6 things to make your medical school lectures better

So, I realize that many schools are trying to minimize lecture hours, but the truth is that this modality will not likely ever go away completely.  As such, I've made a draft of some guidelines for lecturers in the course I co-direct based on common mistakes I've seen.  Implicit in these guidelines is the idea that I have a lot of rotating lecturers, and some of these issues can be avoided by decreasing volume of presenters.  However, we're stuck in a cycle where I can't really easily change that in the next year.  Please share in the comments if you have other things I haven't addressed.

*Note - NSB stands for neuroscience and behavior -a 9 week introductory course on neuroanatomy, neurophysiology with and some clinical neurology, psychiatry, and neurosurgery.

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NSB lecturer guide:

Please adhere to the following guidelines when giving lectures for NSB.  These are general trends which I have noticed over the last few years in terms of best practices and things to avoid if possible.  In general, please remember that these are students who have spent the last year and a half going to lots of lectures.  Things which seem trivial to you as you only do one or two lectures, for them are agonizing as they see these issues over and over again for two years.

1)            Do look over the slides of lecturers who are talking about related topics to your lecturer.

- Helps a lot with keeping continuity through the course.  It would be nice to not have you say, “I’m not sure if you have been over this before or not.”  If you are not sure, please look it up or ask.

2)            Don’t ever say, “This will not be on the test.” 

- Sometimes it is a minor point in your lecture, but it is a major point in a prior lecture (again why it helps to talk to others) or a later lecture (maybe even in the next block).  OK to say, “This is a minor point for the purposes of this lecture,” or “For this lecture, this is primarily FYI.”  We tell the students that everything mentioned in class is potentially testable.  If you don’t want us to potentially test it, don’t mention it at all.  If you must say this, talk to the course director to be sure it REALLY will not be on the test.

3)            Try to stay away from disclosure slide jokes.

- The first person who puts up the “I am actively looking for people to give me money so I can disclose it” slide is funny.  The next five are not so much.

4)            Please know how much time your lecture is scheduled for, and try to stick to that.

- Our general lecture block time is 50 minutes.  In general, we plan our lectures to end 10 minutes prior to the next lecture.  So if your lecture is at 10, you should plan to be done by 10:50.  If you bleed over, this makes everyone behind you have to modify their talks.  If you have a lot of slides left, and are running short on time, consider stopping where you are at, and recording the end of the lecture to be posted online.

- If you are the last lecturer of the day, it is OK to keep going (within reason).  However, please announce that it is OK for students who need to leave to be able to get up and go.  Some students have tight commute times to get to community preceptor sites by 1 PM or have to walk across campus to do OSCE testing over the noon hour.  Also keep in mind that there are noon talks which occur periodically in the lecture hall.

5)            If you are not skilled at PP or basic functions of the audio/visual equipment, please learn minimum functions.

- For PP, you should be able to start and stop your presentation, restart  from the middle of a presentation, go backwards and forwards using only keyboard, understand what the purpose of a right click is, start and stop video presentations, be able to disengage auto-advancing of slides.

- For A/V, you should be able to turn on and off overhead projector, mute/ unmute the screen, turn on/off the mic,  Turn mic up/ down using front panel controls.

- If you are uncomfortable with this, talk to TSO, and they can help you learn how to do these things.

6)            Do feel free to experiment with audience participation techniques.

- Using clickers for in-lecture quizzing, use of pause for students to work through a problem together, and other techniques are great ways to get students involved in the lecture.

Are laptops/ tablets connected to WiFi forces for good or evil in lecutre hall?

This post is in response to several things I've read and heard lately about the use of devices to connect to the internet in medical school large group teaching sessions.  Essentially these posts or comments have been either strongly in favor of the introduction of these technologies, or strongly against.  I haven't found much of a middle ground.

Those against argue from the idea of distraction.  The argument is laid out in several recent research studies looking at the effects of multitasking on cognitive performance.  The basic idea is summarized pretty well here, in an article from the San Fransisco Chronicle.  This is the view held by many basic science course directors who make comments to the effect of, 'if they have their laptops out, they are likely playing solitaire.'  I've also seen some people speaking about generational differences in learning styles who state that the Millenial generation has grown up with multiple electronic devices going.  This falls back on the data that they feel like they have done this for a long time, and should be good at it, but they are not really.  As they don't have any insight into this potential hazard, we as course directors should act to squash this tendency by telling everyone to turn off their electronic devices.  Hence, the common wisdom among these presentations is that it is important to have the learners switch off their devices on entering the classroom for their own good.

On the other hand, there are many potential up sides to having a wired classroom.  First, audience response systems using web-based or local networks are becoming more sophisticated and more robust.  This is much more than the audience clicker system where the audience can push a button to answer usually a multiple choice question (A,B, C, or D).  But there are systems like Twitter that can allow 'back-hallway' discussions or ability to ask questions which can be answered by the presenter in real time.  Newer platforms can collate rich text entries and also collect images.  Many of these allow ability to catch if the audience is out of step more efficiently by than the traditional method of waiting for someone to raise their hand.  Secondly, there is also the ability for the individual learner to go down a 'rabbit hole' right away to pursue a question they may have had.  For example, I interjected a clinical example of hemiballism after a lecturer was talking about subthalamic nucleus anatomy.  I had not shown a video, as I just stood up and extemporaneously gave the discussion.  As soon as I was done talking, a student in front of me had called up a video of hemiballism with a video demonstrating it.  And these are just a few brief examples of the good that can come from online activity during a lecture.

The last point I'd like to bring up, is that this will likely not be a point of discussion soon.  Our med school is considering going to a paperless system where all notes are distributed electronically. Our med school is likely a bit behind the curve on this.  My point is the same devices that allow you to read PP slides, and take notes on them also play Angry Birds.  There's not currently a good way to facilitate one task while blocking the other.  My point is that the ability for a lecturer to demand that everyone turn off their devices.  Thus, this may be analagous to a record company trying in the late Nineties to divert attention from digital devices playing their music and focusing only on
CD's.  Who's bought a CD recently?

So, where do we go from here?  As I look over the neuroscience course this morning, most electronic devices (except mine) are showing slides on epilepsy treatment (which is the lecture we're having today).  So most people are using the technology wisely.  However, with email only a click away, the temptation is strong for attention to wander?  What are your thoughts?