Is Skipping Med School Lectures Making Inferior Doctors?

Emily Kahoud

Disclosures

November 14, 2018

Education is a privilege many cannot afford. Given its increasing cost, the tendency for students of any discipline to skip the very classes they amass debt to attend is surprising. However, given the far heftier price tag of medical education, the tendency for medical students in particular to avoid the lectures designed to help them become quality doctors is inexplicable to some and alarming to others.

Medical school courses are taught by the experts in our field: researchers developing novelty drugs to target a new pathway, or physician-scientists who may be the first to discover a new treatment for a previously untreatable disease. They have illustrious careers to share with us, if we take the time to listen. However, medical students are increasingly not attending these lectures, never meeting those who have come prepared to share a lifetime's worth of wisdom with the amateurs who sit before them.

How does any of this make sense, given the vast amounts of money students are investing in their education, which overwhelmingly consists of the very lectures they no longer attend? More important, what does a classroom with empty seats mean for future doctors?

Skipping and Acing Classes

Recent research forces academic introspection: Undergraduate students who skip class tend to see a corresponding dip in their grades. Except, a recent study by a research team at the University of Central Florida College of Medicine, led by assistant professor of pediatrics Christine A. Kauffman, MD, found that lecture attendance during medical school is not as predictive of good grades as we'd like to think, given how much we pay for this seemingly invaluable resource.

Kauffman described the setting in which their research was conducted. "This is a second-year course—it's a preclinical course." The evaluation of students' performance consisted of a "single multiple-choice question exam based on medical knowledge." Of note, Kauffman explains, "The lecture-based materials, all of the materials, were available to the students online," Kauffman explained. "So whether or not they attended the in-person session, they had the materials available to them."

Kauffman's team also distributed the Motivated Strategies for Learning Questionnaire to these same students, which looks at multiple subscales of motivation and learning styles, and they compared this with the students' performance. Out of the 15 subscales examined, they were only able to connect one to performance: self-efficacy. "Those who were more confident seemed to perform better than those who were less confident."

Of note, "self-efficacy was negatively correlated with attendance," Kauffman explained. Basically, those who were more confident were less likely to attend classes. The opposite was also true, as Kauffman described, "Those who scored highly in peer-learning and help-seeking behaviors were students who were more likely to attend. Our assumption from that is that the social aspects of the learning environment were important to those students, and that's the reason they chose to attend."

This is a crucial point often underrepresented in many discussions about how lectures are "obsolete." Most medical students do not dispense with lecture altogether. This isn't about ignoring the information; it's about changing how the information is received and consumed.

The evolution of medical education is a restructuring and rebalancing. Some students feel more productive speeding through lectures at 1.5 times or twice their normal speed on video. This gives them the luxury to be creative with the rest of their day. They can watch videos on YouTube that complement their understanding and fill in gaps where multiple angles of attack may be useful. Other students dig through the overwhelmingly vast array of other options for review and practice. From First Aid to UWorld, Kaplan, Boards and Beyond, Lecturio, Board Vitals, and many more, the list seems endless compared with the amount of time allotted for this glut of resources.

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