Personal view or opinion piece
Open Access

A series of reflections on eLearning, traditional and blended learning

Poh Sun Goh[1]

Institution: 1. National University of Singapore
Corresponding Author: Dr Poh Sun Goh ([email protected])
Categories: Medical Education (General), Teaching and Learning, Technology
Published Date: 14/10/2016


This is a collection of twelve short reflections written consecutively over several weeks focused on eLearning or Technology enhanced learning, traditional learning and blended learning. They were inspired after a summer "sabbatical" spent thinking about these topics. Each short reflection is subtitled individually and organised in the following sections. This collection can be read sequentially or each section individually, depending on interest and individual preference.

Keywords: eLearning; Technology enhanced learning; Traditional learning; Blended learning

eLearning, and global eTeaching

eLearning leverages on the the internet and the mobile web to connect individuals to ideas and information, and other people. The exponential rise in adoption of broadband, mobile and social technology has opened up unparalleled opportunities for educators, to use technology to support and enhance learning.

eLearning allows educators to broadcast content and information to a global audience, yet also "narrowcast", by personalising education and content for individual learners. This capacity to scale up access to information, at a time, place, and pace dependent on an individual learner's immediate learning requirements is unprecedented. It has never been easier for educators to create, access and curate digital educational content, and share this with a wide local, and global audience.

To take full advantage of these digital tools and platforms, and maximise their educational potential requires a combination of some formal training, both in educational technology, as well as very importantly in educational theory and principles of evidence based practice, combined with an active, experimental and scholarly mindset. The emphasis should always be on the "learning" in eLearning, with the purpose of technology to support and enhance learning. The focus should never be on the "e" in eLearning. A constant question for educators to always ask is "whether this technology adds value to current teaching and learning methods, and critically evaluate both what is gained, and what is potentially lost by the use or reliance on technology or eLearning methods.

One of the most effective methods is to combine traditional teaching and assessment strategies, with eLearning; by using a "blended" approach. Blended eLearning leverages on both the reach and accessibility of technology and engagement platforms; with the strengths of face to face student teacher and peer to peer interaction. The intent always is to strengthen student motivation and engagement with the educational material, and promote active learning, as well as "deep" (rather than superficial) learning.

In addition to helping students, technology can widen the educational reach of teachers, beyond the classroom. Apart from facilitating pre-class preparation (by "Flipping" the classroom), technology can facilitate and promote longitudinal learning; support and document student engagement with the material, as well as document student learning and achievement of learning objectives in a visible manner.

For administrators, and educational leaders, eLearning can promote a more consistent educational experience, accessible for peer review and evaluation for quality; and provide a method to document and evaluate teaching, and student learning.

What are the strengths of live classroom teaching?

What are advantages of live classroom teaching? Why do we take time, and pay for the experience of a live concert performance? Even when a video of a teaching presentation, often in high quality and modular; or a concert performance is available online? I believe we value the experience of a live teaching session, the immediacy of being present and engaged, through more than a digital visual and auditory experience. A live teaching session gives an additional sense of space, and place. Live teaching, and a live concert performance engages more of our senses, even when there is no opportunity to interact directly with the teacher or performer. We see a presentation, in a wider context. We hear a presentation, both with our ears, and by feeling it. Live teaching or a performance offers the possibility of "live" audience engagement, by posing questions, and having an interactive conversation with some audience members. Attending a live teaching session reduces the possibility of outside, or online distractions. Our attention is more focused. We are more present in the moment.

Many of these qualities can be replicated with an online educational experience. This is increasing with the wider use of multimedia, videos, interactive elements, audience engagement tools, and soon to enter mainstream immersive 3D and virtual reality interfaces. Our task as educators is to constantly focus on using sound educational and pedagogical practices, while simultaneously blending the strengths of live teaching, with online learning.

The difference between the reading experience with a physical book, and a digital one

Reading a physical book is both an intellectual, and tactile experience. The physical experience of holding a book, of turning pages, browsing, skimming, deep reading is coupled with a memory of where favourite sections lie in a book, and a sense of where one is in the book, at the beginning, middle or later sections, or end. The experience with a physical book can be a deeper and more engaging one, compared with its digital, or online version. We trade the accessibility of a digital or online copy, for the kinaesthetic experience of the physical version. An online copy is useful as a quick reference, just in time review. The physical copy facilitates long, deep reads. It is easier to get lost in the physical pages, diving deep into a series of ideas with a physical book, compared with its digital or online version. We can choose when, and where to review online material, or its physical version, to take advantage of the utility, and best use of each format.

