Are Medical Lectures Harmful to the Process of Learning?

J. Willis Hurst, MD

Disclosures

December 11, 2001

In This Article

Is Lecturing Teaching?

I have been invited often to "give a talk" or "give a lecture" at a medical school or a hospital. I usually respond that I would enjoy the visit very much and add, "I would rather teach on ward rounds or in a small conference than lecture if that can be arranged." This statement reflects my belief that lecturing, as commonly done, is not teaching. Rather, it is an easy method of dispensing information to a large group of people. This of course is important, but it does not accomplish the 3 steps involved in the learning process. These steps are: remembering information; thinking, which is the rearrangement of information; and learning, which is the use of information in a thought process until the person is fluent. A true teacher works with individuals and assists them in their efforts to learn how to learn. Obviously, more often than not, a lecturer does little more than present step 1 -- the information step -- to the members of an audience. If that is all a trainee or practitioner is exposed to, his or her brain will swell with information that is never used in a personal thought process. So the information, which sounded so wonderful when it was heard, is gradually forgotten.

Some lecturers do not understand the limitation of the brain of a listener. Lecturers may show 60 complex slides during the 60 minutes they talk. Each slide may be filled with information, but it is moved rapidly to make room for the next slide so there is inadequate time for the members of the audience to read the small print, much less make a note about it. Most brains are not designed to register and store all of the information that is presented in such a manner. Some lecturers intersperse slides of mountains, flowers, or nudes, hoping to capture the attention of the audience. This act, of course, has the opposite effect in that it interferes with the train of thought needed for the listeners to follow the medical message the lecturer is trying to convey. This act marks the speaker as one who does not understand how the mind works.

The self-operated computer was designed to save the day. However, thus far, my own statistics indicate that at least half of the lectures are delayed 5-15 minutes while the speaker and several others fiddle with gadgets hoping to make them work. Accordingly, they lose the interest of the restless audience. Then, not only do some lecturers show too many slides, but they continue to use dark blue print on a black background, place too many lines on a slide, and fail to appreciate that the fancier and more expensive the slide, the less it teaches. Now we have modernized the detractors of the past.

Successful lecturers try to do 2 things: present concepts with interesting examples and metaphors rather than spewing out hundreds of facts, and reveal to the listeners their intense interest in the subject. If the lecturer does not seem to be excited by the subject, it is unlikely that members of the audience will be. On the other hand, when the lecture is given with the apparent enjoyment of the speaker, a few members of the audience might consider the possibility that the subject being discussed could be of some importance. A few in the audience might be encouraged to pursue the matter further after they part company with the lecturer.

True teaching does not take place unless there is a feedback system that permits the lecturer to determine whether the following has taken place: his or her message was received by the listener; the content of the message was used by the listener; and an acceptable degree of understanding of the subject was attained by the listener. In other words, the educational value of a lecture can only be judged by the actions of the listener after he or she leaves the lecture room.

Despite a few exceptions, lecturing, as it is usually done, cannot be referred to as true teaching. The act of lecturing is usually the simple announcement of so-called facts, rather than true teaching.

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