The effectiveness of e-learning has been demonstrated primarily by studies of higher education, government, corporate, and military environments. However, these studies have limitations, especially because of the variability in their scientific design. Often they have failed to define the content quality, technological characteristics, and type of specific e-learning intervention being analyzed. In addition, most have included several different instructional and delivery methodologies, which complicates the analysis. Most of these studies compared e-learning with traditional instructor-led approaches.
Yet three aspects of e-learning have been consistently explored: product utility, cost-effectiveness, and learner satisfaction. Utility refers to the usefulness of the method of e-learning. Several studies outside of health care have revealed that most often e-learning is at least as good as, if not better than, traditional instructor-led methods such as lectures in contributing to demonstrated learning. Gibbons and Fairweather11 cite several studies from the pre-Internet era, including two meta- analyses that compared the utility of
computer-based instruction to traditional teaching methods. The studies used a variety of designs in both training and academic environments, with inconsistent results for many outcomes. Yet learners’ knowledge, measured by pre-post test scores, was shown to improve. Moreover, learners using computer-based instruction learned more efficiently and demonstrated better retention.
Recent reviews of the e-learning (specifically Web-based learning) literature in diverse medical education contexts reveal similar findings. Chumley-Jones and colleagues22 reviewed 76 studies from the medical, nursing, and dental literature on the utility of Web- based learning. About one-third of the studies evaluated knowledge gains, most using multiple-choice written tests, although standardized patients were used in one study. In terms of learners’ achievements in knowledge, Web-based learning was equivalent to traditional methods. Of the two studies evaluating learning efficiency, only one demonstrated evidence for more efficient learning via Web-based instruction.
A substantial body of evidence in the nonmedical literature has shown, on the basis of sophisticated cost analysis, that e-learning can result in significant cost- savings, sometimes as much as 50%, compared with traditional instructor-led learning. Savings are related to reduced instructor training time, travel costs, and labor costs, reduced institutional infrastructure, and the possibility of expanding programs with new educational technologies. Only one study in the medical literature evaluated the cost-effectiveness of e-learning as compared with text-based learning. The authors found the printing and distribution of educational materials to be less costly than creating and disseminating e-learning content.
Studies in both the medical and nonmedical literature have consistently demonstrated that students are very satisfied with e-learning. Learners’ satisfaction rates increase with e-learning compared to traditional learning, along with perceived ease of use and access, navigation, interactivity, and user- friendly interface design. Interestingly, students do not see e-learning as replacing traditional
instructor-led training but as a complement to it, forming part of a blended-learning strategy.