The methods for authoring and distributing course content are undergoing substantial changes due to advancement in computer technology. Paper has been the traditional method to author and distribute course content. Paper enables students to personalize content through highlighting and note taking but does not enable the incorporation of multimedia elements. Computers enable multimedia content but lack the capability of the user to personalize the content. Therefore, we investigated TK3 eBooks as a potential solution to incorporate the benefits of both paper and computer technology. The objective of our study was to assess the utility of TK3 eBooks in the context of authoring and distributing dermatology course content for use by second-year medical students at the University of Utah School of Medicine during the spring of 2004. We incorporated all dermatology course content into TK3 eBook format. TK3 eBooks enable students to personalize information through tools such as "notebook," "hiliter," "stickies," mark pages, and keyword search. Students were given the course content in both paper and eBook formats. At the conclusion of the dermatology course, students completed a questionnaire designed to evaluate the effectiveness of the eBooks compared with paper. Students perceived eBooks as an effective way to distribute course content and as a study tool. However, students preferred paper over eBooks to take notes during lecture. In conclusion, the present study demonstrated that eBooks provide a convenient method for authoring, distributing, and using course content but that students preferred paper to take notes during lecture.