Background Existing research on the costs associated with the design and deployment of eLearning in health professions education is limited. The relative costs of these learning platforms to those of face-to-face learning are also not well understood. The lack of predefined costing models used for eLearning cost data capture has made it difficult to complete cost evaluation. Objective The key aim of this scoping review was to explore the state of evidence concerning cost capture within eLearning in health professions education. The review explores the available data to define cost calculations related to eLearning. Methods The scoping review was performed using a search strategy with Medical Subject Heading terms and related keywords centered on eLearning and cost calculation with a population scope of health professionals in all countries. The search was limited to articles published in English. No restriction was placed on literature publication date. Results In total, 7344 articles were returned from the original search of the literature. Of these, 232 were relevant to associated keywords or abstract references following screening. Full-text review resulted in 168 studies being excluded. Of these, 61 studies were excluded because they were unrelated to eLearning and focused on general education. In addition, 103 studies were excluded because of lack of detailed information regarding costs; these studies referred to cost in ways either indicating cost favorability or unfavorability, but without data to support findings. Finally, 4 studies were excluded because of limited cost data that were insufficient for analysis. In total, 42 studies provided data and analysis of the impact of cost and value in health professions education. The most common data source was total cost of training (n=29). Other sources included cost per learner, referring to the cost for individual students (n=13). The population most frequently cited was medical students (n=15), although 12 articles focused on multiple populations. A further 22 studies provide details of costing approaches for the production and delivery of eLearning. These studies offer insight into the ways eLearning has been budgeted and project-managed through implementation. Conclusions Although cost is a recognized factor in studies detailing eLearning design and implementation, the way cost is captured is inconsistent. Despite a perception that eLearning is more cost-effective than face-to-face instruction, there is not yet sufficient evidence to assert this conclusively. A rigorous, repeatable data capture method is needed, in addition to a means to leverage existing economic evaluation methods that can then test eLearning cost-effectiveness and how to implement eLearning with cost benefits and advantages over traditional instruction.

BACKGROUND Existing research on the costs of delivering courses online courses is limited. The way in which these learning platforms compare in cost to face-to-face learning is also poorly understood. This lack of data has made it difficult to evaluate whether the investments spent by organisations on online learning are effective in comparison to face-to-face instruction. OBJECTIVE The key aim of this scoping literature review is to better understand the state of evidence about whether eLearning demonstrates cost advantages over face-to-face instruction and report the results of a research question centred on: What data exists to define cost calculations related to eLearning? Specifically, we investigate the extent to which the literature can provide details for calculation of the costs for eLearning design, development, and delivery. METHODS Scoping review using a search strategy of MeSH terms and related keywords centred on eLearning and cost calculation with a population scope of health professionals in all countries. The search was limited to English language studies. No restriction was placed on literature publication date. RESULTS In total, 7344 articles were returned from the original search of the literature. Of these, 232 were relevant to associated keywords or abstract references to cost following screening. Full-text review resulted in 168 studies being excluded, with 42 studies providing data and analysis of the impact of cost and value in health professions education. A further 22 studies provided details of costing approaches for the production and delivery of eLearning. CONCLUSIONS There is an emerging body of studies capturing costs in eLearning. However, costs in these studies were collected inconsistently and in relation to a wide variety of factors or had an alternate study-related focus. Although there is a perception that eLearning is more cost-effective than face-to-face instruction, there is not yet sufficient evidence to assert this conclusively. A rigorous, repeatable and data capture method is needed, in addition to a means to leverage existing economic evaluation methods that can then test whether eLearning cost-effectiveness and how to implement with cost benefits and advantages over traditional instruction. CLINICALTRIAL N/A

Background eLearning (defined as asynchronous/synchronous online learning delivered via the internet, either used on a stand-alone basis or using blended learning design) presents a significant opportunity to provide a scalable and cost-effective means of delivering of health education in contrast to one-time delivery of face to face instruction. Economic evaluation makes use of implementation costs for the basis of comparative analysis of cost value determination between different intervention types. Although there exist models for the calculation of costs in standard education programmes, eLearning is a different implementation design than face to face instruction because the initial effort is concentrated on the construction of intervention before implementation and the factors which influence their production require iteration and refinement. Understanding these iterations and their impact on cost is vital in order to develop a strong evidence base on the total cost of implementation of eLearning. ObjectiveTo identify the ingredients for the production and delivery of a small private online course, complete a variance calculation of the ingredients for the cost of production and delivery of a small private online course and explore the factors impacting the planning of costs for eLearning delivery. MethodsThis study uses a mixed-methods study design was implemented, with a single-use case study design structured for study observation and cost analysis used to analyse financial data. ResultsThe implementation costs of the course were significantly underestimated at commencement making the total effort to deliver the cost untenable when baselined against the budget with a 41% negative variance from the project budget. The course was delivered despite this budget overrun because there was an obligation to deliver the course for the anticipated budget; had they failed to do this they would not have received compensation from the funder for the course activity. The two principal factors for the cost overruns were the deficiency of the use of the project budget and the under-reporting of personnel costs. ConclusionsAlthough there has been the development of costing capture models for the capture of the components or ingredients of educational interventions, the driver for these models has been the development of frameworks to allow for the further economic evaluation of learning types. Further work is required to the foundational aspects of cost capture in the production of eLearning, as to ensure that total costs are recorded to capture the real costs of delivery.