e-Learning, Adaptive Learning and Mobile Learning

  • Yasser El Miedany


Electronic learning, or e-learning, describes the use of information technology or the Internet for learning activities. The integration of e-learning into undergraduate, graduate and continuing medical education is consistent with adult learning theory and presents a revolution in medical education. Technology is a powerful tool for effective teaching and deeper learning. Incorporating technology into teaching and learning activities introduces new thinking about teaching effectively. It also increases opportunities to invent new learning experiences for students that will take us further beyond traditional classroom or lecture-based learning. This chapter will start by discussing the differences between e-learning, e-teaching and e-training, followed by the reasons for introducing e-learning in the medical education process. It will discuss also components of e-learning, the e-learning and the science of adult learning and the role of the teacher in e-learning. It will expand to discuss the perceptual as well as blended learning, to conclude on the future of e-learning.


e-Learning Blended learning Adaptive learning Perceptual learning M-learning e-Learning components 


  1. 1.
    Ozuah PO. Undergraduate medical education: thoughts on future challenges. BMC Med Educ. 2002;2:8–10.CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Nair BR, Finucane PM. Reforming medical education to enhance the management of chronic disease. Med J Aust. 2003;179:257–9.PubMedGoogle Scholar
  3. 3.
    Leung WC. Competency based medical training: review. BMJ. 2002;325:693–6.CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Rosenberg M. E-Learning: strategies for delivering knowledge in the digital age. New York: McGraw-Hill; 2001.Google Scholar
  5. 5.
    Wentling T, Waight C, Gallaher J, La Fleur J, Wang C, Kanfer A. E-Learning: a review of literature 2000. Accessed 14th Feb 2018. 2005. Urbana: University of Illinois National Center for Supercomputer Applications; 2000.Google Scholar
  6. 6.
    Rice S, McKendree J. In: Swanwick T, editor. Understanding medical education: evidence, theory and practice. 2nd ed. Oxford, UK: Wiley; 2014. p. 161–73. Chapter 12.Google Scholar
  7. 7.
    Moberg TF, Whitcomb ME. Educational technology to facilitate medical students’ learning: background paper 2 of the medical school objectives project. Acad Med. 1999;74:1146–50.CrossRefGoogle Scholar
  8. 8.
    Ward JP, Gordon J, Field MJ, Lehmann HP. Communication and information in medical education. Lancet. 2001;357:792–6.CrossRefGoogle Scholar
  9. 9.
    Ellaway R, Masters KAMEE. Guide 32: e-learning in medical education. Part 1: learning, teaching and assessment. Med Teach. 2008;30:455–73.CrossRefGoogle Scholar
  10. 10.
    Masic I. E-learning as new method of medical education. Acta Inf Med. 2008;16(2):102–17.CrossRefGoogle Scholar
  11. 11.
    Chodorow S. Educators must take the electronic revolution seriously. Acad Med. 1996;71:221–6.CrossRefGoogle Scholar
  12. 12.
    Ruiz J, Mintzer M, Leipzig R. The impact of E-learning in medical education. Acad Med. 2006;81(3):207–12.CrossRefGoogle Scholar
  13. 13.
    Ward JP, Gordon J, Field MJ, Lehmann HP. Communication and information technology in medical education. Lancet. 2001;357:792–6.CrossRefGoogle Scholar
  14. 14.
    Chu LF, Chan BK. Evolution of web site design: implications for medical education on the Internet. Comput Biol Med. 1998;28:459–72.CrossRefGoogle Scholar
  15. 15.
    Gibbons A, Fairweather P. Computer-based instruction. In: Tobias S, Fletcher J, editors. Training & retraining: a handbook for business, industry, government, and the military. New York: Macmillan Reference USA; 2000. p. 410–42.Google Scholar
  16. 16.
    Clark D. Psychological myths in e-learning. Med Teach. 2002;24:598–604.CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Emami H, Najafi L. Key success factors in E-learning in medical education. Aust J Basic Appl Sci. 2011;5(10):1359–64.Google Scholar
  18. 18.
    Smith R. Guidelines for authors of learning objects. Accessed 22 Mar 2018. Austin: The New Media Consortium; 2004.Google Scholar
  19. 19.
