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New Publication: “The Rise and Stall of eLearning: Best Practices for Technology-Supported Education”

The following editorial was recently published at J Contin Educ Nurs. 2015 Jul;46(7):292-4. Please contact me directly if you are interested in obtaining a pdf of the article.

The Rise and Stall of eLearning: Best Practices for Technology-Supported Education

“eLearning” is a commonly used term in education today, but what does it mean? This column explores issues that educators need to be aware of in planning how technology-based education is most effectively delivered.

A Common Understanding

It is believed that the origins of the terms “eLearning” and “online learning” date back to the 1980’s. Over the decade that followed, the opportunities presented by this new ‘type’ of instruction were widely lauded, as noted in this example from 1998:

“…nearly 50% of higher education institutions currently engage in some type of online learning. Academic and professional organizations agree that using web-based learning environments can offer sound pedagogical benefits….‘ The web is revolutionizing some areas of study through increased opportunities for learning and alternative formats for information.” 1

However, even in recent years the study of these now ubiquitous types of instruction has been hampered by often conflicting understanding of what is actually being explored. For instance, the terms “elearning”, “online learning” or “web-based learning”, and “distance learning” have been widely used by both educators and researchers. For our purposes, we will simplify the terminology in keeping with the meta-analysis recently published by Moore, Dickson-Deane, and Galyen2:

  • Distance Learning = simply describes the ability for an educational intervention to overcome geographic constraints.
  • Online or Web-based Learning = principally describes education that is accessed through use of the internet with the opportunity for connectivity and enhanced flexibility in design. It is seen as a newer and improved form of distance learning.
  • eLearning (or e-Learning) = while the term “eLearning” originally focused on computer-based training (CBT)3, it now is understood to more broadly describe education available through any technology with enhanced opportunity for connectivity and flexibility in design while overcoming constraints of both time and space.

Importantly, as we simplify the terminology, this is perhaps our first critical insight –the general definitions of “distance learning”, “online learning”, and “eLearning”, while perhaps intuitive to some, fail to adequately describe the nature of the underlying instructional design and/or educational interventions. Instead, they provide a more general description of the experience or opportunity. It is therefore critical for educational planners to focus more on the specific design of their education and not rely on catch-all or umbrella terminology to describe the learning experience.

A Promise Unfulfilled

Given this initial insight, we might still accept that the basic promise of technology-supported education seems well validated – with technology, content could be accessed by more learners, in more convenient ways, largely independent of geography, and asynchronously (if so desired). It should be pointed out that the generally established benefits of technology-supported education fall short of proving impact on attitudes, learning, or behavior change. These cognitive and psychomotor benefits are largely dependent on the specific interventions being delivered through educational technology.

The simple truth is that technology-supported education can be used to distribute and deliver really good education OR really mundane education – using computers and the internet is not an educational silver bullet, but it could be a remarkable educational tool. For example:

Tens of thousands of enduring ‘webcasts’ are produced each year. These activities, typically comprised of simple, video-based content, can significantly impact the reach of content but have not been shown to have huge impact on engagement, completion rates, or learning.4, 5 Takeaway: The convenience and expanded reach of viewing videos online does not automatically equal better learning.

More recently Massive, Open, Online, Courses or MOOCs have emerged as a means of providing nearly universal access to educational content. These courses are usually comprised of a curriculum or connected series of brief enduring webcasts presented over time. While we continue to learn more about the model, it is generally acknowledged that MOOCs have largely failed to live up to their substantial hype – the dissemination hasn’t been as wide as intended, the audiences have remained more homogeneous than desired, and attrition rates continue to underwhelm.6 Takeaway:  Learners still need more structure and more motivation to make the commitment to learn.

Even more recently the “Flipped Classroom” has emerged as a blended model of online activities serving to prepare learners for a live event that can then focus more on application than knowledge transfer. While my colleagues and I have recently had tremendous success with this model utilizing a more data-centric approach, other faculty and instructors have struggled to derive benefits that match the additional level of planning and resources that are needed. 7, 8 Takeaway: How the pieces are blended and how data is leveraged is much more important than simply fronting a meeting with extra assignments and work.

The need to critically evaluate these emerging models in technology-supported education is not insignificant – over the past 10 years alone more than 68 million clinicians have participated in webcasts as an element of their professional development.9 Clearly, educators could have great impact if we could optimize each approach and fully realize the potential of the technology.

Uncovering the Missing Link

The good news is that each of the examples above provides a critical lesson for educators. In short, the ultimate value of technology-supported education is not inherent in technology per se, but how that technology and the data it generates is leveraged. From the more traditional webcast we can learn that information can be broadly disseminated, but also that technology provides an opportunity to create engaging environments for active learning. These environments allow for new forms of learning data to be collected and explored  so the learning experience can be increasingly dynamic, refined, and personalized. From MOOCs we can learn that activities can be tied together and that understanding how learners navigate through a connected curriculum can provide critical insights into what topics or lessons are most interesting and/or most challenging. From the flipped classroom we can learn how data-driven and agile educational design can enhance blended and sequential learning experiences, enabling educators to better focus their face-to-face interventions based on the data and insights gleaned from the online components.


The generalized terminology applied to technology-supported education is often vague or conflicting. We must dive more deeply into the how technology and evidence is being used to drive learning. While technology may present an enhanced opportunity for connectivity and flexibility in design, it will not happen without planning and intention.  To derive the ultimate benefits from ‘eLearning’ that have been posited, the various technologies we choose must be leveraged intelligently to create opportunities to connect learners, to structure learning experiences, and to collect the critical forms of learning data that must become front and center in the educational planning process.


1 Blackboard Education Report. “Educational Benefits of Online Learning.” 1998. ; Accessed May 1, 2015.

2 Moore JL, Dickson-Deane C, and Galyen K. (2011). “e-Learning, online learning, and distance learning environments: Are they the same?” The Internet and Higher Education 14 (2): 129–135.

3 Cross J. “The DNA of eLearning.” ; Accessed May 1, 2015.

4 Williams JG. “Are online learning modules an effective way to deliver hand trauma management continuing medical education to emergency physicians?” Can J Plast Surg. 2014 Summer;22(2):75-8.

5 Mazzoleni MC, Maugeri C, Rognoni C, Cantoni A, and Imbriani M. “Is it worth investing in online continuous education for healthcare staff?” Stud Health Technol Inform. 2012;180:939-43.

6 EdTech Now. “MOOCs and other ed-tech bubbles.”;  Accessed May 1, 2015.

7 McGowan BS, Balmer JT, and Chappell K. “Flipping the Classroom: A Data-Driven Model for Nursing Education.” J Contin Educ Nurs. 2014;45(11):477–478.

8 Rees J. “The flipped classroom is decadent and depraved.” 2014.; Accessed May 5th, 2015.

9 ACCME Annual Reports.; Accessed May 15th, 2015.

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Brian is a research scientist and educational technologist. He helped transform Pfizer’s Medical Education Group and previously served in educational leadership roles at HealthAnswers, Inc.; Acumentis, LLC.; Cephalon; and Wyeth. He taught graduate medical education programs at Arcadia University for 10 years. Dr. McGowan recently authored the book "#socialQI: Simple Solutions for Improving Your Healthcare" and has been invited to speak internationally on the subject of information flow, technology, and learning in healthcare.

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