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Med schools focus on active learning but not ready to kill the lecture

Remember the lecture class? A big hall, either too hot or too cold, crammed full of students listening to a droning professor and maybe falling asleep? It’s been one of the hallmarks of post-high school education.

Lecture classes used to be particularly prominent in medical school, where students would attend hours-long lectures.

But teaching methods have changed, and at medical schools, especially, lectures are starting to go the way of the dodo. This year, the University of Vermont’s Larner College of Medicine will begin to phase out lecture classes, drawing national headlines in the process.

In Maryland, Johns Hopkins University’s School of Medicine changed its curriculum in 2009, with the goal of reducing lecture time and adding more focus on active learning. And for students, all lectures are optional.

But the lecture will not be disappearing from the Hopkins classroom anytime soon.

“Lectures have gotten a bad rap because there are so many bad lecturers out there,” said Dr. Henry Fessler, assistant dean for undergraduate medical education at Johns Hopkins. “But they’re here to stay.”

The University of Maryland’s School of Medicine also takes a holistic approach, combining lectures and discussion groups.

“Too much lecturing is a bad thing,” said Dr. David Mallott, associate dean of the school of medicine. “I think everybody has a limit to how much they can shift through … On the other hand, I think it’s a fallacy to say we should get rid of all lectures. Nobody’s shown that that’s a good idea either.”

Lectures can be the best way to transfer facts and data to students, said Fessler, who also serves as director of the fellowship training program in pulmonary and critical care. In many cases, the lecture class can come down to the lecturer.

“A great lecturer can really be inspirational, if they’re done right,” Fessler said.

At the University of Vermont, students will study material before they go to class and then participate in discussion groups, led by professors.

But Fessler did not want to discount the lecture and the different ways students learn.

“A minority of the class attends lectures in person,” he said. “But the ones that do, they are there because they like that. They like the opportunity to ask questions and hear things in person.”

Johns Hopkins also makes its lectures available online, allowing students to go through at their own pace. Students can pause to take notes, grab some water or just take a break.

Active learning has become an important part of education. Studies show that students retain more information and engage more in the material when they can be hands-on and participate in small-group discussions.

Fessler, 61, went into teaching in part to move away from the lectures that dominated his medical school experience.

“I really didn’t like my own medical school,” he said. “When people of my generation went through medical school, it was all lectures all the time. It was very little critical thinking or analysis.”

Active learning has another benefit: It mimics the professional atmosphere students will experience as a doctor. They work in small teams, collaboratively.

Medical schools have also adopted earlier patient contact, more patient contact and simulated experiences.

Still, the lecture will remain. In part, the lecture also becomes a part of a doctor’s career. Experienced physicians deliver lectures to interns and residents. Scientists deliver lectures on their findings.

At Hopkins, Fessler delivers a lecture on how to lecture, a task he described as somewhat “haughty.”

“One way to reduce the number of bad lecturers in the future is to teach students how to be good lecturers now,” he said.

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