Health care professionals learning online : a case study review of educational effectiveness

The advent of the World Wide Web and Internet in the early 1990s has led to a major investment in information and communication technologies for educational purposes. The technology and growth of the Internet has been developing at an exponential rate, creating a situation where what constitutes effective educational practice has not been fully developed in the literature. Existing models of evaluation in the area are limited in scope or based on untested assumptions. These limitations are combined with a relative paucity of original research dedicated to explaining or predicting phenomena related to successful outcomes in Web-based learning, particularly from the perspective of the learners. This study addresses some of these gaps and the outcomes provide guidance for the future development of Web-based learning resources. It demonstrates the importance of sound instructional design and pedagogy and the results of the study point towards the overall effectiveness of the World Wide Web for learning. The study used a naturalistic theory approach in conjunction with a multilevel evaluation to examine the impact of Web-based learning on over 300 health professionals enrolled with an Australasian Continuing Professional Education (CPE) provider, Med-E-Serv. The overall effectiveness of a number of the provider's courses was assessed in terms of learner satisfaction, cognitive achievement and self-reported application of knowledge gained from the course or behaviour change in professional practice. In addition, the impact of pedagogical and instructional design moderators (timing, pacing, feedback/interaction, problem-based learning [PBL] and learner autonomy) was assessed in terms of their impact on learner achievement and satisfaction. The study found that health professionals expressed a high level of satisfaction (overall impressions, 98.1%) with the learning environment and a statistically significant improvement in cognitive achievement (Eta-square = 0.551). Self-reported application of course content into practice, or changes in professional practice (recorded as review, modify, change) was high (68.7%). Of the courses examined, 57% used a clinical assessment tool that 96.8% of respondents implemented into practice. This high percentage combined with Zobs analysis (3.757) indicated that behaviour change was greater as a result of those courses that included a clinical learning tool. The study revealed that pedagogical and instructional design moderators are inherently positively correlated to learner satisfaction. For example, the association between interaction, course feedback and learner satisfaction was positively correlated. Additionally, PBL was viewed as conducive to learning (94.95%), a finding supported by the pre-post course test scores. Learner autonomy in choosing the rate and pacing of course material and their relationship to satisfaction was significant (0.774, p