E-learning for education in primary healthcare - turning the hype into reality: A Delphi study

Objective: E-learning has the potential to provide effective education for general practice, but there are significant difficulties that must be overcome. Design: We initiated a two-round Delphi study, aiming to identify expectations and barriers to e-learning in primary healthcare education. Methods: We distributed questionnaires to 60 primary care experts who are also experts in the field of e-learning. Their responses were independently analysed by two of the authors (J.G., H.C.V.) and were clustered to form 32 themes. These were fed back to the participants in a second postal questionnaire with the objective of reaching agreement or disagreement, with a cut-off of 80%. Results: The response rate was 67% (n=40) in the first and 60% (n=36) in the second round. The extent of agreement reached ranged from 8% (e-learning is displacing practical teaching and learning") to 97% ("e-learning needs convincing didactical concepts"). Agreement was high with the themes "e-learning gets a new focus by mixed learning concepts" and "users will have a higher level of media competence 5 years from now" (94% each). There was a positive attitude to e-learning, but there was concern about the lack of orientation towards users' needs and the poor development of innovative didactical concepts. In implementing e-learning in primary care, education should be independent of financial influence from the healthcare industry in order to eliminate conflicts of interest. Conclusion: The experts' responses show that e-learning in primary healthcare education can contribute substantially to undergraduate, graduate, and continuing medical education, and should therefore be evaluated in systematic studies.