Blended Learning in Health Professions Education: A Systematic Review of Pedagogical Approaches, Digital Innovations, Learning Outcomes, and Implementation Challenges
Although BL is highly effective in HPE, its long-term sustainability depends on transitioning from ad hoc implementation to institutionally supported, theory-driven instructional design, and educators and higher education institutions should prioritise intentional pedagogical design and sustained institutional support.
Abstract
This study aims to examine the implementation patterns, technology integration, learning outcomes, student engagement, and sustainability factors of blended learning (BL) in health professions education (HPE) between 2020 and 2024 across diverse pedagogical and educational contexts. Despite the increasing adoption of BL in HPE, the existing literature lacks a comprehensive, theory-informed synthesis of implementation patterns, technology integration, the relationship between student engagement and learning outcomes, and sustainability factors across disciplines and educational settings. This study employed a Systematic Literature Review (SLR) following the PRISMA 2020 guidelines. The review was conducted using the Scopus database and included studies published between January 2020 and December 2024. A total of 41 peer-reviewed empirical studies were selected from an initial pool of 65 records through rigorous title and abstract screening, followed by full-text eligibility assessment. Data were synthesised narratively, and the findings were organised thematically according to five research questions using an integrated theoretical framework encompassing constructivism, cognitive load theory, multimedia learning theory, and self-regulated learning theory. The findings revealed that 58.5% of the included studies implemented general BL approaches, whereas 41.5% adopted established pedagogical frameworks. Technology integration primarily involved multimedia resources (53.7%), digital assessment platforms (43.9%), and video conferencing tools (43.9%). Overall, BL demonstrated high effectiveness, with 86% of the reported learning outcome measures indicating positive results. Structured active engagement exhibited the strongest positive association with learning outcomes (r ≈ 0.55–0.75). The main challenges included substantial resource requirements and difficulties in student self-regulation, whereas instructional design support emerged as the most important facilitating factor. These findings suggest that although BL is highly effective in HPE, its long-term sustainability depends on transitioning from ad hoc implementation to institutionally supported, theory-driven instructional design. Accordingly, educators and higher education institutions should prioritise intentional pedagogical design and sustained institutional support to ensure the effective and sustainable implementation of blended learning in health professions education.
Interest in telehealth has led to an increase in the availability of online telehealth courses. Understanding student perspectives of the learning experience and how the courses equip students with the skills for their future professions is warranted. To this end, five health, education, and social science electronic databases and a search engine (i.e., Pubmed, EBSCO, Proquest, Elsevier, and Google Scholar) were searched as part of a systematic review for peer-reviewed research published in English over 10 years (2013-2023). Ten studies were selected for the final review, resulting in the perspectives of 2,305 healthcare students and professionals. The curriculum content and student feedback were synthesised using thematic analyses and presented using a combination of flowcharts and tables. Each study was also assessed for bias using critical appraisal tools for qualitative, quantitative and mixed-method research designs. Key pedagogical themes emerged, including simulations, interprofessional collaboration, resources, self-directed learning, peer learning, feedback, and technology. The use of simulations and interprofessional collaboration emerged as the two most regularly cited aspects of teaching that students found useful. Recommendations described potential inclusion of pedagogical techniques when conducting online training, and teaching methodology requiring further investigation.
Hsien-Jin Teoh, Haruka Kitamura, S. Edirippulige· Australian Journal of Clinic...· 0 citations
Abstract The United Nations' Sustainable Development Goals (SDGs) provide a global framework for addressing interconnected social, economic, and environmental challenges by 2030. This review examines how the SDGs have been incorporated into interdisciplinary degree and professional training programs for the mental health workforce, broadly defined. The review systematically searched and analyzed the literature, resulting in 47 papers eligible for full‐text assessment. Studies were examined for pedagogical frameworks, teaching strategies, and programmatic interventions explicitly linking SDGs to mental health workforce education. Pedagogical practices were categorized thematically, and the review identified both the educational philosophies underpinning integration efforts and the practical teaching interventions applied. Data were synthesized to describe trends, highlight gaps, and provide insights into approaches for embedding sustainability content in mental health education. Three overarching pedagogical approaches emerged from the reviewed studies: (1) active and critical learning, emphasizing reflective engagement with SDG‐related issues; (2) collaborative learning, fostering interdisciplinary knowledge‐sharing and teamwork; and (3) experiential and service learning, enabling applied practice in community and global contexts. While evidence showed innovative integration of SDGs into curricula, significant gaps remained in consistency and scalability. Challenges included limited programmatic coordination, insufficient training for educators, and a lack of frameworks guiding mental health–specific integration. Overall, findings indicate growing but uneven incorporation of SDGs into education for the global mental health workforce. The review shows how the SDGs can be embedded into mental health workforce education through deliberate and structured pedagogical strategies.
Madeleine Pownall, Ember Corpuz, Richard Harris et al.· Applied Psychology: Health a...· 0 citations
A significant gap exists between Kenya's digital health policy ambitions and nursing graduates' competencies and context-appropriate digital tools are urgently needed.
