Digital transformation for sustainable healthcare education: Evaluating the impact of Moodle learning management system on ICD-11 training

The Malaysian Ministry of Health (MOH) adopted the International Classification of Diseases Eleventh Revision (ICD-11) and used a Moodle learning management system (LMS) for clinical coder training, providing a sustainable model for continuous education. This study evaluates user satisfaction, attitudes, and the perceived impact of the ICD-11 Moodle LMS on clinical coding competencies, exploring correlations with socio-demographic and professional characteristics to inform equitable digital training program design. A cross-sectional survey was conducted from February to July 2025 with 214 MOH officers across Malaysia. The survey collected data on user satisfaction with the platform’s quality and support, attitudes towards online learning, and its impact on clinical coding skills, knowledge, and confidence. The sample consisted mainly of female participants (64.5 %) and those aged 31–40 (50.0 %). Results indicated that a high percentage of users were satisfied (57.5 %) and had positive attitudes towards the platform’s flexibility (71.9 %). While majority participants agreed that the LMS improved their knowledge (82.2 %), clinical coding skills (80.8 %), and coding accuracy (81.8 %), the perceived impact on coding confidence (76.6 %) was lower. Moreover, multiple regression analysis identified occupation and ethnicity as significant predictors of user attitudes, while level of education was a significant predictor for both satisfaction and impact scores. The ICD-11 Moodle LMS was a viable and effective tool for knowledge transfer during this transition period. The findings suggested that while the platform is well-received, its impact on practical skills is limited. Thus, to enhance its effectiveness and promote a sustainable healthcare workforce, future digital training programs should be tailored to account for occupational, ethnic, and educational differences. ● Moodle LMS adoption supports ICD-11 training and act as a sustainable option for coder training. ● Users are satisfied with platform's flexibility, which improves knowledge, but not practical skills. ● Occupation and ethnicity predict user attitudes, while education level influences satisfaction and impact scores.