Digital transformation for sustainable healthcare education:Evaluating the impact of Moodle learning management system on ICD-11 trainingOA

Background:The Malaysian Ministry of Health(MOH)adopted the International Classification of Diseases Eleventh Revision(ICD-11)and used a Moodle learning management system(LMS)for clinical coder training,providing a sustainable model for continuous education.This study evaluates user satisfaction,attitudes,and the perceived impact of the ICD-11 Moodle LMS on clinical coding competencies,exploring correlations with sociodemographic and professional characteristics to inform equitable digital training program design.Methods:A cross-sectional survey was conducted from February to July 2025 with 214 MOH officers across Malaysia.The survey collected data on user satisfaction with the platform’s quality and support,attitudes to-wards online learning,and its impact on clinical coding skills,knowledge,and confidence.Findings:The sample consisted mainly of female participants(64.5%)and those aged 31-40(50.0%).Results indicated that a high percentage of users were satisfied(57.5%)and had positive attitudes towards the plat-form’s flexibility(71.9%).While majority participants agreed that the LMS improved their knowledge(82.2%),clinical coding skills(80.8%),and coding accuracy(81.8%),the perceived impact on coding confidence(76.6%)was lower.Moreover,multiple regression analysis identified occupation and ethnicity as significant predictors of user attitudes,while level of education was a significant predictor for both satisfaction and impact scores.Interpretation:The ICD-11 Moodle LMS was a viable and effective tool for knowledge transfer during this tran-sition period.The findings suggested that while the platform is well-received,its impact on practical skills is limited.Thus,to enhance its effectiveness and promote a sustainable healthcare workforce,future digital training programs should be tailored to account for occupational,ethnic,and educational differences.