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Letters
February 11, 2009

Internet-Based Education for Health Professionals

JAMA. 2009;301(6):598-600. doi:10.1001/jama.2009.70

To the Editor: The meta-analysis by Dr Cook and colleagues1 deals with the very current topic of Internet-based education for health professionals. The authors conducted a comprehensive and rigorous approach: multiple dimensions (satisfaction, knowledge, and behaviors) were considered both for experimental and quasi-experimental studies. Unfortunately, neither methodological accuracy nor the broad inclusion criteria can overcome the weakness of the primary research included in the analysis. The consistency of the results demonstrated by the sensitivity analysis may be reassuring regarding the inclusion of many uncontrolled before-and-after designs (more than half in the Internet-based learning vs no intervention comparison), but more concerns arise from the novelty effect sometimes referred to as the Hawthorne effect.2

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