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BACKGROUND: Web-based distance learning is considered a promising approach to replace or supplement conventional nursing instruction. However, no systematic review has been seen to explore the effect of web-based distance education in nursing. AIM: To examine the efficacy of the web-based distance education for nursing students and employed nurses. METHODS: A systematic review of randomized controlled studies was undertaken. Multiple search strategies were performed in PubMed and Embase until July 2012. Two reviewers independently selected trials, conducted quality critical appraisal, and extracted the data from the included studies. RESULTS: Nine randomized controlled trials met inclusion criteria, among which five studies were rated as A quality level, and the other four studies as B quality level. The results showed that web-based distance learning has produced equivalent or better effects in knowledge acquisition. For nursing skill performance, four studies revealed a positive role for the new teaching mode, and one study showed a negative viewpoint. This review also demonstrated that participants generally accepted web-based education with high satisfaction rates. Two studies reported a more positive trend for self-efficacy in performing nursing skills in the experiment group compared with control group. Some negative feedbacks were also expressed. CONCLUSION: Web-based education has encouraging effects in improving both participants' knowledge and skills performance, and in enhancing self-efficacy in performing nursing skills, with a high satisfaction rate expressed by participants. More rigorous experimental studies are advocated.
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