1 1Core Surgical Trainee/CT2, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, UK

2 Consultant, General Medicine/Endocrinology, Queen Elizabeth Hospital Woolwich, London, SE18 4QH, UK


Introduction: Postgraduate medical education involves the use ofonline-learning tools. However, there is a paucity of data on theuse of online-learning among doctors who are in their 1st and 2ndyears of professional work after graduating from medical school(also known as Foundation doctors). Our aim was to explore theuse of online-learning among Foundation doctors.Methods: A cross-sectional study was carried out, usingconvenience sampling. During one month, 66 Foundationdoctors from across 2 district hospitals and 1 teaching hospital inSoutheast England filled out a specially designed questionnaire.Data were collected and analyzed using Microsoft Excel™, and reported in numbers and percentages.Results: The majority of Foundation doctors (86.4% (n=57))reported using online-learning packages. These are the toolswhich consist of key information on a particular topic, and maybe interactive and broken down into several smaller modules.Less than half embarked on online-learning in their 1st month ofemployment, with a decline in the numbers who started in thelater months. Of those who reported completing online-learningpackages, 57.9% (n=33) reported completing non-compulsorymodules, 66.7% (n=38) reported completing a range of 0-15modules per week, and 75.4% (n=43) completed the moduleswithout skipping components. More Foundation doctors reportedusing online-learning for lifelong learning (63.6% (n=42)) andfilling knowledge gaps (51.5% (n=34)) than improving theirpractice following a mistake (24.2% (n=16)). Additionally, onlinelearningwas used less frequently than medical websites or searchengines, for the aforementioned purposes.Conclusion: Most Foundation doctors use online-learning, butthis needs to be incorporated into their postgraduate learningactivities earlier in their career and directed more towardsimproving their clinical practice.Keywords: Cross-sectional studies, Education, Distance, Hospitals, Teaching

  1. Ally M. Foundations of Educational Theory for Online Learning. In: Anderson T. (ed.) The Theory and Practice of Online Learning. 2nd ed. Athabasca University, Canada: AU Press; 2008. p 15-44.
  2. Brown AR, Bradley DV. Elements of Effective e-Learning Design. IRRODL. 2005; 6(1). Available from: [Accessed 15th April 2018].
  3. Mason RD, Pegler CA, Weller MJ. A learning object success story. Journal of Asynchronous Learning Networks. 2005; 9(1): 97–105.
  4. Conference Of Postgraduate Medical Deans (UK). A Reference Guide for Postgraduate Specialty Training in the UK (Gold Guide). 6th ed. 2016.
  5. Cole BL. Do video display units cause visual problems? - a bedside story about the processes of public health decision-making. Clinical and Experimental Optometry. 2003; 86(4): 205-220.
  6. Oha K, Animagi L, Paasuke M, Coggon D, Merisalu E. Individual and work-related risk factors for musculoskeletal pain: a cross-sectional study among Estonian computer users. BMC Musculoskeletal Disorders. 2014; 15(181).
  7. Autti T, Autti H, Vehmas T, Laitalainen V, Kivisaari L. E-learning is a well-accepted tool in supplementary training among medical doctors: an experience of obligatory radiation protection training in healthcare. Acta Radiologica. 2007; 48(5): 508-513.
  8. Burgess G, Holt A, Agius R. Preference of distance learning methods among post-graduate occupational physicians and hygienists. Occupational Medicine. 2005; 55(4): 312-318.
  9. Dyrbye L, Cumyn A, Day H, Heflin M. A qualitative study of physicians' experiences with online learning in a masters degree program: benefits, challenges, and proposed solutions. Medical Teacher. 2009; 31(2): e40-6.
  10. Bergold M, Strametz R, Weinbrenner S, Khan KS, Zamora J, Moll P, et al. Evidence-based Medicine online for young doctors - a randomised controlled trial. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. 2013; 107(1): 36-43.
  11. Gordon M, Chandratilake M, Baker P. Improved junior paediatric prescribing skills after a short e-learning intervention: a randomised controlled trial. Archives of Disease in Childhood. 2011; 96(12): 1191-1194.
  12. McCarthy SE, O'Boyle CA, O'Shaughnessy A, Walsh G. Online patient safety education programme for junior doctors: is it worthwhile? Irish Journal of Medical Science. 2016; 185(1): 51-8
  13. Oppenheim AN. Questionnaire design, interviewing and attitude measurement. 2nd ed. London: Continnuum-3PL; 1998.
  14. Health Research Authority. Research requiring NHS R&D review but not ethical review. Available at: [Accessed 7th April 2015]
  15. Ruf D, Berner MM, Kriston L, Maier I, Harter M. General practitioners online: the conditions are good, but use of the Internet for continuing medical education found to be poor. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. 2008; 102(5): 291-297.
  16. Ali IS, Khan M, Khan A, Shah MF, Ali G. Trainees' feedback on the prevailing teaching methods in postgraduate medical institute, Lady Reading Hospital, Peshawar, Pakistan. Journal of the College of Physicians and Surgeons (Pakistan). 2012; 22(5): 317-319.
  17. Goh J, Clapham M. Attitude to e-learning among newly qualified doctors. Clinical Teacher. 2014; 11(1): 20-23.
  18. Gaskell N, Hinton R, Page T, Elvins T, Malin A. Putting an end to Black Wednesday: improving patient safety by achieving comprehensive trust induction and mandatory training by day 1. Clinical Medicine (London). 2016; 16(2): 124-8.
  19. Wong G, Greenhalgh T, Pawson R. Internet-based medical education: a realist review of what works, for whom and in what circumstances. BMC Medical Education. 2010; 10(12).
  20. Dunet DO, Reyes M, Grossniklaus D, Volansky M, Blanck HM. Using evaluation to guide successful development of an online training course for healthcare professionals. Journal of Public Health Management and Practice. 2008; 14(1): 66-75.
  21. Young KJ, Kim JJ, Yeung G, Sit C, Tobe SW. Physician preferences for accredited online continuing medical education. The Journal of continuing education in the health professions. 2011; 31(4): 241-246.