2011; 33: 325–327
Provision of electronic learning resources by UK
medical schools for final year students
ANDREW BALDWIN1, RICHARD WEBB2, NICOLA GAINSBOROUGH3, DAVID HOWLETT4& CELINE INGLIS1
1East Sussex Hospitals Trust, UK,2Brighton and Sussex University Hospitals Trust, UK,3Brighton and Sussex University
Hospitals Trust & Brighton and Sussex Medical School, UK,4East Sussex Hospitals Trust & Brighton and Sussex Medical
The widespread availability of the internet and development of online learning technology has seen electronic learning become a
key part of medical education. This study examines the current situation in the delivery of e-learning solely to final year medical
students by UK medical schools. A total of 25 UK medical schools were surveyed with responses received from 21. Seventy-one
percent of respondents provided e-learning to final year students (15/21). Requirements for this form of educational delivery are
likely to increase but further analysis of their use is required.
Advances in technology and the widespread availability of the
internet has allowed for the rapid development and use of
electronic media to facilitate and deliver learning. The
emergence of learning technologies and the delivery of
internet-based electronic learning has assumed an increasingly
important role in the delivery of medical education. Online
learning is considered a cultural norm for today’s students
(Howlett et al. 2009).
Studies evaluating e-learning have shown it to be an
effective teaching tool that has received high levels of student
satisfaction (Chumley-Jones et al. 2002). This is especially true
when blended with traditional teaching methods such as
lectures and seminars (Chumley-Jones et al. 2002; Ruiz et al.
2006). E-learning can help to ensure continuity of curriculum
delivery and continuity of learning.
Advances in computer-assisted learning systems has seen
the development of a number of different e-learning modal-
. Clinical cases: Case-orientated teaching using common
clinical presentations and scenarios supplemented with
questions (also referred to as virtual patients (Cook 2009)).
. Video content: The use of video files to deliver seminars or
tutorials or to demonstrate clinical skills.
. Questions: Online questions in the MCQ, EMQ or single
best answer format.
. Interactive content: For example, case discussion web logs,
synchronous or near synchronous dialogue with a tutor or
interactive flash-based teaching tools.
Aims and objectives
This study aimed to look at the current situation in delivery
of e-learning by UK medical schools solely to final year
medical students. The objectives were to determine the type,
format and amount of content provided as well as the usage of
cases by students.
A survey was sent by facsimile to the deans of 25 UK medical
schools throughout the UK. The following information was
. Whether online learning was provided for final year
. The format of online learning resources.
. The number of online clinical cases, questions and answers,
video learning and interactive cases provided.
. Whether completion of cases was mandatory.
. Whether completion of cases was tracked.
. Whether user satisfaction surveys were undertaken.
. Any additional comments (reported as free text).
Twenty-one responses were received (21/25; 84%). Of these,
15 medical schools (15/21; 71%) stated that e-learning was part
of the teaching resources given to final year students.
Six schools stated that e-learning was not part of their final
year course. Table 1 shows the format and number of
resources provided by each school; the completion rate of
cases (defined as the average number of cases completed by
students); whether completion is mandatory and whether
student feedback was sought.
Of the 15 medical schools providing electronic learning,
80% deliver content in more than one format (12/15; 80%).
Four medical schools provide content in all four formats
surveyed – clinical cases, questions and answers, video
Correspondence: A. Baldwin, Eastbourne District General Hospital, Kings Drive, Eastbourne, BN21 2UD, UK. Tel: (01323) 417400; fax: (01323)
414966; email: firstname.lastname@example.org
ISSN 0142–159X print/ISSN 1466–187X online/11/040325–3 ? 2011 Informa UK Ltd.
learning and interactive cases (4/15; 27%). Online cases are the
most popular format used by schools (12/15; 80%), closely
followed by video learning (11/15; 73%). The total number of
online resources provided by each school varied from 4 to 490.
Six of the 15 medical schools provide more than 50 clinical
cases (6/15; 40%).
Only one of the respondents required mandatory (summa-
tive) completion which formed part of the course credit.
The remainder used e-learning in a purely formative manner.
Completion rate was recorded by three medical schools
(3/15; 20%). Completion rate for cases ranged from 30 to 75%.
A total of eight out of 12 medical schools sought user feedback
from students (8/12; 67%). All of those who had gained user
Comments by student users stated that more online material
was wanted, with more questions and answers in exam format
and more scope for interactive feedback.
