Background: Massive open online course (MOOC) research is an emerging field; to date, most research in this area has focused
on participant engagement. Objective: Here, we evaluate both participant engagement and measures of satisfaction, appropriateness and burden for a
MOOC entitled Understanding Multiple Sclerosis (MS) among a cohort of 3,518 international course participants. Methods: We assessed the association of key outcomes with participant education level, MS status, caregiver status, sex and age
using summary statistics, t-tests and chi square tests. Results: Our key findings were: (1) the course was well received, with 97% of participants satisfied, with an appropriate pitch
and low burden (a mean of 2.2 hours engagement per week); (2) people living with MS were less likely than those not living
with MS to complete the course; (3) caregivers and participants without a university education were more likely to apply the
material by course completion. Conclusions: The Understanding MS MOOC is fit for purpose; it presents information in a way that is readily understood by
course participants and is applicable in their lives.