All ELM courses employ a standardized, four-step learning process to assess performance and provide targeted feedback in areas of weakness, allowing users to continually improve. The methodology closes the learning loop when a course is completed in each topic area.

1. Pre-Assessment – ELM identifies the participant's knowledge level prior to taking the course; meanwhile, the user gains comfort with the testing methodology and course content.
   • Pre-Test: Each participant in an ELM course unit begins with an initial evaluation of background knowledge.
   • Goals & Objective: Learners are provided with an overview of what the course intends to accomplish.
   • Overview of Issues: Each course unit explores basic foundation concepts with illustrations and examples of legal, standard of care, or clinical management issues.
2. Formative Assessment – ELM checks for understanding and comprehension throughout the course experience.
   • Case Studies: The standard of care is illustrated through case studies and problem analysis.
3. Summative Assessment – ELM verifies that the participant has satisfactorily mastered the course material by summarizing key content and providing targeted feedback.
   • Post-Test: After completion of each course unit, a formal post-test is taken. When a participant demonstrates mastery of each topic area, he/she is certified as having successfully completed the course unit.
   • Targeted Feedback: After each test, participants are provided with feedback materials to further strengthen any weak topic areas that the participant may have passed with a low score.
   • Certification: When a participant demonstrates satisfactory performance, he/she is certified as having successfully completed the course and is awarded CME credits.
4. Continual Improvement – ELM gathers feedback from participants.
   • Post-Course Evaluation: All participants are asked to complete an evaluation to assist in our efforts to continually improve and develop the courseware.