2011; 33: 297–302 E-learning: Is the revolution over? RACHEL ELLAWAY Northern Ontario School of Medicine, Canada Abstract There are many forms of technology used in medical education, only some of which are directly focused on the learning process. After more than a decade of disruptive change around e-learning we may be moving into a period of consolidation. This paper explores the evidence for such a change and the implications for teaching, learning and research in medical education. Introduction This paper was developed from a closing address given at the joint MedBiquitous and International Virtual Patient Conference in London in April 2010. The thesis of the presentation was that a noticeable shift from primary to translational had taken place and this marked a more general move towards the consolidation of e-learning within medical education. There are many technologies and activities that constitute ‘e-learning’. As an illustration, topics at the 2010 AMEE e- Learning Symposium included: instructional materials, simula- tors (such as virtual patients), case- and problem-based learning, communication (such as web-conferencing), collab- oration (such as wikis and discussion boards), e-portfolios, assessment (both formative and summative), evidence-based medicine, mobile and point of care learning, lecture polling and capture (including the use of ‘clickers’), and digital professionalism. Clearly e-learning is not a single technology or technique. It is a loosely defined amalgam of information communication technologies (ICTs) used in education, usually but not exclusively mediated in some way through the Internet. Despite the label, much of what is called e-learning is defined by teachers rather than learners. A better term might therefore be ‘e-teaching’ to reflect both what the teacher does and what they direct their learners to do (Ellaway & Masters 2008). The term ‘e-learning’ should be used (if at all) to cover what learners do, much of which is unseen and beyond institutional scrutiny. While the learning process can be richly supported or mediated using technologies, learning is still intrinsically a cognitive and embodied phenomenon. The term ‘technology- enhanced learning’ (TEL) may better represent the relation- ships between technology and learner. This article will nevertheless reflect on e-learning as its basic construct and use a number of critical lenses to consider its development along with the future of what has proved to be a particularly disruptive and intriguing educational phenomena. How did we get here? Connecting learners, teachers and administrators through technologies and providing near ubiquitous access to content and tools has shifted our relationship with the digital from optional convenience to near-ubiquitous dependence. This is reflected in the ways in which the digital mediates or influences almost every aspect of contemporary medical education. For example, Google and Wikipedia are now the first point of search and reference for both faculty and learners (even though some may deny using such plebeian sources), much of the administration of medical schools has moved online and many libraries have shifted from paper to electronic collections with their once hallowed stacks being turned into collaborative learning spaces. Furthermore, the flavour of learning management system or virtual learning environment used (such as WebCT, Backboard or Moodle) increasingly defines the way the school or institution works (Weller 2007) and portfolios, lecture recording, and web-conferencing are similarly more a matter of ‘how’ than ‘if’. As an illustration of the relatively short time in which these changes have taken Practice points . E-learning is an aggregate of digitally-mediated educa- tion activities; learning is still learning. . Although the use of digital technologies in medical education is widespread, only some is directly educa- tionally focused. . After a decade of disruptive change we seem to be moving into a period of consolidating the use of the digital in medical education. . The e-learning context determines what is done and how it is valued. . Good evidence is limited; scholarship needs to be more critically engaged with the broader dimensions of technology use in medical education. Correspondence: Dr Rachel Ellaway, Assistant Dean and Associate Professor Informatics, Northern Ontario School of Medicine, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada. Tel: (705) 662 7196; email: rachel.ellaway@nosm.ca ISSN 0142–159X print/ISSN 1466–187X online/11/040297–6 ß 2011 Informa UK Ltd. 297 DOI: 10.3109/0142159X.2011.550968