly is not a requirement for credit.

Lastly, the face-to-face methods can be inconvenient and costly, especially when travel is involved. This is important for busy professionals who may not have the time to seek out and attend live programs.³

Potential Advantages and Limitations of Web-based Instruction:

Web-based instruction provides a way for learners to complete CE programs on their own time and any location with Internet access (which is practically everywhere nowadays). With 24-hour, flexible access, web-based instruction is both convenient and accessible. It also allows for a greater variety of topics from which to select. Learners have the ability to seek out programs that align with their professional interests. These programs can be accessed through numerous professional organizations, Universities, and medical education companies.  Lastly, most web-based programs test the learner’s understanding of the material at completion of the course and often include critical thinking and problem-solving exercise to determine if the learner retained the information presented.³

Unfortunately, technical problems are inevitable with both web-based and face-to-face instruction. When technical problems are encountered, learning is hindered and learner satisfaction declines.⁴ Technical problems are more difficult to overcome with web-based instruction due to the dependence on technology to deliver the instruction. Technical issues are a bit easier to address during face-to-face programs because the instructor is still able to communicate with the audience and can use alternative methods, like providing paper handouts, if the instructor has planned ahead.⁴

Comparing the changes in pre-test and post-test scores, one study found that the face-to-face and web-based methods were equally effective with regard to the knowledge gained after the topic was presented.³ This is not surprising as both delivery methods seem to achieve similar knowledge gains in aggregate across many studies. That is, pre-test and post-test scores are significantly better after the instruction is completed. However, what studies have not yet demonstrated is the effectiveness of instruction in terms of practice change. This means that it is still unknown if CE leads to behavior change or improves patient outcomes regardless of the instructional method used.²

With the Internet playing a vital role in our lives now, it is safe to say that web-based instruction is here to stay.⁴ By exploring the advantages and limitations to both face-to-face and web-based methods, we are better able to choose the method that is most effective for what we, as individual learners and educators, are trying to accomplish. In many states, regulatory boards require that a portion of continuing education be completed via live face-to-face instruction.³ I believe when we combine the two methods and are cognizant of the advantages and limitations of each, we are more likely to achieve our continuing education goals.

References:

1. Cook, D. Web-based learning: pros, cons and controversies. Clin Med 2007; 7:37-42.
2. Rouleau G, et al. Effects of E-learning in a Continuing Education Context on Nursing Care: Systematic Review of Systematic Qualitative, Quantitative, and Mixed-Studies Reviews. J Med Internet Res 2019; 21(10):e15118. 
3. Brown, L. Continuing Education Showdown: Online Learning vs. In-Person Seminars. Acupuncture Today 2013; 14(12).
4. Khatony, A. et al. The effectiveness of web-based and face-to-face continuing education methods on nurses’ knowledge about AIDS: a comparative study. BMC Medical Education 2009; 9:41.