Equlinet AmareTefera JimmaHiba AbdelrahmanAbebe Zerihun2026-01-132026-01-132025-1210.2147/AMEP.S554861https://dspace.ughe.org/handle/123456789/1116Introduction: Blended e-learning guided by the First Principles of Instruction (FPI) can enhance learning outcomes while reducing costs, performing comparably to face-to-face training. However, in low- and middle-income countries, its application in health professions education remains limited, with little empirical evidence and minimal evaluation from learners’ perspectives. This study was designed, implemented, and evaluated an FPI-based blended course to generate evidence and insights for future course design and to assess the teaching and learning quality (TALQ) from learners’ viewpoints. Methods: A descriptive, correlational design was employed at the Health Professional Education training program at the University of Global Health Equity in Rwanda between February and April 2025, and data were collected using the reliable Teaching and Learning Quality survey instrument. A descriptive statistic, a one-way multivariate analysis of variance and correlation analysis were conducted to analyse the collected data. Results: This study, involving 38 postgraduate certificate-level learners (79.1% response rate) from four types of institutions, found strong support for the integration of FPI elements in a blended e-learning module. Learners frequently engaged in problem-solving activities, reported significant learning progress, and rated the course quality as outstanding with high satisfaction. Furthermore, strong correlations were observed among teaching and learning quality measures, while no significant associations were found between demographic variables and teaching and learning quality scores. Conclusion: The blended eLearning lesson design—structured around a central problem, activation of prior knowledge, multimedia-based explanations, collaborative discussions, and opportunities for reflection and application—demonstrated effective integration of the first principles of instruction. This integration of FPI within a blended e-learning framework was a key factor in promoting student engagement, learning progress, and satisfaction, thereby contributing to the overall enhancement of teaching and learning quality. Keywords: blended e-learning, first principles of instruction, teaching and learning quality, University of Global Health Equity, RwandaenBlended e-learningTeaching and learning qualityMedical EducationRwandajournal-article