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MEDICAL EDUCATION
Year : 2022  |  Volume : 20  |  Issue : 4  |  Page : 259-261

Lecture at crossroads in medical education: Is it time to say goodbye or introduce specific strategies to enhance their effectiveness?


1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission13-May-2022
Date of Decision22-May-2022
Date of Acceptance27-May-2022
Date of Web Publication17-Oct-2022

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_50_22

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  Abstract 


Over the past couple of decades, medical education has transformed extensively and a number of curricular reforms have been introduced. Lectures have been regarded as one of the teaching–learning methods, which have been with us for decades together, and have been adopted as one of the key strategies by the teachers to pass knowledge to students. In general, an effective lecture should aim to attain three goals, namely to impart useful information, introduce some kind of curiosity among students so that they decide about learning on their own, and provide practical relevance. Even though the lecture is being widely used, owing to their inherent limitations, their use as a solitary method of teaching–learning has been discouraged by the educators and regulatory bodies. To conclude, the lecture method in medical education has its own pros and cons. However, considering the advantages attributed to lectures and the presence of strategies that can be incorporated to eliminate the pitfalls in lectures, at present, lecture methods can be still continued for medical education delivery. Nevertheless, we have to make the lecture sessions interactive and ensure that students indulge in active learning, and this essentially calls for faculty development programs.

Keywords: Large group teaching, lecture, medical education


How to cite this article:
Shrivastava SR, Shrivastava PS. Lecture at crossroads in medical education: Is it time to say goodbye or introduce specific strategies to enhance their effectiveness?. Curr Med Issues 2022;20:259-61

How to cite this URL:
Shrivastava SR, Shrivastava PS. Lecture at crossroads in medical education: Is it time to say goodbye or introduce specific strategies to enhance their effectiveness?. Curr Med Issues [serial online] 2022 [cited 2022 Dec 1];20:259-61. Available from: https://www.cmijournal.org/text.asp?2022/20/4/259/358643




  Introduction Top


Over the past couple of decades, medical education has transformed extensively and a number of curricular reforms have been introduced to ensure effective delivery of the information to medical students.[1] We must realize that the most effective strategy to enhance teaching efficiency and enable the attainment of the intended learning outcomes will be through the promotion of active learning.[1],[2] Active learning ensures that students engage themselves in the learning process as they not only engage with the learning resource materials but are also actively involved in the classroom discussions, and encourage team learning by collaborating with other peers.[2],[3] At the same time, there is better interaction between the teachers and students, and the learning process is further facilitated by the frequent delivery of feedback to the students about their performance.[2],[3]


  Large Group Teaching Top


Most medical schools across the world tend to enroll 50–250 students in each academic year for their undergraduate training. In nations like India, many medical schools have been permitted to enroll 200–250 students, which is definitely a challenge for medical teachers, especially if we are aiming for active learning.[3] Lectures have been regarded as one of the teaching–learning methods, which have been with us for decades together, and have been adopted as one of the key strategies by the teachers to pass knowledge to students. It will not be wrong to state that in many settings, large group teaching has been equated with lectures in multiple settings and is regularly used by medical teachers as their primary teaching method.[4]


  Lectures in Medical Education Top


A lecture in medical education refers to the systematic presentation of facts and information from a qualified teacher. As already mentioned, lectures have been most commonly adopted by the medical teachers, and this is predominantly because of the existing traditions (viz., as students, the teachers of today were taught by their teachers using only lecture method), and convenience (as teachers can simultaneously pass information to the complete cohort of students in one go).[4],[5] In general, an effective lecture should aim to attain three goals, namely to impart useful information, introduce some kind of curiosity among students so that they decide about learning on their own, and provide practical relevance (viz., establish a connection between the knowledge given and how it will help medical students to improve their patient care practices).[5],[6]


  Strengths of a Lecture Top


The lecture is a strategy that can be employed to introduce a new topic in any subject and thereby stimulate and encourage students to move forward in their journey of attainment of learning objectives.[3],[5] In addition, as teachers while preparing their content can refer to a multitude of resources, they can provide richness and depth of knowledge to the students and thus become useful for students.[4] As all batch students are taught about the topic together, there is no variation in terms of the content and removes the possibility of variation in the stimulus.[5] Moreover, as medical teachers have to discharge a wide range of roles (viz., researcher, clinician, assessor, and administrator), other than teaching, the employment of the lecture method saves a lot of time (person-hours), when compared with small-group teaching.[6] Further, as teachers are physically present in the session, they can change the pace of their teaching based on responses from students and also emphasize important points and common mistakes/confusions.[4],[6]


  Potential Limitations of a Lecture Top


Even though the lecture is being widely used, owing to their inherent limitations, their use as a solitary method of teaching–learning has been discouraged by the educators and regulatory bodies.[3] The recently released medical education regulations in India have put a cap on didactic lectures, and it has been specified that none of the subjects should have more than one-third of the time allocated to lecture in their entire schedule.[7] The rest of the available time should be utilized with the help of small-group teaching methods (such as problem-based learning, case-based learning, team-based learning, practical, and demonstration) that promote active learning and better student engagement.[7] We must understand that the effectiveness of a lecture will essentially depend on the lecture skills of the teacher and thus teachers should be trained in the skills of lecturing.

