Lectures may be not necessary

Horton, D.M., Wiederman, S.D., & Saint, D.A. (2012). Assessment outcome is weakly correlated with lecture attendance: influence of learning style and use of alternative materials. Adv Physiol Educ. 36(2): 108-15. doi: 10.1152/advan.00111.2011.

 PodiumCreative Commons License Karin Dalziel via Compfight

Is this the case, lectures aren’t necessary? Or are they just done badly? Are they so awful that a student can do better out of a book? What are you trying to do in your lecture, hit on every little nuance and implication?

Is it wrong for a medical professor to subsume material? Do you feel an obligation to teach not just the fence post, but how it was dug in, the nature of the concrete, the cross bars, the preserving stain, the …. Am I making any sort of point here? Do you really feel the preserving stain will be the same after this person finishes residency?

Deep Freeze Evan Leeson via Compfight

To play devil’s advocate, consider the typical classroom situation. In some colleges of medicine, we have students year one that are pharmacists, physiotherapists, MBA’s, and believe it or not, theater arts students. What a diverse, colourful, uneven knowledge base! Imagine a first year course on anatomy. In a typical, classical scenario, the professor stands up there and drones, reviewing the muscle origin and insertion points, the courses of arteries and nerves. Or, one would stand beside the cadaver, and demonstrate the landmarks. The physios would ace it, the pharmacists would have to really stretch, the MBA’s would turn green, and the theater arts students would… I don’t know, “act nonplussed”. What is the better learning situation? What is the best use of time, from the perspective of the instructor, and the student?

    Now, I’m not at all suggesting subsuming the dissection. But does the physiotherapist, who has already done many of the lectures, have to sit through them again? Why not go straight to the dissection, after a cursory review? Online teaching has the ability to let the student go at their own pace. Truly individualized learning. The Plato / Accucess computer system looks very advanced for K-12 students, used in some boards in the US, truly able to help the teacher mediate the individual student. Here we have an impersonal computer program being able to truly individualize training for a student. Things the student already knows, or is good at, is subsumed. My goodness, I wish I had some sort of software like that for reading myself! What a time saver!

    Medicine isn’t there yet. Maybe will never be there, in my lifetime. Online teaching should be at least considered. I suggest the best experience would be a composite, much as Draves (2013) suggests. Two ideal streams would compliment each other, an online learning of material, and small group discussion (F2F!) for that emotional linkup, for problem solving, and collaborative work. It would be wonderful if we could someday use technology to assess what the student knows to focus learning efforts.

Until then we need to do something. Formative testing can help us understand where the students are. We need to do this, and then to ask ourselves, as clinicians, what the fence posts are, and where to put them. Some of our students will already know them, yes. But will they know them as a clinician knows them? We owe it to our students to use our clinical experience to choose the really essential, gritty knowledge base that they must know. If you’re standing in front of the class, teach them a skeleton upon which they can hang other information. Don’t ask them to go home and pick what they guess is most important to learn.

Knowledge gaps can actually assist learning. They force students to reach beyond the current class and subject material, to dig deep, to go home and read, and actively learn. Let them put up the fence rails.

Remember, we have brilliant students, right?




Draves, W. A. (2013). Advanced teaching online. River Falls, Wi.: LERN Books.