Medical Teacher
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
How To: Improve Lecturing George Brown & David Tomlinson To cite this article: George Brown & David Tomlinson (1979) How To: Improve Lecturing, Medical Teacher, 1:3, 128-135 To link to this article: http://dx.doi.org/10.3109/01421597909023826
Published online: 03 Jul 2009.
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HOW TO...
Improve Lecturing
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GEORGE BROW” and DAVID TOMLINSON George Brown, B.SC, D. PHIL, is Senior Lecturer in University Teaching Methods, University of Nottingham, and David Tomlinson, B.SC, PH.D, is Lecturer in Physiology and Pharmacology, University Hospital and Medical School, Clqton Boulevard, Nottingham. This article outlines a simple model of the way students learn from lectures and describes nine basic skills of lecturing. I t goes on to explore three lecture methodsthe classical method, the problem-centred method and the sequential method-from the point of view of their usefulness, requirements and pitfalls. Finally, it proposes five basic steps in the preparation of a lecture. Why Improve Lecturing? Lecturing is just one of many methods of teaching. However, whereas newer methods, such as games, tapeslide programmes or computer-assisted learning, are planned and evaluated systematically, lecture methods are rarely subjected to such rigorous planning and analysis. This lack of attention to the lecture accounts, in part, for its apparent relative ineffectiveness as a teaching method. It is true that lectures are not usually as effective as small-group methods for solving complex problems or changing attitudes. Nor are they as effective as laboratory classes for developing psychomotor skills. For imparting ideas and information, however, lectures are at least as good as other methods (Costin 1972; Bligh et al. 1975; McCleish 1976). It is also true that there are psychological gaps between lecturers’ intentions, what they transmit and what signals students receive from them. The proportion of points made during lectures which are written down in students’ notes may vary from 11 to 40 per cent depending upon the method used for analysing lecture notes (see Howe and Geoffrey (1977) and Hartley and Davies (1968) for reviews of student note-taking). However, lectures are at least as effective as other methods of teaching for outlining a field of knowledge, for enunciating and applying general principles and for generating understanding. Perhaps most important of all, lectures can be used for generating enthusiasm and interest in a subject (see Verner and Dickinson 1968; Rosenshine 1970). For if a student is motivated by a lecturer and provided with guidelines, then the student will become self-motivated and goaldirected. What some researchers do not point out is that lec128
turing is an economical way of teaching which has been in use for some 2,500 years. There are many methods of lecturing and many possible uses for lectures. They are likely to remain one of the essential methods of medical education. Rather than bemoaning the deficiences of lectures one should seek ways of improving their effectiveness. As Spence (1928) observed, “The decrying of the wholesale use of lectures is probably justified. The wholesale decrying of the use of lecturing is just as certainly not justified .” One way of improving the effectiveness of lectures is to introduce lecturers and students to the processes of teaching and learning that go on in lectures. Associated with these processes are various skills and methods of lecturing, strategies for improving the preparation and structure of lectures and ways of helping students learn from lectures. Interested readers are referred to Bligh (1972) and Brown (1978) for further information. Learning from Lectures Students learn from lectures by listening, observing, summarizing and note-taking. A hidden variable in their activities is understanding. Sometimes understanding is gained during the lecture, sometimes it emerges after the lecture when the students pore over the lecture notes they have taken. Figure 1 sets out a simple scheme for examining the processes of learning from lectures. It is derived from studies of human information processing (Lindsay and Norman 1972). A lecturer sends messages verbally, extra-verbally, non-verbally and through his or her use of audiovisual aids. The verbal messages may consist of definitions, descriptions, examples, explanations or comments. The ‘extra-verbal’ component is the lecturer’s vocal qualities, hesitations, stumbles, errors and use of pauses and silence. The ‘non-verbal’ component consists of his or her gestures, facial expressions and body movements. All of these types of messages may be received by the students who may sift, perhaps store and summarize, and note what they perceive as the important messages. A lecturer transmits not only information. His or her
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Figure 1. Learning f r o m lectures. Messages transmitted by the lecturer may pass directly f r o m students’ shortterm memory (STM) to their notes, or the messages may be ‘processed’ in their long-term memory (LTM) and thereby understood before they are taken down in the students’notes. (A V A =audiovisual aids)