Francisca Mibei, D. Ongori, D. Adero· International Journal of Dig...· 0 citations
The purpose of this paper is to examine how the Sustainable Development Goals (SDGs) are integrated into a nursing education program at the Universidad Técnica del Norte (UTN), Ecuador and to identify the institutional, curricular and pedagogical factors associated with their explicit incorporation. The study aims to clarify the gap between SDGs awareness and formal curricular enactment in higher education for the health sciences.
The study adopts a sequential mixed-methods design combining qualitative, quantitative and documentary approaches. Data were collected through a faculty focus group, surveys administered to instructors (n = 35) and undergraduate nursing students (n = 498) and a microcurricular review of official course syllabi (n = 45) within the UTN nursing program. Quantitative analyses included nonparametric tests, correlation analyses, clustering techniques and logistic regression, while qualitative and documentary data were integrated through methodological triangulation.
Although faculty awareness of the SDGs is relatively high, their translation into explicit curricular practice remains uneven, with fewer than two thirds of instructors reporting formal integration. Faculty engagement is concentrated primarily on SDGs 3 (Good Health and Well-Being) and SDGs 4 (Quality Education), reflecting disciplinary proximity, while broader socio-ecological goals receive limited attention. Logistic regression analysis showed moderate explanatory capacity (McFadden’s pseudo-R2 = 0.429), indicating that structural and curricular factors play a stronger role in explicit SDGs integration than pedagogical activity alone. Among students, exposure to the SDGs is widespread, but levels of deep understanding are modest, and knowledge is only weakly associated with perceived importance. The micro-curricular analysis reveals that explicit SDGs references are largely absent from foundational courses and become more prevalent in professionalizing and practice-based stages, particularly during the Rota.
The study is limited by its single-institution design and the small faculty sample size, which may restrict statistical power and generalizability. Future research should adopt multi-institutional and longitudinal designs and incorporate direct measures of sustainability competence development.
The findings provide actionable guidance for curriculum governance and faculty development in nursing education. They support the need to institutionalize SDGs integration from early curricular stages, align active pedagogies with explicit learning outcomes and assessment criteria and strengthen program-level mechanisms to ensure coherent and traceable Education for Sustainable Development (ESD).
By strengthening the integration of the SDGs in nursing education, higher education institutions can better prepare future nurses to address health inequities, promote preventive and community-based care and contribute to sustainable health systems. Such integration also enhances graduate employability by developing competencies increasingly valued in the global health sector, including sustainability awareness, equity-oriented practice, community engagement and responsible use of health resources. In the Ecuadorian context, and more broadly in the Global South, such curricular alignment has the potential to enhance social justice, public health outcomes and community well-being through professionally trained agents of sustainable development.
To the best of the authors’ knowledge, this study provides one of the first empirical, multilevel analyses of SDGs integration in nursing education in Ecuador. By combining faculty and student perspectives with micro-curricular evidence from UTN, it offers an evidence-informed framework for strengthening ESD in health sciences programs, particularly in Global South contexts.
Katty Elizabeth Cabascango Cabascango, Patricia Marlene Aguirre Mejía, Freddy Hernán Villota González et al.· International Journal of Sus...· 0 citations
This systematic integrative review synthesises empirical evidence on teacher-mediated digital pedagogies and their influence on learning and mental health in low-resource schools. Digital technologies are widely promoted as solutions to educational inequality. However, reform initiatives continue to prioritise access to devices and connectivity. Less attention is given to how teachers shape digital learning environments and to the psychological impact of these environments. Mental health challenges, including stress, disengagement, and technostress, remain prevalent in under-resourced contexts. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Structured searches were conducted in Scopus, Web of Science, ERIC, and Google Scholar. The search included peer-reviewed empirical studies published between 2015 and 2025. Studies examined digital pedagogy, teacher practice, low-resource schooling, and mental health outcomes. After screening and eligibility assessment, 27 studies were included in the final synthesis. Data were analysed using inductive thematic synthesis. Sociocultural theory and self-determination theory guided the interpretation. Three interrelated dimensions emerged. The first is pedagogical mediation, which includes scaffolding and instructional structure. The second is social-emotional mediation, which includes belonging, autonomy support, and psychological safety. The third is contextual mediation, which reflects infrastructural and socio-economic constraints. The findings show that digital tools support learning and mental health when used with intentional teacher mediation. Technology alone does not produce equitable or psychologically supportive outcomes. Bridging educational and mental health gaps requires sustained investment in teacher capacity and relational digital pedagogy in low-resource settings.
Ntombikayise Nkosi· International Journal of Stu...· 0 citations
Results indicated that interactive, simulation-based workshops enhance educators' assessment skills, knowledge and confidence, however, important gaps remain regarding optimal programme length, pedagogical frameworks, translational of training into the work environment and longitudinal outcomes.
L. Alpine, M. O’Grady, Julie Broderick et al.· Higher Education, Skills and...· 0 citations
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