Replicating classroom activities online

"See one, do one, and teach one". A common classroom sequence is for the teacher or instructor to illustrate and demonstrate a concept or idea, a problem solving technique or approach, a technical skill; followed by a request to the students to demonstrate their understanding by using this knowledge, or demonstrate a skill, with feedback by the instructor. When students are able to teach other students, this gives the teacher further assurance and evidence of deeper learning. One challenge in class is to allow all students to demonstrate their learning at the same time. Online workspaces and digital tools can facilitate this. This can occur on a digital online writing wall where all students can write and post material, with the teacher moderating; or even through the use of simple email and SMS texts. The key idea is to use widely available, easy to use technology platforms to facilitate and support learning. The principle is to promote active learning.

Preparing for a teaching session, and live teaching, is much easier when your educational materials are available on hand

Preparing for a teaching session, and live teaching, is much easier when you have access to educational materials online. Teaching and interacting with students using an educational website takes advantage of educational content that has been created and curated previously, and made easily accessible via an indexed hyperlinked online teaching repository. To use a cooking analogy, as teachers, we now have ready access to a well stocked and organised grocery store and food ingredient larder (our educational repository of reusable learning objects); potential recipes (our curricular and teaching plans); as well as semi-prepared and previously given teaching sessions (items in our fridge and freezer). We are now able to efficiently prepare a meal (deliver a teaching session), even a live cooking demonstration (live teaching session), as our educational materials are available on hand, and can be easily illustrated and demonstrated on a teaching or educational website.

Understanding basic theory using a few illustrative examples, mastering a topic by exposure to and experience with many examples

Typical examples or real-life scenarios can be used to illustrate theory, and help students understand fundamental principles. Mastering a topic usually requires exposure to and experience with many examples, both typical and atypical, common to uncommon including subtle manifestations of a phenomenon. The traditional method of doing this is via a long apprenticeship, or many years of practice with feedback and experience. A digital collection of educational scenarios and cases can support and potentially shorten this educational and training process. Particularly if a systematic attempt is made to collect and curate a comprehensive collection of all possible educational scenarios and case-based examples, across the whole spectrum of professional practice. Online access to key elements, parts of and whole sections of these learning cases; used by students with guidance by instructors under a deliberate practice and mastery training framework, can potentially accelerate the educational process, and deepen learning.

We spend time both in the real world, and online

We spend time and inhabit both the real world, and the online one. This enables us to distinguish between both experiences, and appreciate what we value most about live interaction, and the tangibility of physical media. The texture and physical presence of a book, or journal article. The ease of remembering where certain passages are in an article or book. The physical appearance, and design of a book adding to its character; similar to the framing of a painting adding to the work of an artist. Writing and annotating notebooks, and then reviewing the pen strokes and jottings provides an added tangibility to a passage or phrase. Visiting a bookshop or museum provides a multi-sensory experience, a sense of place and space. Physical exploration slows us down, while preserving a sense of discovery, allowing both browsing, and deep contemplation.

The collected work in a museum, or digital collection, should be on display, for viewing, and reviewing

Digital collections should be on display, readily available for viewing and reviewing. This process allows the viewer/learner to develop perceptual recognition, and insights into the common and key elements which distinguish different categories of work, and strengthens the ability of the viewer/learner to quickly, accurately, and confidently identify similarities and differences between two pieces of work, or case scenarios. Educators have a curatorial role in collecting, making available, and displaying learning objects, and teaching scenarios. Digital collections, online tools and platforms have made this process much easier.

Our students now have much better access to information, they can look it up, or ask someone

Technology has enabled our students to have much better access to information. It is easier now to look up information, or ask someone. As educators, it is even more important now to teach students how to ask questions, to look for information, and to evaluate the credibility, source and value of the information. Knowing where to look, what to look for, and what questions to ask is a key digital competency.

Getting information off the Internet is like taking a drink from a fire hydrant” by Mitchell Kapor.

Compare and contrast

How do you use and review a case collection? A collection of teaching material? Plan to spend time carefully going through and observing each example. Review examples side by side. Look for similarities, and differences. Compare and contrast. Review a series of similar examples, and contrasting ones. Repeat this process. With each session, your ability to recognise key features increases. Keep repeating this process until you become very familiar and confident in your ability to quickly and accurately recognise each example, each case scenario - and be able to state what each example is, to justify this diagnosis or opinion, and be able to describe what actions to take next.

What is evidence of learning? How can we as teachers promote and encourage learning?