non-verbal cues may convey meaning and attitudes which highlight, qualify or distort the essential messages. The latter may be clearly structured and meaningful or they may be confused and seemingly meaningless. The information, meaning and attitudes conveyed by the lecturer may or may not be attended to by the students. Attention fluctuates throughout a one-hour
Table 1. Some basic skills of lecturing. 1. Explaining
2. Orientation 3 . Closure 4. Liveliness
5. Using audiovisual aids 6 . Varying student activities
7. Giving directions 8 . Comparing
9. Narrating
Giving understanding, using examples and illustrations Opening a lecture, introducing a topic or theme Summarizing and linking topics and themes Generating interest and enthusiasm, gaining and holding attention The effective use of blackboards, overhead projectors, slides, models and handouts Listening, observing, note taking, brief small-group discussions, simple problem solving and even laughter Indicating how to carry out procedures or how to solve various types of problem Comparing and contrasting. Giving similarities and differences or advantages and disadvantages of various methods, approaches and perspectives Reading from an article, or a text to illustrate or exemplify a point of view
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lecture. After 20 minutes there is a marked decline in attention followed by a peak of attention just before the lecture ends (Lloyd 1968; Maddox and Hoole 1975; Johnstone and Percival 1976). This decline in attention is less likely to occur if the lecture includes some short activities for students such as brief small-group discussions or simple problem solving. Any change of activity is, in fact, likely to renew attention. Hence, some lecturers slip in occasional amusing slides, tell anecdotes or just give their students a two-minute break. Messages that are received by the students are filtered and stored temporarily in the short-term memory. They are forgotten after about 30 seconds if they cannot be rehearsed (kept in mind) or noted or if they cannot be transferred to the long-term memory. The long-term memory most readily receives messages which are closely related to the network of concepts and facts which are already stored in the long-term memory. The long-term memory will also store new messages which are only loosely associated with existing facts and ideas. Facts and concepts that are incomprehensible are most likely to be forgotten. Competing messages are also difficult to cope with. If a lecturer shows a complicated diagram and talks at the same time, should students note what they see or what is said? It is unlikely that they will have time to do both. Practical Implications
The implications of this simple model of learning are that if you want students to learn from lectures and to take good notes, you must structure your presentation so that it is meaningful and interesting and you must ensure that you gain and sustain the students’ attention. In addition the ideas and facts which you present must be capable of being assimilated readily into the students’ existing store of knowledge and skills. You might also spend some time helping students directly to improve their learning from lectures. A student’s response or ‘output’ is not only a set of intelligible notes which may be understood and, if necessary, restructured and learnt. It also consists of reactions to the lecture and lecturer. These reactions are usually non-verbal signals and may be received, interpreted and acted upon by a lecturer who is not solely occupied with reading aloud from his notes or writing on a blackboard. Perhaps more important than immediately observable responses are the longer term changes which may occur in a student. A lecture may change a student’s perceptions of a problem or theory, it may increase the student’s insight and it may stimulate him or her to read, think and discuss ideas with others.
Skills of Lecturing The processes of learning may be conveniently classified into nine overlapping clusters of component skills (Table l ) , each of which may be a target for improvement by a lecturer seeking to better his or her technique. Skills 1 and 5 are probably the most important. 129
Explaining
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Put simply, explaining is giving understanding to others. Some people explain aptly, getting to the heart of the matter. Others explain ineptly, using analogies, concepts and procedures that cannot be understood without an understanding of the very thing they are trying to explain. All of us can improve our ability to explain if we analyse what, precisely, we wish to explain. Unfortunately, we sometimes do not do this until after our first attempt at explaining. An example of a first attempt is given in Figure 2. You may like to read the transcript and try to improve upon it before reading the next sections of this article. Figure 2. Tapescript of a first attempt at explaining. Er- the - the title of my talk today is why nude mice are important to biologists.
