E-learning: is there anything special about the "E"?

E-learning has been widely utilized in medical education and suggested by some proponents to represent a fundamental advance in educational methodology. We challenge this conclusion by examining e-learning in the context of broader learning theories, specifically as they relate to instructional design and methods. Core tenets of educational design are applied to e-learning in a unified model for instructional design, and examples of e-learning technologies are examined in the context of medical education, with reflections on research questions generated by these new modalities. Throughout, we argue that e-learning is a tool that, when designed appropriately, can be used to meet worthy educational goals.