The purpose of this study is to compare an adaptive Web-based learning system to a non-adaptive system for teaching physicians-in-training about ambulatory medicine.

Not all Web-based instruction is equally effective at facilitating learning. Adaptation to characteristics of individual learners may enhance Web-based learning by emulating a face-to-face teacher's response to a learner's needs. Learner baseline knowledge level is one variable to which Web-based instruction may adapt. We will enhance Web-based instructional modules used in the Internal Medicine resident continuity clinics so that they adapt to learner baseline knowledge. We will then compare the adaptive Web-based format to the standard format. We hypothesize that the adaptive format will have higher learning efficiency, and that achievement will be similar for the two groups. We also hypothesize that residents will prefer the adaptive format and find it to be more motivating than the standard format.

Inclusion Criteria:

• Internal medicine residents (Mayo-Rochester campus)