The objective of this study was to evaluate the effectiveness of e-learning as a supplement to on-campus education for the acquisition of skills in palpation and ultrasound examination of the knee in a physiotherapy degree course. Forty-six students (28 females) from the University of Granada, with a mean age of 21.5 yrs, received 4 h of theoretical and practical on-campus training on palpation and ultrasound examination of the knee joint. They were then randomly distributed into two groups: experimental, with free access to the ECOFISIO website on musculoskeletal palpation and ultrasound assessment; and control, with access to documents and books on the topic. Structured objective clinical evaluation (SOCE) and multiple-choice questionnaire (MCQ) were used to assess the educational intervention. We also measured the time taken by the students to generate a reliable ultrasound image and to localize a specific knee structure by palpation. There was no significant intergroup difference in the acquisition of theoretical knowledge as assessed by the MCQ (p = 0.39). Scores were significantly higher in the experimental group than in the control group for skills in palpation ability (p = 0.041) and ultrasound assessment (p < 0.001) of the knee. Students in the e-learning group needed less time to palpate the musculoskeletal structure (p = 0.041) but more time (p = 0.012) to obtain their superior ultrasound images. In conclusion, these results contribute evidence that e-learning is an effective educational strategy for physiotherapy students to acquire skills in palpation and ultrasound imaging of the knee as a supplement to on-campus education. (C) 2012 Elsevier Ltd. All rights reserved.