The major limitations of the lecture include the passive nature of the students, and thus the overall passage becomes one-way, wherein students have limited opportunity to engage and thus learn.[8] In addition, as students do not receive any feedback about their performance (unlike any other SGT methods), they fail to identify their learning gaps.[3],[5] Further, as the attention, span of any student is not more than 15–20 min, if the teachers fail to break the monotony, the lecture becomes ineffective. Moreover, lecture, do not appeal to all types of learners, and thus the needs of all of them are never met, and we cannot forget that these lectures only addresses the cognitive domain.[3],[8] In fact, we have to resort to other teaching–learning methods (viz., practical, demonstration-observe-assist-perform, simulation, and bedside teaching) to ensure training of psychomotor and affective domains. Furthermore, the possibility of passage of a large amount of information to the students cannot be ruled out, which further makes it difficult for the students to comprehend.[5]


  Strategies to Enhance the Effectiveness of the Lecture Top


Considering the merits of a lecture and the attributes which a lecture adds to the medical curriculum delivery, it is essential that lectures should continue as one of the teaching–learning methods.[8] However, this does not mean that we can ignore the potential limitations of lectures and just continue because it is more convenient or that we are used to them.[3] The first and foremost step will be to train medical teachers in different lecturing skills (viz., lesson planning, set induction, presentation, questioning, reinforcement, stimulus variation, use of audiovisual aids, nonverbal cues, and closure).[1],[9] This can be accomplished by roping in the medical education unit of the institution, which carries out a series of faculty development programs for the benefit of all teachers in a phase-wise manner and also through microteaching sessions.

These planned training sessions can aim to train students not only in lecturing skills but also expose them to a wide range of interactive teaching–learning methods (such as think-pair-share, buzz, and brainstorming) that can be incorporated to make the overall session interactive and effective.[1] The teachers should not only obtain feedback from the students about their class but also adopt specific strategies (such as a 1-min paper [to identify the learning points], muddiest points [to identify the concept that students have not understood], feedback from colleagues, questions asked by students, overall attendance, and participation of students in the class) to evaluate the effectiveness of their sessions. Furthermore, some additional methods can be added to the lecture to enhance the overall impact of the lecture sessions.[9] In addition, as educators, we should promote research activities by carrying out comparative studies to assess the effectiveness of lecture sessions with other methodologies.[10]


  Conclusion Top


The lecture method in medical education has its own pros and cons. However, considering the advantages attributed to lectures and the presence of strategies that can be incorporated to eliminate the pitfalls in lectures, at present, lecture methods can be still continued for medical education delivery. Nevertheless, we have to make the lecture sessions interactive and ensure that students indulge in active learning, and this essentially calls for faculty development programs.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, et al. Active learning increases student performance in science, engineering, and mathematics. Proc Natl Acad Sci U S A 2014;111:8410-5.  Back to cited text no. 1
    
2.
Mehta NB, Hull AL, Young JB, Stoller JK. Just imagine: New paradigms for medical education. Acad Med 2013;88:1418-23.  Back to cited text no. 2
    
3.
Prober CG, Heath C. Lecture halls without lectures – A proposal for medical education. N Engl J Med 2012;366:1657-9.  Back to cited text no. 3
    
4.
Smolle J, Rössler A, Rehatschek H, Hye F, Vogl S. Lecture recording, microlearning, video conferences and LT-platform – Medical education during COVID-19 crisis at the Medical University of Graz. GMS J Med Educ 2021;38:Doc11.  Back to cited text no. 4
    
5.
Asghar S, Rahman S, Shaikh S, Aslam S, Karania T. Medical students' perspective on 'effects of seminar teaching method versus lecture-based learning in medical education: A meta-analysis of randomized controlled trials'. Med Teach 2021;43:1100-1.  Back to cited text no. 5
    
6.
Roman B, Hayden C, Parmelee D. Medical education should say goodbye to lectures. Acad Med 2021;96:1499-500.  Back to cited text no. 6
    
7.
Medical Council of India. Graduate Medical Education Regulations – 2019. New Delhi: MCI Press; 2019. p. 65-70.  Back to cited text no. 7
    
8.
Siracusa F, Boichuk A. Medical education fit for the 21st century: A response to “the lecture-free curriculum: Setting the stage for life-long learning”. Med Teach 2021;43:606.  Back to cited text no. 8
    
9.
Jia X, Zeng W, Zhang Q. Combined administration of problem- and lecture-based learning teaching models in medical education in China: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018;97:e11366.  Back to cited text no. 9
    
10.
Sajid M, Shaikh AA, Ikram MF, Cahusac P, Yaqinuddin A, AlKattan W, et al. Comparative analysis of effectiveness between flipped classroom and lecture-based classroom in undergraduate medical education at Alfaisal University. Cureus 2020;12:e11408.  Back to cited text no. 10
    




 

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  In this article
Abstract
Introduction
Large Group Teaching
Lectures in Medi...
Strengths of a L...
Potential Limita...
Strategies to En...
Conclusion
References

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