Summary: 1. Do lectures work in medical education?
2. What key features should effective lectures include?
3. For which levels of learners do lectures work best?
4. What is the best use of lectures in medical education?
Description: At AMEE 2014, I was honoured to chair the session “Teaching and Learning – The Lecture.” The session included 5 studies exploring variations of lecture, with the aim of promoting active learning. Anju Relan from UCLA presented “Repurposing lectures towards active learning: A successful model in a medical school.” The flipped classroom model was used in the teaching. Anna Hofsten from Sweden presented “Alternating large group seminars using the white board with small group discussions helps students be active and reflective.” A cohort of 68 students was assigned into small groups during the lectures. Matthew Wix from UK presented “Can mobile technology replace lectures before student simulation?” Traditionally lectures are used before simulation sessions. Whether lectures can be presented through mobile technology was discussed. Shegufta Mohammad from Bangladesh presented “Situation analysis of large group teaching sessions in the medical colleges of Dhaka city.” She stated that lecture is still the dominant teaching format in Bangladesh, and her study identified issues in lectures. Julie Struthers from UK presented “Lecture video capture: Student friend or staff foe.” Lectures were captured through echo 360, and were perceived effective by students as well as staff.

Lectures have been widely used in medical education as long as medical schools have existed. Various instructional approaches have been invented and studied to make lectures more interesting, for example, team-based learning. Advances in technology such as audience-response system have had a great impact on medical education. Before the innovations and inventions dazzled our eyes, there are a few key issues which deserve our attention.

1. Do lectures work? In June 2014, PNAS published a systematic review of over 260 studies on impacts of lectures. The answer will put those who have doubts about lectures to peace. Yes, lectures work. Just like anything, to make lectures work, it has to meet certain requirements, which leads to my 2nd point.

2. What key features should effective lectures include? It still happens too often that instructors – the content experts go to teach based on how they were taught or intuition. Actually most of our intuition on teaching has been shaped by our experience. Advances in teaching and learning have a great impact on educational practice. Teaching and learning is science-based and evidence-based. Personal experiences are anecdotes, or at most can be counted as case studies if documented through proper scientific approaches. On the other hand, Today’s medical school most has a large cohort of student. How to teach a lecture to 300 students deem attention, discussion and careful preparation. It is laughable to insist “I know how to teach. I don’t have to learn how to do it.” Going back to features of effective lectures, there are stacks of textbooks on this issue. As John Saunders pointed at the eLearning symposium, “there are different philosophies in teaching and learning. The key is to find the ones that work best for you and your students, and to personalize them. ” Instructors should take professional development workshops, attend conferences such as AMEE, or read relevant and up-to-date research.

3. For which levels of learners do lectures work best? For medical education, lectures work for both pre-clinical and clinical teaching. Lectures are still widely used for residency or even continuing medical education. Other factors such as learning objectives and the content area also affect whether lecture is the best format to go.

4. What is the best use of lectures in medical education? With the flipped classroom movement, lectures are no longer the single one best format of information presentation. To merely present information, online videos can definitely replace lectures. The greatest part about the flipped classroom is: Information sharing should be done before lecture, while lecture time should be used for clarification, discussion, and reflection.

Although lectures have been the dominant format in teaching historically, with innovations in instructional approaches and technology integration, instructors should:
1. Be prepared that a good lecture requires time and commitment. For example, Anju Relan from UCLA prepared 3 versions of PPT for their lecture.
2. Be willing to embrace changes. Changes in attitude and perception are the most important and challenging aspect in successful technology integration as research in education technology demonstrated.
3. Be armed with a toolkit of different instructional approaches as well as educational technology.