Introduction: Due to Tanzania’s rising population and shortage of physicians, there has been an emphasis on the expansion of medical schools in the past two decades, both in number and class size. In order to teach a growing student body, faculty adopted e-learning (electronic learning) systems to distribute materials and educate students. At Kilimanjaro Christian Medical University College (KCMUCo) faculty adopted the e-learning system called Learning Management Content System (LCMS+) in 2011. LCMS+ allowed students to access and download course materials during the year; but the association between the downloaded course materials and final grade was unknown. This study aimed to analyze the association between the downloaded materials and final grade in a course between 2011 and 2016.

Methods: To determine the association between downloaded materials and grade, a retrospective analysis study studied first- and second-year medical students in seven courses from 2011-2016 at KCMUCo. The study initially measured the frequency of downloaded course material (i.e. powerpoints, readings, assignments, course outlines and discussion board posts) from LCMS+ per first and second-year student. The final course grades were then obtained. A linear regression was used to assess the association between (1) downloads and grade and (2) sociodemographic variables and grade.

Results: Of the 1,527 students and 5,205 student-course-years studied, there was a weak or null association between downloaded materials and grade for each year and for different types of downloaded material. The distributions of the grades were approximately normal from 2011-2014 and in 2014-2016 there was a left shift of grade distribution. Additionally the female sex and post-service history were associated with slightly lower grades in some of the student years.

Conclusion: This study demonstrated there was no strong association between the number of downloads and grade. There was also no association between the type of downloaded material and grade and the number of materials did not increase the longer the e-learning system was at KCMUCo. More research on how e-learning systems can benefit students is required and may lead to better training for future generations of health care providers.