Implementation Outcomes of Reusable Learning Objects in Health Care Education Across Three Malaysian Universities: Evaluation Using the RE-AIM Framework

Background Current e- learning evaluation focuses on learners’ knowledge gain, satisfaction, perceptions, and attitudes; few assess the implementation outcomes of e- learning resources in teaching and learning. Objective In this study, we used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to systematically evaluate the implementation outcomes of reusable learning objects (RLOs) in the context of health care education. Methods This study is a part of the Advancing Co-creation of RLOs to Digitise H ealthcare Curriculum (ACoRD) project, wherein we developed and implemented 23 RLOs across 3 Malaysian universities for medical, pharmacy, and biomedical curricula. Implementation and dissemination strategies were employed. Data were collected using a self-administered web-based questionnaire and Google Analytics. Results Th is study report s a cumulative RLO access of 7622 users from 48 countries ( reach). Users rated RLOs as very helpful ( 1452/ 2071, 70.1%) or helpful ( 601/ 2071, 29.1 %). Pre assessments and postassessments showed a significant improvement in the knowledge score (21 RLOs, P < .05) and confidence level (17 RLOs, P < .05) (e ffectiveness). All 3 Malaysian universities adopted RLOs in the fields of professional development, primary care medicine, medicine, pediatrics, nursing, pharmacy, and biomedicine ( adoption). The percentage of users who completed RLOs ranged from 5.6% ( 10/ 179) to 8 5% ( 78/ 92), with nonbounced users (users who viewed more than one page) ranging from 16.3% ( 165/ 1014) to 8 8.5 % ( 3 70/ 4 18) ( implementation). In the 4 months following the completion of the AC oRD project, a total of 2107 users accessed RLOs ( maintenance). Conclusions We systematically evaluated the implementation of e- learning resources by using the RE-AIM framework, informing future strategies to integrate e- learning innovations in real-world teaching and learning practices.