Study design and protocol for a comprehensive evaluation of a UK massive open online course (MOOC) on quality improvement in healthcare.

INTRODUCTION:Massive open online courses (MOOCs) offer a flexible approach to online and distance learning, and are growing in popularity. Several MOOCs are now available, to help learners build on their knowledge in a number of healthcare topics. More research is needed to determine the effectiveness of MOOCs as an online education tool, and explore their long-term impact on learners' professional practice. We present a protocol describing the design of comprehensive, mixed-methods evaluation of a MOOC, 'QualityImprovement (QI) inHealthcare: the Case for Change', which aims to improve learner's knowledge and understanding of QI approaches in healthcare, and to increase their confidence in participating, and possibly leading QI projects. METHODS AND ANALYSIS:A pre-post study design using quantitative and qualitative methods will be used to evaluate the QI MOOC. Different elements of the RE-AIM (reach, effectiveness and maintenance) and Kirkpatrick (reaction, learning and behaviour) models will be used to guide the evaluation. All learners who register for the course will be invited to participate in the QI MOOC evaluation study. Those who consent will be asked to complete a presurvey to assess baseline QI knowledge (self-report and objective) and perceived confidence in engaging in QI activities. On completion of the course, participants will complete a postsurvey measuring again knowledge and perceived confidence. Feedback on the course content and how it can be improved. A subset of participants will be invited to take part in a follow-up qualitative interview, 3 months after taking the course, to explore in depth how the MOOC impacted their behaviour in practice. ETHICS AND DISSEMINATION:The study has been approved by the University of Bath Human Research Ethics Committee (reference: 2958). Study findings will be published in peer-reviewed journals, and disseminated at conference and departmental presentations, and more widely using social media, microblogging sites and periodicals aimed at healthcare professionals.