Purpose: To present a formative evaluation of the impact of a multimedia case study as a component of a masters course in health informatics delivered by distance learning. Setting/Participants/Resources: First and second year health informatics students undertaking four core modules of a masters programme at the University of Sheffield. Methodology: Individual qualitative user surveys and interviews. Results/Outcomes: Formative evaluation has played a significant role in refining the case study through its text-based, intermediate and CD-ROM based stages. Feedback from students has resulted in clarification of case study tasks, clearer definition of teaching roles and a revised approach to assessment. At the same time it has highlighted the importance of ongoing revision and maintenance in keeping the scenarios realistic and current. Discussion/Conclusion: The multimedia case study has met many of its original aims in providing greater cohesion for core modules and encouraging greater levels of interaction and multidisciplinary collaboration.