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

## TL;DR

This study evaluated the use of reusable learning objects in healthcare education across three Malaysian universities using the RE-AIM framework, showing positive outcomes in reach, effectiveness, and adoption.

## Contribution

The study provides a systematic evaluation of e-learning implementation outcomes using the RE-AIM framework in a healthcare education context.

## Key findings

- RLOs were accessed by 7622 users from 48 countries, with 70.1% rating them as very helpful.
- Knowledge and confidence levels improved significantly for most RLOs.
- All three universities adopted RLOs across multiple healthcare disciplines.

## Abstract

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.

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.

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.

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).

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.