Undergraduate medical education: the transition to e-learning platform delivery


  1. Dr James Price
  2. Dr Nicholas Andreou
  3. Dr Timothy Heymann


5II Online learning 2


Imperial College London, UK
Imperial College Business School, UK


Undergraduate medical education is unlike other taught undergraduate courses at universities. Whilst other science courses such as mathematics, engineering or biology can rely on traditional face-to-face teaching for most of content delivery, undergraduate medical education sees a transition from pre-clinical teaching to clinical learning half-way during the course. Students are suddenly dispersed over a large geographical area in the various hospitals affiliated with the universities making the delivery of content a challenge.

We aimed to identify whether these structural differences between the preclinical and clinical years are reflected in the amount of direct teaching and e-learning modules received by medical students. We measure and analyse the number of hours of direct, face-to-face teaching students receive during a five-year undergraduate medicine course and discuss the technological implications for the future provision of medical education.

Summary of Work

We analysed the full content delivery over the five-year undergraduate MBBS programme (2012) at a traditional medical school in the UK. Teaching takes place in lectures, small groups, the anatomy theatre, at the bedside and via online lectures (e-modules). We calculated the total direct teaching hours over the programme from student self-reported experience, staff interviews and analysis of timetables. We also measured and analysed the number of e-modules available to students over the same time period.

Comparison between direct and online teaching in pre-clinical and clinical years
Year of study

Average DTH

 Average e-modules


Pre-clinical years (1, 2)


437.5 6


Clinical years (3, 5, 6)


245 50


Percentage change

-45% +730%


Summary of Results

There is a reduction by 45% of direct teaching received as students progress from pre-clinical through to clinical years. In addition, there is a rise by 730% of the number of e-modules available during this transition. 

There are numerous factors that affect content delivery including geographical placement of students, a change in students' learning requirements and additional student factors. 

These factors provide implications for institutions supplying medical education. There must remain innovation in content delivery and schools must embrace emerging technologies to add to the consistency of the student experience and to reduce the uncertainty of the hospital learning environment. Massive Open Online Courses (MOOC) in the USA have achieved increased accessibility whilst saving on cost. The increase in e-learning resolves issues encountered by dispersed geography and provides freedom to focus on the clinical experience.


Content delivery advances to a more electronic approach as a medical student progresses. Replacing direct teaching in the clinical years with e-learning modules will benefit students in remote locations and may provide higher quality clinical experiences which would be more accessible provided at a lower cost. The loss of physical interaction must be acknowledged and student support must be ensured.

Institutions must address the challenges of the clinical learning environment by utilising e-learning platform delivered teaching, especially in the later undergraduate years.

Take-home Messages

E-learning platform delivery is likely to be of increasing importance in the future. Institutions must embrace such new technologies to help ensure the courses they offer continue to be accessible and affordable. New entrants may do so, if they do not.


Harder B. Are MOOCs the future of medical education? British Medical Journal. 2013;346.

Reif L. MIT’s President: Better, More Affordable Colleges Start Online. Time US. 26th September 2013. 

University of Nicosia. St. George’s University of London Medical School Graduate Entry MBBS Degree. Nicosia: University of Nicosia, 2012. 

Toro-Troconis M. iPad pilot launch event at the Faculty of Medicine. Faculty of Medicine Blog. Weblog.  

Summary of Work
Summary of Results
Take-home Messages
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