Continuing Medical Education (CME) interventions continue to be an important factor in the lifelong learning of health care professionals. Online interventions have become increasingly popular since the inception of the Internet. Many CME courses (traditional and online) are evaluated solely on the knowledge gained and participant reactions. However, this study focused on the instructional design of an online CME course and how the design affected the self-efficacy of the learner and the amount of knowledge transferred to the professionals’ practice. Specifically, this study answered the following research questions: 1) How can one design online instruction that will foster a change in health care professionals’ behavior from the course and into medical practice? 2) How can one design online instruction that will increase health care professionals’ self-efficacy with the presented content? The researcher designed two online CME courses regarding the clinical diagnosis of Lyme disease. One course incorporated very few interactive, instructional elements, while the second course incorporated audio, video, and interactive elements. The researcher collected data using both quantitative and qualitative methods via pre-tests, post-tests, a final survey given to participants three weeks after completing the online course, and four interviews. The findings indicated that the knowledge, self-efficacy, and behavior did improve for the majority of participants. However, interactive, instructional elements were not found to be the sole reason for the increase of knowledge, self-efficacy, and change in behavior. The present study did confirm that the instructional design of online courses was important. These results suggest that future CME designers should continue to investigate elements within online courses to see which elements are found to be the most valuable for learners’ gain in knowledge, self-efficacy, and a change in behavior
