Open Access Highly Accessed Research article

A Comparison of Online versus On-site Training in Health Research Methodology: A Randomized Study

Rakesh Aggarwal1*, Nikhil Gupte2, Nancy Kass3, Holly Taylor3, Joseph Ali3, Anant Bhan4, Amita Aggarwal1, Stephen D Sisson3, Sukon Kanchanaraksa3, Jane McKenzie-White3, John McGready3, Paolo Miotti5 and Robert C Bollinger3

Author Affiliations

1 Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India

2 BJ Medical College Clinical Trials Unit, Pune, India

3 Johns Hopkins University, Baltimore, Maryland, USA

4 Researcher, Bioethics and Global Health, Pune, India

5 Office of AIDS Research, NIH, Bethesda, Maryland, USA

For all author emails, please log on.

BMC Medical Education 2011, 11:37  doi:10.1186/1472-6920-11-37

Published: 17 June 2011



Distance learning may be useful for building health research capacity. However, evidence that it can improve knowledge and skills in health research, particularly in resource-poor settings, is limited. We compared the impact and acceptability of teaching two distinct content areas, Biostatistics and Research Ethics, through either on-line distance learning format or traditional on-site training, in a randomized study in India. Our objective was to determine whether on-line courses in Biostatistics and Research Ethics could achieve similar improvements in knowledge, as traditional on-site, classroom-based courses.


Subjects: Volunteer Indian scientists were randomly assigned to one of two arms.

Intervention: Students in Arm 1 attended a 3.5-day on-site course in Biostatistics and completed a 3.5-week on-line course in Research Ethics. Students in Arm 2 attended a 3.5-week on-line course in Biostatistics and 3.5-day on-site course in Research Ethics. For the two course formats, learning objectives, course contents and knowledge tests were identical.

Main Outcome Measures: Improvement in knowledge immediately and 3-months after course completion, compared to baseline.


Baseline characteristics were similar in both arms (n = 29 each). Median knowledge score for Biostatistics increased from a baseline of 49% to 64% (p < 0.001) 3 months after the on-site course, and from 48% to 63% (p = 0.009) after the on-line course. For the on-site Research Ethics course, median score increased from 69% to 83% (p = 0.005), and for the on-line Research Ethics course from 62% to 80% (p < 0.001). Three months after the course, median gains in knowledge scores remained similar for the on-site and on-line platforms for both Biostatistics (16% vs. 12%; p = 0.59) and Research Ethics (17% vs. 13%; p = 0.14).


On-line and on-site training formats led to marked and similar improvements of knowledge in Biostatistics and Research Ethics. This, combined with logistical and cost advantages of on-line training, may make on-line courses particularly useful for expanding health research capacity in resource-limited settings.