The nature of the interaction between participants and facilitators in online asynchronous continuing medical education learning environments

Background: MDcme.ca offers an online asynchronous continuing medical education (CME) environment for family physicians. The nature of participation in online CME using computer-mediated conferencing (CMC) discussion systems and the characteristics of interaction between participants and facilitators is not well understood. Purpose: To examine the association between participant and facilitator participation in online asynchronous CME learning environments. Methods: We analyzed registration and participation data including participant and facilitator postings to an asynchronous CMC discussion system for CME programs offered through MDcme.ca using frequency counts. Pearson r correlation was used to assess the association between numbers of participants and participant postings, facilitator postings and participant postings, and the number of discussion items accessed and participant postings. Results: MDcme.ca offered 25 programs to 327 registrants, of whom 180 actually participated by accessing course materials and online discussion postings. Pearson r correlations showed a significant association between the number of participants and the number of postings, the number of facilitator postings and the number of participant postings, and the mean number of discussion items accessed by participants and the overall number of participant postings. Discussion: Both the number of facilitator postings and the number of discussion items accessed by participants appeared to be important determinants of the amount of interaction that will occur in asynchronous online CME. Curriculum planners and facilitators of asynchronous CME need to be aware of the importance of fostering interactive, stimulating discussions if the potential of asynchronous learning for physicians is to reach its potential in supporting higher levels of critical, reflective, practice-based learning.