In a 2007 study, librarians at the University of South Carolina School of Medicine Library examined freely available online tutorials on academic medical library Web sites. The team identified tutorial topics, determined common design features, and assessed elements of active learning in library-created tutorials; the team also generated a list of third-party tutorials to which medical libraries link. This article updates the earlier study, describing changes and trends in tutorial content and design on medical libraries' Web sites; the project team plans to continue to track trends in tutorial development by repeating this study annually.