E-learning in Postgraduate Medical Education – What Elements Influence Success?

Dr Kunal Patel 10 Sep 2019

As students and trainers, we are now surrounded by multiple options when it comes to choosing our next steps when it comes to further education. What course should it be (if I can afford it)? What method should we use to teach the students? Why is this university’s e-learning platform better than the other? Is our platform good enough to deliver the best in online learning?

Many questions and trust me there are a lot, remain for educators and students alike. So, when it comes to providing an ‘ideal’ course, is there a perfect formula? Of course not, many factors come into play, especially the likes of the target audience and the context that you aim to deliver the course in. As highlighted in a previous report, there is no point delivering, for example, an e-learning course based around hi-tech oncology treatment to providers in a setting where none of it exists, or in a country where the infrastructure is minimal.

Bringing in the right team from the get-go to help deliver your e-learning in postgraduate education is essential and this should be done early on. Hopefully, they won’t convince you to go with non-standardised, non-accredited courses or even MOOCs and if they do, seek another provider! However, an early start with good solid foundations around instructional design, collaboration, mentoring elements, interprofessionalism and assessment are all essential for a good course, and ultimately for the postgraduate student.

This month, a team from the Netherlands conducted a thematic analysis of what elements or factors could influence success in Postgraduate medical education. Honestly, when you break it down, some of the themes may seem obvious and some you may already know. Nevertheless, by bringing out these themes from speaking to ‘creators’ in the education space of e-learning in postgraduate education, they have provided an evidence base to build from.

By conducting interviews and then coding these, they were able to identify key themes and factors. To be precise 3 themes with 11 factors:

E-learning in Postgraduate Medical Education – What Elements Influence Success?


Figure taken from:  Influencing factors in the implementation of postgraduate medical e-learning: a thematic analysis (link provided above)

As mentioned, looking at the image, it may all seem a bit obvious, but this is actually providing a structure to what you may consider something you already know. All 11 factors are displayed within the diagram. Some will interest you more than others, depending on which ‘theme’ you probably lean more toward. For example, if you are purely on the management side of things, understanding support and establishing a user culture that is willing to learn and evaluate with you, is important. However, if you are part of the technical team you need to focus more on themes such as evaluation, so you may continue to improve the e-learning, but also to gather signals for bugs, outdated sources and lack of resources for the future.

Interestingly, the authors found that organization-dependent factors are much less frequently discussed, yet, these are some of the most important. Without resources and management, the development of an e-learning course, could not even begin. This may be because educators and academics alike have very little exposure to businesses and management tools that are essential to delivering technology-enhanced education.

Finally, the authors also attempted to see if these themes and factors crossed over with Roger’s and Kotter’s models of innovation change. Kotter’s model, for example, utilizes an eight-step change management process to implement innovation change within a process or organization.  The authors interpreted their findings to fit Kotter’s model and the table below provides for some interesting comparison:


Figure taken from:  Influencing factors in the implementation of postgraduate medical e-learning: a thematic analysis (link provided above)

Overall, this research was a very interesting read and supports development thinking when it comes to the implementation of postgraduate medical education in an e-learning environment. I would never rely on it on its own, but it can certainly help with discussions within your organization.

Ultimately, every course and every student cohort are different, and they have to be, otherwise there would be no variety in learning and a diverse mix of learners who gain varied skills would not exist. If delivering any e-learning based postgraduate medical education, listen to everyone - students, management, designers, academics and government. Once you’ve heard enough, maybe all that information can then be moulded into groups or in this paper’s case, themes and factors, aiding you to deliver an enjoyable course that also delivers from an educational perspective.