Examining online international health professions education: a mixed methods review of barriers, facilitators, and early outcomes

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Table 5

Qualitative themes and course outcomes.

Theme	Integration into curriculum	Course outcomes	Quantitative finding
CUL	Incorporate international healthcare systems and standards	Pre-post test difference; 2 × 2 ANOVA Final course grade comparisons; independent t-test and Mann–Whitney U	The ECS cohort consistently scored higher on the pre and post test written examinations. There was significant improvement over time in both cohorts. There was no significant difference between cohorts in final course grades (p > 0.05).
TIME	Development of activities that engage online cohorts (flipped classroom)	Pre-post test difference; 2 × 2 ANOVA Final course grade comparisons; independent t-test and Mann–Whitney U	The ECS cohort consistently scored higher on the pre and post test written examinations. There was significant improvement over time in both cohorts. There was no significant difference between cohorts in final course grades (p > 0.05).
PREP	Planning meetings prior to implementation	Pre-post test difference; 2 × 2 ANOVA Final course grade comparisons; independent t-test and Mann–Whitney U	The ECS cohort consistently scored higher on the pre and post test written examinations. There was significant improvement over time in both cohorts. There was no significant difference between cohorts in final course grades (p > 0.05).
B&F	Asynchronous interactions between students and teachers, periodic synchronous group meetings	Pre-post test difference; 2 × 2 ANOVA Final course grade comparisons; independent t-test and Mann–Whitney U	The ECS cohort consistently scored higher on the pre and post test written examinations. There was significant improvement over time in both cohorts. There was no significant difference between cohorts in final course grades (p > 0.05).
REL	Synchronous meetings between assigned advisor-advisee pairs	Pre-post test difference; 2 × 2 ANOVA Final course grade comparisons; independent t-test and Mann–Whitney U	The ECS cohort consistently scored higher on the pre and post test written examinations. There was significant improvement over time in both cohorts. There was no significant difference between cohorts in final course grades (p > 0.05).
SEL	Student selection based on healthcare experience and proven academic record	Correlations; Pearson’s r, Spearman’s Rho	No significant correlation between years of healthcare experience or highest degree earned and final course grade was found (p > 0.05).
STU	A diverse and representative cohort was sought	Correlations; point biserial; Pearson’s r	No significant correlation between gender or age and final course grade was found (p > 0.05).
PRA	Set time zone standards (EST), periodic synchronous meetings	Pre-post test difference; 2 × 2 ANOVA Final course grade comparisons; independent t-test and Mann–Whitney U	The ECS cohort consistently scored higher on the pre and post test written examinations. There was significant improvement over time in both cohorts. There was no significant difference between cohorts in final course grades (p > 0.05).

Theme codes, implementations into the program, and quantitative outcome items used as correlate measures. Primary themes are shaded, subthemes are in white. B&F: Boundaries and Flexibility; CUL: Culture; ECS: Extracorporeal Science; PRA: Practical Considerations; PREP: Preparation; REL: Relationship; SEL: Selecting Participants; STU: Student Characteristics.

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