COMMENTARY

Should Medical Schools Eliminate Lectures?

Arthur L. Caplan, PhD

Disclosures

November 15, 2017

Hi. I'm Art Caplan. I'm at the Division of Medical Ethics at the NYU School of Medicine.

Something interesting is going on in medical school classrooms at the medical school of the University of Vermont. The kind of learning that I'm used to and the kind of teaching that I do aren't taking place there.

It's not that the students are being given nothing to do, but the school has decided to, once and for all, move away from lectures. They're not having people up at the podium pontificating, showing slides, and telling students information. Instead, they're shifting to active learning.

What that means is that instead of just being lectured about something, the students are going to get problems to solve in a way they're expected to absorb what they normally would learn in a lecture before they get to class. Then they're going to work in small groups to solve problems.

Let's say that it's the pharmacokinetics of a drug. They're going to be asked, Given this weight of a patient, and given this amount of drug that you want to get into the bloodstream, and given its pharmacokinetic properties, how would you administer that dose? What would you do if it wasn't being achieved? How would you compensate for that? Work together in a group and try to apply the formulas and the information that, normally, you would just hear in a lecture.

I think that this is a great idea. Why? Not so much because lectures are boring, or people sleep through them, or they just don't show up for them. It turns out that we know from research that active learning lets you retain more information. You do better learning when you're asked to apply information than when you're just lectured to.

I think the University of Vermont is showing us the way forward in terms of medical training, and probably training for nurses and physical therapists and a lot of other people in healthcare and beyond. I think we're going to be getting away from the lecture format and moving to the active learning format.

That makes sense, because the science tells us that's the right way to teach. We may not be familiar with it; we may not be comfortable doing it; and it may require some of the professors to, if you will, become old dogs learning new tricks. But I think if we're committed to science and to the importance of evidence, then moving in this direction has to be the way to go.

I apologize for lecturing to you on this topic. I'm not giving you an active problem to figure out. In the future, maybe we'll replace my opinions with exercises and challenges with some type of puzzle-solving, and, in fact, we will learn more effectively and more efficiently.

Until that day arrives, I'm Art Caplan at the Division of Medical Ethics at the NYU School of Medicine. Thanks for watching.

Talking Points

Issues to Consider: Should Medical Schools Eliminate Lectures?

  • Some healthcare professionals are concerned that eliminating lectures could jeopardize medical schools' regional and professional accreditation statuses, discourage prospective students, and alienate alumni donors and faculty members.

  • The transition from lectures to active learning may be costly for medical schools, because they will have to retrain professors, attend conferences and workshops, and renovate classrooms.

  • Since the 2012-2013 academic year, when Touro College of Osteopathic Medicine in New York began offering a shortened-lecture curriculum with more active learning, the pass rate on an important licensing exam has climbed to above 95%—higher than the national average.[1]

  • It is said that millennials have the traits of being confident (goal-oriented and motivated), team-oriented, technology-savvy, and pressured to succeed, which should favor the use of active learning methods over passive methods.[2]

  • Although there is evidence that exam scores improve and failure rates decline with active learning compared with traditional lecturing, many faculty still prefer lecture-based teaching.[2]

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