Few tests of the new methods of e-learning can be more exacting than to improve standards of clinical care by hard-pressed nurses in Kenya’s busy hospitals and clinics. But such is the ambition which drives the country’s first nationwide e-learning programme for nurses, devised by the African Medical and Research Foundation (AMREF). In this candid and detailed account Angela Nguku chronicles the evolution of the e-learning programme. From her perspective as coordinator of the AMREF Virtual Nursing School in Nairobi, she charts both the obstacles – a shortage of qualified tutors, the scarcity of clinical placements – and the priorities to overcome them.