    Littlejohn A. Issues in reusing online resources. In: Littlejohn A, editor. Reusing online resources: a sustainable approach to eLearning. London: Creative Print and Design; 2003. p. 1–6.Google Scholar
  20. 20.
    Johnson CE, Hurtubise LC, Castrop J, et al. Learning management systems: technology to measure the medical knowledge competency of the ACGME. Med Educ. 2004;38:599–608.CrossRefPubMedCentralGoogle Scholar
  21. 21.
    Phelps C, Michea YF. Learning management systems’ evaluation focuses on technology not learning. AMIA Annu Symp Proc. 2003:969.Google Scholar
  22. 22.
    Fallon C, Brown S. E-learning standards: a guide to purchasing and deploying standards-conformant E-learning. Boca Raton: St Lucie Press; 2003.Google Scholar
  23. 23.
    The MedBiquitous Consortium: new educational achievement standard unveiled to track learner progress and milestones. 2017. Accessed on 25 Mar 2018.
  24. 24.
    Harden R, Laidlaw J. E-Learning. In: Essential skills for a medical teacher. Churchill: Elsevier; 2012. p. 165–70.Google Scholar
  25. 25.
    Dennick R, Wilkinson S, Purcell N. Online assessment. AMEE guide No 39. Med Teach. 2009;31:192–206.CrossRefPubMedCentralGoogle Scholar
  26. 26.
    Kirkpatrick DL. Evaluating training programs: the four levels. San Francisco: Berrett-Koehler; 1994.Google Scholar
  27. 27.
    Ellaway R, Poulton T, Fors U, McGee J, Albright S. Building a virtual patient commons. Med Teach. 2008;30:170–4.CrossRefPubMedCentralGoogle Scholar
  28. 28.
    Harless WG, Drennon GG, Marxer JJ, Root JA, Miller GE. CASE: a computer-aided simulation of the clinical encounter. J Med Educ 1971. 1971;46(5):443–8.Google Scholar
  29. 29.
    Kononowicz A, Hege I. Virtual patients as a practical realisation of the e-learning idea in medicine. In: Soomro S, editor. E-learning experiences and future. InTech. ISBN: 978-953-307-092-6. Available from:
  30. 30.
    Barrows HS. An overview of the uses of standardized patients for teaching and evaluating clinical skills. AAMC Acad Med. 1993;68(6):443–51. discussion 451–3CrossRefGoogle Scholar
  31. 31.
    Bradley P. The history of simulation in medical education and possible future directions. Med Educ. 2006;40:254–62.CrossRefGoogle Scholar
  32. 32.
    Zemsky R, Massy WF. Thwarted innovation – what happened to e-learning and why? A final report for the weather station project of the learning alliance at the University of Pennsylvania in cooperation with the Thomson corporation. Pennsylvania: The University of Pennsylvania; 2004. p. 1–76.Google Scholar
  33. 33.
    Miayzoe T, Anderson T. Interaction equivalency in an OER, MOOCS and informal learning era. J Interact Media Educ. 2013;2:Art 9. Available online from: Last accessed Mar 2018CrossRefGoogle Scholar
  34. 34.
    Itself, Sharma N, Doherty I, Dong C. Adaptive learning in medical education: the final piece of technology enhanced learning? Ulster Med J. 2017;86(3):198–200.Google Scholar
  35. 35.
    Zimmer T. Rethinking higher Ed: a case for adaptive learning. Forbes. 2014. Available online from: Last accessed Nov 2016.
  36. 36.
    Paramythis A, Loidl-Reisinger S. Adaptive learning environments and eLearning standards. Electron J e-Learning. 2004;2:181–94.Google Scholar
  37. 37.
    Plass, J. (2014). Elsevier adaptive learning. [Internet]. Available online from: Last accessed Mar 2018.
  38. 38.
    McMahon GT, Drazen JM. Introducing NEJM knowledge+ and its adaptive personalized learning. New Engl J Med. 2014;370(17):1648–9.CrossRefGoogle Scholar
  39. 39.
    Kellman PJ. Adaptive and perceptual learning technologies in medical education and training. Mil Med. 2013;178(10 Suppl):98–106.CrossRefGoogle Scholar
  40. 40.
    Krasne S, Hillman J, Kellman P, Drake T. Applying perceptual and adaptive learning techniques for teaching introductory histopathology. J Pathol Inf. 2013;4:34.CrossRefGoogle Scholar
  41. 41.
