The aim of the study was to explore the relationship between degree of participation and learning outcomes in an e-learning course on medical informatics. Overall activity in using course materials and degree of participation in the discussion forums of an online course were studied among 39 medical students. Students were able to utilise the course material in discussion groups focusing on the lectures, quizzes and students' own notes. Each student's data recording of activities and individual participation in discussion in the online course was analysed in order to assess which activities predicted learning outcome. Higher course grades were associated with studying the course material frequently and also with regular participation in reading postings and replying to them. There were no connections between learning outcome and the students' original contributions to the discussion forums. There were no statistically significant differences between male and female students in how they utilised the various components of the learning material.