How do we know as teachers that someone has learnt something? We can ask a question, to elicit or promote recall; which in itself helps the learning process. We can test recognition, or assess the ability to use new knowledge or skill; to apply this in a new situation, or justify an answer with recently learnt knowledge, or (demonstrate) insight from integrating new with prior knowledge. The common statement that "assessment or testing drives learning" describes this process. Evidence of learning can be sought by getting students to recall, to recognise, to do, to justify, to explain.

Time on task

It takes time to learn anything worthwhile. To accumulate knowledge and skills. To integrate this new learning, and be able to, and be confident applying this in the workplace, and real life settings.

This is the difference between undertaking a program of training, and formal courses, compared with short symposia and workshops, or an isolated lecture. Formal training programs gives students time, space, and a place to learn. On a regular basis. This promotes a cumulative increase in learning. Combining theoretical learning with practical case studies integrates basic principles with practice points, and promotes transfer of learning from the classroom to the real world. Online learning programs should include elements from traditional classroom practices which facilitate learning. This includes scheduled time to review the learning material, to work on applying what is learnt by working on assessments and assignments, individually and by learning collaboratively with peers; as well as provide opportunities for timely feedback from instructors.

Take Home Messages

One of the most effective methods is to combine traditional teaching and assessment strategies, with eLearning; by using a "blended" approach. Blended eLearning leverages on both the reach and accessibility of technology and engagement platforms; with the strengths of face to face student teacher and peer to peer interaction. The intent always is to strengthen student motivation and engagement with the educational material, and promote active learning, as well as "deep" (rather than superficial) learning.

Notes On Contributors

POH SUN GOH, MBBS, FRCR, FAMS, MHPE, is an Associate Professor and Senior Consultant Radiologist at the Yong Loo Lin School of Medicine, National University of Singapore, and National University Hospital, Singapore. He is a graduate of the Maastricht MHPE programme, and current member of the AMEE eLearning committee. 





There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (


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Barbara Jennings - (21/10/2016) Panel Member Icon
I really enjoyed reading this article. The author's perspectives resonated with my own reflections about the importance of marrying sound pedagogical principles with technological tools that can enhance engagement and learning-gain.
I agree that educators have a responsibility to curate the useful information that exists within their sphere of expertise (given its sheer volume) and to disseminate digital collections and tools as widely as possible. It is also really satisfying for a teacher to find that their reach and influence can be global with the help of TEL.
I have a couple of reservations about the article. First, the author describes the piece as a series of short reflections; but they seemed to be a series of conclusions. And I really wanted to know why the author made his inferences, what challenges and barriers he faced at times, and how that journey felt. This could be particularly helpful information for our next generation of educators who will be considering other innovations. And this takes me to my second concern; I think that citations to the seminal research that underpins the principles discussed would have enhanced the article. Even opinion pieces and personal viewpoints can be more valuable to readers, particularly those new to the field, if they can track and consider the development of the evidence base.
However, I am still keen to recommend the author’s narrative to any curriculum planners wondering if e-learning and blended learning have come of age (they have). And it will be a satisfying read to all educationalists who want to check that the central importance of social learning; simulated cases; active learning; and timely evaluation still endure.
Ken Masters - (15/10/2016) Panel Member Icon
A nice overview of some of the concepts of eLearning. I do take issue with a few of the contentions, however. For instance, the view that physical books allow for longer deep reads, while an online copy is for shorter reference, etc. I suspect that this is based primarily on the author’s personal experience; around the world, millions of readers “take” electronic books from libraries, to read at their leisure, or while on holiday. These are any genre, from text books, and manuals, to novels. In medical care, speak to home carers, and other similar night-duty staff, and many will tell you of the convenience of being able to read a book from a tablet while sitting with a sleeping patient, rather than having to schlepp books around. I would also like to have seen the author addressing the facility of online learning to allow students to be more creative in their learning (i.e. creating materials, rather than merely consuming them). Still, this is a useful overview of some of the elements eLearning, and it shows a world beyond the limits of simply using an LMS to broadcast videos or PowerPoint presentation to students.
Trevor Gibbs - (14/10/2016) Panel Member Icon
It would be difficult to criticise this paper since I have little doubt that most of us at one time or another asked similar questions and thought similar thoughts.
I very much enjoyed the positive approach that the author brought to these thoughts and I felt more comfortable ( as a technological dinosaur) that in fact we were not just sitting back and accepting e-learning as the best thing since sliced bread ( what was the best thing before sliced bread?)

All that can be asked now is that the shapers and formers in medical education can begin to address some of these areas and support the movement forward with sound research