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Validation is needed for any newly developed model or framework because it requires several real-life applications. The investment made into e-learning in medical education is daunting, as is the expectation for a positive return on investment. The medical education domain requires data-wise implementation of e-learning as the debate continues about the fitness of e-learning in medical education. The domain seldom employs frameworks or models to evaluate students' performance in e-learning contexts. However, when utilized, the Kirkpatrick evaluation model is a common choice. This model has faced significant criticism for its failure to incorporate constructs that assess technology and its influence on learning. This paper aims to assess the efficiency of a model developed to determine the effectiveness of e-learning in medical education, specifically targeting student performance. The model was validated through Delphi-based Expert Judgement Techniques (EJT), and Cronbach's alpha was used to determine the reliability of the proposed model. Simple Correspondence Analysis (SCA) was used to measure if stability is reached among experts. Fourteen experts, professors, senior lecturers, and researchers with an average of 12 years of experience in designing and evaluating students' performance in e-learning in medical education participated in the evaluation of the model based on two rounds of questionnaires developed to operationalize the constructs of the model. During the first round, the model had 64% agreement from all experts; however, 100% agreement was achieved after the second round, with all statements achieving an average of 52% strong agreement and 48% agreement from all 14 experts; the evaluation dimension had the most substantial agreements, next to the design dimension. The results suggest that the model is valid and may be applied as Key Performance Metrics when designing and evaluating e-learning courses in medical education.

Performance evaluation is one of the most critical components in assuring the comprehensive development of e-learning in medical education (e-LMED). Although several studies evaluate performance in e-LMED, no study presently maps the rising scientific knowledge and evolutionary patterns that establish a solid background to investigate and quantify the efficacy of the evaluation of performance in e-LMED. Therefore, this study aims to quantify scientific productivity, identify the key terms and analyze the extent of research collaboration in this domain. We searched the SCOPUS database using search terms informed by the PICOS model, and a total of 315 studies published between 1991 and 2022 were retrieved. Performance analysis, science mapping, network analysis, and visualization were performed using R Bibliometrix, Biblioshiny, and VOSviewer packages. Findings reveal that authors are actively publishing and collaborating in this domain, which experienced a sporadic publication increase in 2021. Most of the top publications, collaborations, countries, institutions, and journals are produced in first-world countries. In addition, studies evaluating performance in e-LMED evaluated constructs such as efficacy, knowledge gain, student perception, confidence level, acceptability, feasibility, usability, and willingness to recommend e-learning, mainly using pre-tests and post-tests experimental design methods. This study can help researchers understand the existing landscape of performance evaluation in e-LMED and could be used as a background to investigate and quantify the efficacy of the evaluation of e-LMED.

The performance evaluation of e-learning in medical education has been the subject of much research lately. Researchers are yet to achieve a consensus on the definition of performance or the suitable constructs, metrics, models, and methods to help understand student performance. Through a systematic review, this study put forward a working definition of what constitutes performance evaluation to reduce the ambiguity, arbitrariness, and multiplicity surrounding performance evaluation of e-learning in medical education. A systematic review of published articles on performance evaluation of e-learning in medical education was performed on the SCOPUS, Web of Science, PubMed, and EBSCOHost databases using search terms deduced from the PICOS model. Following the PRISMA guidelines relevant published papers were searched and exported to Endnote. Screening and quality appraisal were done on Rayyan. Three thousand four hundred and thirty-nine published studies were retrieved and screened using predetermined inclusion and exclusion criteria. One hundred and three studies passed all the criteria and were reviewed. The reviewed literature used 30 constructs to operationalize performance. The leading constructs are knowledge and effectiveness. Both constructs were used by 60% of the authors of the reviewed literature to define student performance. Knowledge gain, satisfaction, and learning outcome are the most common metrics used by 81%, 26%, and 15% of the reviewed literature to measure student performance. The study discovered that most researchers forget to evaluate the "e" or electronic component of e-learning when evaluating performance. The constructs operationalized and metrics measured were primarily focused on learning outcomes with minimal focus on technology-related metrics or the influence of the electronic mode of delivery on the learning process or evaluation outcome. Only 6% of the reviewed literature applied evaluation models to guide their evaluation process -- mostly the Kirkpatrick evaluation model. Also, most of the included studies used randomization as an experimental control method, mainly using pre- and post-test surveys. Modern evaluation methods were rarely used. Only 1% of the reviewed literature used Google Analytics, and 2% used data from a learning management system. This study increments the existing body of knowledge in performance evaluation of e-learning in medical education by providing a convergence of constructs, metrics, models, and methods and proposing a roadmap to guide students' performance evaluation process from the synthesis of findings and the gaps identified through the systematic review of existing literature in the domain. This roadmap will assist in informing researchers of grey areas to consider when evaluating performance to ensure more quality research outputs in the domain.

Medical education is vital in producing competent healthcare professionals and advancing medical knowledge. The integration of e-learning has emerged as a transformative approach to enhance medical education by improving accessibility, cost-effectiveness and interactive learning experiences. With the COVID-19 pandemic further accelerating e-learning adoption, analysing the trends, publication collaborations and publication patterns in this domain is crucial. This study conducted a bibliometric analysis of published documents on the Scopus database in e-learning in medical education to explore the trends in scientific productivity. Publications in the domain has sporadically increased since the onset of the COVID-19 pandemic. The pandemic introduces a changing focus in research and emerging trends, with COVID-19 becoming a dominant topic and emerging theme. A collaborative research environment exists between authors; however, there is a divide between developed and developing countries in publication distribution, emphasising the need for equitable participation. This study contributes to a comprehensive understanding of e-learning in medical education, emphasising collaboration, publication patterns, emerging trends, and the impact of the COVID-19 pandemic. Researchers can leverage these findings to advance e-learning in medical education and enhance the quality of medical training and education.