    Kellman PJ, Kaiser MK. Perceptual learning modules in flight training. Proceedings of the 38th annual meeting of the human factors and ergonomics society, vol. 18. Santa Monica: Sage Publications; 1994. p. 1183–7.Google Scholar
  42. 42.
    Guerlain S, La Follette M, Mersch TC, Mitchell BA, Poole GR, Calland JF, et al. Improving surgical pattern recognition through repetitive viewing of video clips. IEEE Trans Syst Man Cybern A Syst Hum. 2004;34:699–707.CrossRefGoogle Scholar
  43. 43.
    Kellman PJ, Massey CM, Son JY. Perceptual learning modules in mathematics: enhancing students’ pattern recognition, structure extraction, and fluency. Top Cogn Sci. 2010;2:285–305.CrossRefGoogle Scholar
  44. 44.
    Sowden PT, Davies IR, Roling P. Perceptual learning of the detection of features in X-ray images: a functional role for improvements in adults’ visual sensitivity? J Exp Psychol Hum Percept Perform. 2000;26:379–90.CrossRefGoogle Scholar
  45. 45.
    Kellman PJ. Adaptive and perceptual learning technologies in medical education and training. Mil Med. 2013;178:98–106.CrossRefGoogle Scholar
  46. 46.
    Mettler E, Massey C, Kellman P. Improving adaptive learning technology through the use of response times. In: Carlson L, Holscher C, Shipley T, editors. Proceedings of the 33rd Annual Conference of the Cognitive Science Society. Boston: Cognitive Science Society; 2011. p. 2532–7.Google Scholar
  47. 47.
    Nodine CF, Kundel HL, Mello TC, Weinstein SP, Orel SG, Sullivan DC, et al. How experience and training influence mammography expertise. Acad Radiol. 1999;6:575–85.CrossRefGoogle Scholar
  48. 48.
    Speelman C, Martin K, Flower S, Simpson T. Skill acquisition in skin cancer detection. Percept Mot Skills. 2010;110:277–97.CrossRefGoogle Scholar
  49. 49.
    Albarrak A. E-learning in medical education and blended learning approach. In: Mendez-Vilas A, editor. Education in a technological world: communicating current and emerging research and technological efforts. Badajoz: Formatex; 2011. p. 147–53.Google Scholar
  50. 50.
    Hayashi T, Tominaga H, Yamasaki T. Blended learning contents for university education. In: The 7th International conference on information technology based higher education and training. Piscataway: IEEE; 2006. p. 499–502.Google Scholar
  51. 51.
    Oakman H. Blended learning – the new normal. Education technology. 2016. Accessed on 26 Mar 2018.
  52. 52.
    Gagliani SM, Topol EJ. iMedEd: the role of mobile health technologies in medical education. Acad Med. 2014;89:1207–9. Scholar
  53. 53.
    Payne KB, Wharrad H, Watts K. Smartphone and medical related app use among medical students and junior doctors in the United Kingdom (UK): a regional survey. BMC Med Inform Decis Mak. 2012;12:121. Scholar
  54. 54.
    Mosa AS, Yoo I, Sheets LA. A systematic review of healthcare applications for smartphones. BMC Med Inform Decis Mak. 2012;12:67. Scholar
  55. 55.
    Bullock A, Fox F, Barnes R, et al. Transitions in medicine: trainee doctor stress and support mechanisms. J Workplace Learn. 2013;25:368–82. Scholar
  56. 56.
    Hardyman W, Bullock A, Brown A, et al. Mobile technology supporting trainee doctors’ workplace learning and patient care: an evaluation. BMC Med Educ. 2013;13:6. Scholar
  57. 57.
    Franko OI, Tirrell TF. Smartphone app use among medical providers in ACGME training programs. J Med Syst. 2012;36:3135–9. Scholar
  58. 58.
    Mickan S, Atherton H, Roberts NW, et al. Use of handheld computers in clinical practice: a systematic review. BMC Med Inform Decis Mak. 2014;14:56. Scholar
  59. 59.
    Chang AY, Ghose S, Littman-Quinn R, et al. Use of mobile learning by resident physicians in Botswana. Telemed J E Health. 2012;18:11–3. Scholar
  60. 60.
