This paper is a narrative account of the journey of a health lecturer, a science lecturer and an instructional designer in meeting the changing needs of health service delivery to post graduate nurses in New Zealand. The challenges included changing the design of the e-learning component of a 300 hour post-graduate children's health assessment course from content delivery to a student centred constructivist focus using asynchronous discussion forums. Making this change included the lecturers meeting challenges in relation to coordinating the delivery of "hard" knowledge with "soft" knowledge. This was an evolutionary process which required a paradigm shift in the lecturers' concept of teaching and learning