There is increasing use of hypermedia online learning in continuing medical education (CME) that presents the learner with a wide range of different learning resources, requiring the learner to use self-regulated learning (SRL) skills. This study is the first to apply an SRL perspective to understand how learners engage with hypermedia online learning in CME. We found that the main SRL skills used by learners were use of strategies and monitoring. The increasing use of strategies was associated with increasing interest in the topic and with increasing satisfaction with the learning experience. Further research is recommended to understand SRL processes and its impact on learning in other aspects of hypermedia online learning across the different phases of medical education. Research is also recommended to implement and evaluate the learning impact of a variety of approaches to develop the SRL skills of hypermedia online learners in CME.

BACKGROUND:In 2009, The National Institute for Health and Clinical Excellence (NICE) developed an undergraduate online learning package on the practical application of evidence-based medicine with the intention that it would be integrated into existing medical curricula.METHODS:Complementary methodologies were used to yield a diversity of quantitative and qualitative data on how the online learning package was integrated.RESULTS:The modules of the online learning package received an overall positive reaction from the users but uptake of the modules was lower than expected. Even though some curriculum integration occurred, several students were unaware that the package existed, some lacked the time to use the package and others would have preferred to have had the package earlier in their course.CONCLUSIONS:A new model for the effective integration of online education packages into existing undergraduate medical curricula is proposed, especially when developed by external organisations. This new model should enable educationalists to better reveal and overcome the contextual and process challenges, barriers and solutions to implementing effective flexible learning approaches. When introducing new learning resources into a curriculum, many factors are important, especially the learners' perceived needs and how these vary at different stages of their course.

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We have two articles this time. First, Dan Lashbrook describes what sounds like a lively and fun session on his day-release course for GP trainees. It looks as though the trainees learnt a lot along the way as well. Our second article describes an evaluation of some e-learning modules. The authors make a good case for the educational and economic value of e-learning as opposed to ‘live’ refresher courses. What do you think?