In order to ensure and increase access to high-quality learning opportunities it is becoming more and more common to integrate e-learning into health-related environments. The rapid development of these new learning environments also requires continuous monitoring and evaluation, to guarantee the quality of the health-care education. In this project a holistic model based on a systems approach is used in order to evaluate a video conference-supported course in emergency medicine. Questionnaires and observations as well as interviews in groups and individually were used for data gathering. The course participants were 27 junior doctors, 18 from the Stockholm node and 9 from the Kalmar node; 11 lecturers were involved. The collaborative pedagogical approach was appreciated; all participants agreed that their peers contributed to the learning process. The greatest advantage of the course was that high-quality education was made available to a group of junior doctors who did not have alternative possibilities for participating in a traditional course. To offer a proficient video conference environment for synchronous two-way communication, the course must be developed at three levels: technical environment; individual information and communications technology skills; and course organisation. Potential users must be offered adequate training and technical support. The course organisation must encourage the sharing of responsibilities and tasks between the participating nodes. (Contains 1 figure and 5 tables.)