Background. Skillful surgical care demands proper patient assessment and decision-making. These skills are honed through long hours and years of clinical practice. A decrease in work hours is reducing the number of cases managed by medical students and residents. We have developed a set of interactive, web-based teaching modules to help fill this gap. Materials and methods. The modules aim to teach surgical decision-making in a convenient, nonthreatening manner. Surgical case material is presented in a graphically rich environment, including video and sound to enhance realism. At the end of each webpage, the user must make a management decision. The correct answer is subsequently provided with immediate feedback. Medical students used and evaluated the modules during their surgical clerkships. Additionally, students took a pretest and 1-week delayed posttest after completing the modules to assess the program's efficacy. Results. Eight modules involving pediatric and general surgery have been completed. Medical students gave high ratings to the quality of the modules and found the interactive format both engaging and educationally effective. Eighty-seven percent of medical students rated the program's educational value as above average to excellent. On pre- and posttest analysis, students' scores improved an average of 24.8% (P < 0.001). Conclusion. Students enjoy web-based educational material. Additional modules covering a range of surgical topics are in development. Web-based modules appear to be an effective clinical teaching tool, well-suited for integration into the clinical curriculum. (c) 2006 Elsevier Inc. All rights reserved.