    Lippman H. How apps are changing family medicine. J Fam Pract. 2013;62:362–7.PubMedPubMedCentralGoogle Scholar
  61. 61.
    Bullock A, Webb K Technology in postgraduate medical education: a dynamic influence on learning? In: Postgraduate Medical Journal Published Online First. 2015. Scholar
  62. 62.
    Dala-Ali BM, Lloyd MA, Al-Abed Y. The uses of the iPhone for surgeons. Surgeon. 2011;9(1):44–8.CrossRefPubMedCentralGoogle Scholar
  63. 63.
    Ozdalga E, Ozdalga A, Ahuja N. The smartphone in medicine: a review of current and potential use among physicians and students. J Med Internet Res. 2012;14(5):e128.CrossRefPubMedCentralGoogle Scholar
  64. 64.
    Prgomet M, Georgiou A, Westbrook JI. The impact of mobile handheld technology on hospital physicians’ work practices and patient care: a systematic review. J Am Med Inform Assoc. 2009;16(6):792–801.CrossRefPubMedCentralGoogle Scholar
  65. 65.
    Boruff JT, Storie D. Mobile devices in medicine: a survey of howmedical students, residents, and faculty use smartphones and other mobile devices to find information. J Med Libr Assoc. 2014;102(1):22–30.CrossRefPubMedCentralGoogle Scholar
  66. 66.
    Ventola CL. Mobile devices and apps for health care professionals: uses and benefits. Pharm Ther. 2014;39(5):356–64.Google Scholar
  67. 67.
    Franko OI, Tirrell TF. Smartphone app use among medical providers in ACGME training programs. J Med Syst. 2012;36(5):3135–9.CrossRefPubMedCentralGoogle Scholar
  68. 68.
    Oehler RL, Smith K, Toney JF. Infectious diseases resources for the iPhone. Clin Infect Dis. 2010;50(9):1268–74.CrossRefPubMedCentralGoogle Scholar
  69. 69.
    Aungst TD. Medical applications for pharmacists using mobile devices. Ann Pharmacother. 2013;47(7–8):1088–95.CrossRefPubMedCentralGoogle Scholar
  70. 70.
    Gray TG, Hood G, Farrell T. BMJ Innov. 2015;1:25–32. Scholar
  71. 71.
    UK Department of Health. High quality care for all. 2008. Accessed 27 Mar 2018.
  72. 72.
    Kern D, Thomas P, Howard D, Bass E. Curriculum development for medical education. Baltimore: Johns Hopkins University Press; 1998.Google Scholar
  73. 73.
    Reddy R, Wladawsky-Berger I. President’s information technology advisory committee. Transforming health care through information technology. Arlington: National Coordination Office for Information Technology Research & Development; 2001.Google Scholar
  74. 74.
    Internet 2 Web page Accessed 22 Nov 2005. Ann Arbor: Internet 2 Consortium. 2005.
  75. 75.
    Walker R, Dieter M, Panko W, Valenta A. What it will take to create new Internet initiatives in health care. J Med Syst. 2003;27:95–103.CrossRefGoogle Scholar
  76. 76.
    Tidmarsh PJ, Cummings J, Hersh WR, Freidman CP. Distributed medical informatics education using Internet2. Proc AMIA Symp. 2002:787–91.Google Scholar
  77. 77.
    Vincent DS, Berg BW, Hudson DA, Chitpatima ST. International medical education between Hawaii and Thailand over Internet2. J Telemed Telecare. 2003;9(2 suppl):S71–2.CrossRefGoogle Scholar
  78. 78.
    Kim S. The future of e-learning in medical education: current trend and future opportunity. J Educ Eval Health Prof. 2006;3:3. Scholar
  79. 79.
    Wiecha J, Barrie N. Collaborative online learning: a new approach to distance CME. Acad Med. 2002;77:928–9.CrossRefGoogle Scholar
  80. 80.
    Wiecha JM, Gramling R, Joachim P, Vanderschmidt H. Collaborative e-learning using streaming video and asynchronous discussion boards to teach the cognitive foundation of medical interviewing: a case study. J Med Internet Res. 2003;5:e13.CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Yasser El Miedany
    • 1
    • 2
  1. 1.King’s College London, Darent Valley HospitalDartfordUK
  2. 2.Rheumatology and RehabilitationAin Shams UniversityCairoEgypt

Personalised recommendations