Abstract
Background: As the use of e-learning continues to grow at higher education institutes, it is increasingly important to examine the impact that this educational method has on the students’ academic performance. Behavioral engagement is thought to be an important factor influencing this performance. The aim of this study was to investigate whether the behavioral dimensions of engagement of medical students with an e-learning resource were associated with better academic performance. Methods: We recruited 151 fi fth-year medical students in the clerk program of Internal Medicine in Chang Gung Memorial Hospital. We used an e-learning resource (AccessMedicine) to enhance asynchronous learning, and classified the levels of the students’ behavioral dimensions of engagement for learning as "Complete", "Partial" or "No" engagement according to the use of nine AccessMedicine e-learning modules. Assessment of learning achievements included the results of the fi rst stage medical license examinations, written multiple-choice questions based on internal medicine curriculum, and formative assessments for clerkship in internal medicine. Results: The level of engagement to use e-learning resources was signifi cantly higher in the students that passed the first stage of the medical license examination compared to those that failed (85.0% vs. 50.0% respectively, p = 0.010). There was also a signifi cant association with the attendance of morning meetings (p < 0.001). Success in the written multiple-choice questions, formative assessments, and narrative medicine was signifi cantly higher among the “Complete” group (n = 120) that completed the nine AccessMedicine modules compared to the "Partial" group (n = 19) that only partly completed the modules and the "No" group (n = 12) that did not complete any modules. Conclusions: The behavioral dimensions of engagement of the medical students to use the e-learning resource were positively associated with learning achievements, suggesting that developing effective e-learning educational strategies to enhance greater engagement may improve academic performance.
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