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Are you still engaged? Leveraging the LMS to support engagement in asynchronous courses

Published online by Cambridge University Press:  29 May 2026

Damian N. Di Florio
Affiliation:
Department of Neuroscience, Department of Cancer Biology, Center for Clinical and Translational Science, Jacksonville, FL, USA
Kristina B. Nelson*
Affiliation:
Center for Clinical and Translational Science Education Resources, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic , Rochester, MN, USA
Ryan C. Jimison
Affiliation:
Center for Clinical and Translational Science Education Resources, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic , Rochester, MN, USA
Ross A. Dierkhising
Affiliation:
Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
Carmen J. Silvano
Affiliation:
Center for Clinical and Translational Science Education Resources, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic , Rochester, MN, USA
Felicity T. Enders
Affiliation:
Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
*
Corresponding author: K. B. Nelson; Email: nelson.kristina@mayo.edu
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Abstract

Introduction:

Asynchronous online courses are plagued with the challenge of engaging students consistently. Behavioral interventions, such as bottlenecks (enforced deadlines) and nudges (automated reminders), may modulate behaviors that lead to engagement and can now be easily applied and measured in a Learning Management System (LMS).

Methods:

This study included three groups of three asynchronous online courses each over three academic quarters. Two distinct behavioral interventions, bottlenecks and nudges, were implemented to increase engagement with the course compared to non-intervention controls.

Results:

The results showed that behavioral intervention tools increase student engagement with course materials by measures of increased student access to the course and reduced time to quiz completion. However, there was no significant impact in grades across the three groups.

Conclusion:

The use of nudges and bottlenecks as behavioral interventions to increase engagement in asynchronous courses for Clinical and Translational Science Education is recommended as part of best practice in course design with the same or similar structure.

Information

Type
Research Article
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and/or adaptation of the article.
Copyright
© Mayo Foundation for Medical Education and Research, 2026. Published by Cambridge University Press on behalf of Association for Clinical and Translational Science
Figure 0

Figure 1. Study Timeline for all courses displaying the weeks of the course. Study timeline shows where nudges occurred (in the bottleneck + nudges group) and where the bottleneck occurred (in the bottleneck without and with nudges groups) relative to course start and end. Each rectangle represents 1 week in the course schedule. (Created in BioRender. Di Florio, D. (2026)https://BioRender.com/x4vs32e).Figure 1 long description.

Figure 1

Figure 2. Course Access for all Courses. (a, d, and g) Course access by synchronized relative dates in course comparing control (black and transparent white/gray) bottleneck (blue) and bottleneck + nudges (red) (81 days for all groups in Course 1, 77 days for Course 2, and 80 days for Course 3). (b, e, and h) Hits per day models for Courses 1–3 (N/group are overlaid on these graphs). (c, f, and i) Course access across total days in each course for Course 1 (control = 85 days, bottleneck = 92 days, and bottleneck + nudges = 88 days), Course 2 (control = 82 days, bottleneck = 87 days, and bottleneck + nudges = 84 days), and Course 3 (control = 85 days, bottleneck = 84 days, and bottleneck + nudges = 88 days).Figure 2 long description.

Figure 2

Figure 3. Figure 3 long description.Tool Usage Across Courses Compared to Study Arms. Plots showing relative tool usage (%) in different study arms for (a) course 1, (b) course 2, and (c) and course 3.

Figure 3

Figure 4. Overall Course Grades. (a) for course 1, (b) course 2, and (c) and course 3 among control vs bottleneck without and with interventions. Abbreviations: C, control group (no intervention), B, bottleneck group (without nudges), B + N, bottleneck and nudges.Figure 4 long description.

Figure 4

Figure 5. Time to quiz completion for all Courses. Linear slope models (left) are displayed along with data tables (right) showing Δ slope, Δ Δ slope, and 95% confidence intervals (95% CI) in (a) course 1, (b) course 2, and (c) course 3.Figure 5 long description.

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