The medical education department conducts final tests at the end of the batch. The tests measure the increasing of knowledge in the basics of medical science. Within five years, the number of students who passed the post-test 69%. There are some ways to increase the number of students who pass the test, one of which is e-learning. The board believes by using the e-learning will give the student a more chance to learn and increased the possibility pass the test. The board decided to develop a web based LMS for facilitating the students to access the course material and discussions outside the classroom like other Indonesian universities do. The learning material in video tutorials, portable document files, and presentation files which are easily accessed by students. After three years of implementation of e-learning, the number of students who passed the post-test decreased to 55%. The board found that the using of e-learning is failing to increase the students’ knowledge. Why does this happen?