In one school where e-learning was not delivered to final
year students, it was commented: ‘We don’t use online clinical
cases, since in the final year students are supposed to be
seeing real ones’. One university provided extensive online
resources to students in the first 4 years of study but not to final
year students. The reason for this was not stated. Another
medical school where students had completed written exam-
inations by the end of the fourth year did not provide
e-learning to final year students as the final year was seen as an
The results show a broad use of electronic learning resources
by medical schools but a wide variety in the type and quantity
of e-learning materials. This suggests there is no consensus on
what constitutes the appropriate ‘blend’ of new and traditional
Review of literature in the area of e-learning in medical
education suggests a gap between the perceptions of how
e-learning could be used and the current reality of its use. This
is likely to reflect the cost (both time and financial commit-
ment) of developing such resources. The results do suggest
significant investment in e-learning and arguably such an
investment, as well as the successful future development of
e-learning resources, requires more detailed analysis of use
and user satisfaction.
This study did not investigate the factors that contribute to
the use or non-use of e-learning by students and it is not clear
if the student feedback sought from medical schools was from
both users and non-users. Future studies exploring these issues
would be beneficial to curriculum designers. In evaluating
e-learning, medical schools will be better able to predict the
outcome of their use and subsequently develop materials that
meet the needs of learners. Evidence that e-learning improves
the skills and knowledge of future doctors should also be
Clinical cases are currently the most favoured format used
and this reflects the traditional way in which medicine is
taught. However, the use of video and interactive formats
reflects a changing learning style through the use of new
media tools. Further studies are required to determine what
specifically makes an effective online case or tutorial
E-learning allows medical schools to provide core content
that meets educational and curriculum needs – material that is
both reliable and reusable and is not restricted by geographical
boundaries. It allows dissemination of large amounts of
information to increased numbers of students at a potentially
reduced cost, while providing a valuable educational resource
(Choules 2007). E-learning is convenient to students as it
allows them to learn at their own pace, selecting when and
how to learn and to use content that favours their learning style
(Ruiz et al. 2006).
Table 1. Online teaching resources provided by UK medical schools to final year medical students.
Format of online
Total number of
resources (total clinical cases,
questions, videos and
Are cases mandatory
(summative)? Completion rate of cases Student feedback sought?
Yes (1 case per week)
Q 10þ1 per week30–50%
Notes: C, Cases: Case-based teaching with common clinical presentations, examination findings, investigations and management supplemented with questions; Q,
Q&A: Online questions in the MCQ, EMQ or single best answer format; V, Video: The use of video files delivering seminars/tutorials or demonstrating clinical skills; I,
Interactive: Case discussion web logs, synchronous or near synchronous dialogue with a tutor.
N.B. Six medical schools responded that they do not supply e-learning to final year students and are not included in the results table.
A. Baldwin et al.
E-learning is used by the majority of UK medical schools
surveyed in order to teach final year medical students. There
is, however, great variation in the provision, amount and type
of online resources. Greater scope for evaluating the use of
such resources is required in order to determine whether the
aims of online learning match the outcomes and whether the
benefits merit the significant investment and set-up costs.
The authors thank Professor Jon Cohen, Dean Brighton and
Sussex Medical School and Professor of Infectious Diseases.
Declaration of interest: The authors report no conflicts of
interest. The authors alone are responsible for the content and
writing of the article.
Notes on Contributors
As a group, the authors have been involved both as academic faculty and
former students, in developing and evaluating on?line learning tools used
as part of a new curriculum at Brighton and Sussex Medical School (BSMS),
which saw its first cohort of students graduate in 2008. As part of the final
year of study, BSMS provides a varied online programme of study that aims
to enhance the knowledge, clinical and professional skills of students in
preparation for qualification.
education: A review of the current situation. Postgrad Med J
Chumley-Jones HS, Dobbie A, Alford CL. 2002. Web-based learning: Sound
educational method or hype? A review of the evaluation literature.
Acad Med 77:86–83.
Cook DA. 2009. Virtual patients: A critical literature review and proposed
next steps. Med Educ 43(4):303–311.
Howlett DC, Vincent T, Watson G, Owens E, Webb R, Gainsborough N,
Fairclough J, Taylor N, Miles K, Cohen J, et al. 2009. Blending online
techniques with traditional face to face teaching methods to deliver
final year undergraduate radiology learning content. Eur J Radiol
Kim S. 2006. The future of E-Learning in medical education: Current trend
and future opportunity. J Educ Eval Health Prof 3:3, Epub (2006)
Ruiz JG, Mintzer MJ, Leipzig RM. 2006. The impact of E-learning in medical
education. Acad Med 81(3):207–212.
AP. 2007.Theuseof e-learningin medical
Provision of electronic learning