Table 1.

Design-reality gap assessment showing the question asked, score, and answer.

Question	Score	Answer
Information: What is the gap between the information assumptions/requirements of the new e-learning system design, and the information currently in use in reality in the Hospital?	1	The information provided by e-learning is the same as currently used. Some slide presentations may need to be edited.
Technology: What is the gap between the technology assumptions/requirements of the new e-learning system design, and the technology currently in use in reality in the Hospital?	7	The technology is in place, but staff are not trained or used to it.
Processes: What is the gap between the work processes required for successful implementation of the new e-learning system, and the work processes currently in use in reality in the Hospital?	2	There does not appear to be a gap between the current processes; however, participants at distant sites may feel excluded by not being face to face and may be excluded from discussion.
Objectives and values: What is the gap between the objectives and values that key stakeholders require for successful implementation of the new e-learning system design, and their current, real objectives, and values?	1	There needs to be acceptance of VC. Some people may be technophobic. The objectives of key stakeholders are the same.
Staffing and skills: What is the gap between the staffing numbers and skills levels/types required for successful implementation of the new e-learning system design, and current, real staffing, and skills?	7	There are no local and support staff at the distant sites and doctors and nurses have no technical training. It is assumed that after training staff will be able to make connections and undertake basic trouble shooting with support from Durban.
Management systems and structures: What is the gap between the management systems and structures required for successful implementation of the new e-learning system design, and current, real management systems, and structures?	5	Management systems are in place for delivery of educational sessions but participation at the far sites is dependent on local managers employed by the DOH and on the Provincial DOH continuing to sanction VC e-Learning.
Other resources: What is the gap between the other resources (money, time, other) required for successful implementation of the new e-procurement system design, and current, real availability of those resources?	5	The University has the resources to maintain and support the system at its venues but is dependent on the DOH for continued support at many of the distant sites.
Total	28