O.K. Well, the thymus as most of you probably know is- e r - a large-er-organ -that is located in the-em-upper part of the chest. It’s referred to as a lymphoid organ because most of the cell-cellspossessed by the organ-most of the consituent cells in this- in the thymus are lymphocytes- a specific cell type. It’s importance lies in the fact that lymphoid cells processed by this by this organ- e r m - are cells which control the mechanism of graft rejection. This is important in transplantation. Erm they also have a specific role in immune responseserm -and the role here is one of control. It’s the thymocytes. the lymphoid cells rising from this organ, which determine the pattern of an immune response. Now, one way of studying the importance of such an organ is to remove it and to see what happens in its absence, so that surgical ablation or thymectomy. as it‘s known in this particular instance. has become quite a widespread procedure by (tape inaudible). What happens is the thymus is removed. This is a procedure normally combined with irradiation e r - irradiation of sufficient intensity to destroy- erm other lymphocytes present in the body since lymphocytes are particularly sensitive to irradiation, erm- the procedure doesn’t unduly affect other cell types but erm - in particular instances where irradiation has to be given of - enn a lethal quantity then the erm problem is that the- erm animal has then to be reconsitituted with marrow cells and kept on a variety of antibiotics to prevent infection since lymphocytes have such a-a-an important rolefunction in erm immune responses. An animal deprived of these lymphocytes then has to be kept artificially to ensure its survival. by the administration of antibiotics and so on. Such a mouse, anyway is known as an immunologically deprived animal and it is an extremely valuable erm it’s an extremely valuable- enn animal to the biologists because it provides a sort of tool whereby the role of other cell types can be assessed. You’ve destroyed the lymphocytes in-in this particular animal, You can then re-inject other erm - specific cell types and see how they function in when various stimuli are given to them. Organs, for insta’nce can be erm transplanted back into the animal and their role can be assessed in the absence of other interfering factors. So where does the nude mouse come into all this? Well, in 1966- erm Flanagan first described a creature “The nude mouse is a homozygous recessive condition” and I think one ought to explain here using the blackboard, -ermthe nude condition-erm-is governed by a single gene and since each gene is -is-is represented by two in each cell of the body you have three possible combinations. You have a d - a plus, plus combination (writes on board). This is known as the wild type, -
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The lecturer who gave the explanation in Figure 2 was young and inexperienced. It was his first attempt at explaining a topic to an audience of intelligent nonspecialists. He viewed the videotape of his efforts, commented negatively and set about improving his explanation. He did this by asking himself the questions:
1. What precisely do I wish to explain? (expressed in the form of a question). 2. What other questions are hidden in the question I wish to explain? It is clear that the question “Why are nude mice important to biologists?” contains within it some hidden questions such as “What are nude mice?”,“What features of nude mice make them important”, “Why?”. Having formulated these questions, the lecturer produced the explanation which is given in Figure 3. It is not perfect, but most people think that it is better than his first attempt for an audience who knewqnothing about nude mice, The structure of an explanation is probably more important than any other of its features. Hence the emphasis on this aspect in our article. Explaining
Figure 3. Tapescript of a second attempt at explaining. T h e title of my talk is why nude mice are important to biologists. The term the ‘nude mouse‘ is used to describe a strain of mouse which arose by mutation from normal laboratory mice u m . It’s a condition which is characterized by two main features. These are, first of all, absence of hair, hence the term the ‘nude mouse’, and the second feature is the absence of a thymus and it is the second property, the absence of a thymus, which is the subject of my talk. Now, the basic point is going to be summarized in this first table. So. there are two conditions possible, either the thymus is present or it is absent. Thymus present, a naturally occurring condition. leads to an ability to respond. (Perhaps I should stand on this side.) T h e absence of a thymus which either can be experimentally induced or i t can occur naturally in the nude mouse leads to inability to respond immunologically. T h e question then rephrased is why is the absence of a thymus a useful condition and the answer - um -simply is that animals without a thymus cannot respond immunologically and therefore such animals can be injected with foreign cells um and the role and the function of these cells can then be studied without the interference of immune response, T h e second table then once again summarizes this main. this-um-this statement of mine. No thymus results in no immune response, therefore there is no interference from the immune response, hence injected cells can survive and can be studied-a very useful experimental situation. Going back to the first table u m , the last point which I want to make is that the natural condition, i.e. the nude mouse. is preferable to the experimental condition um - because in order to achieve the experimental condition complex surgery is involved. This needs to be followed by prolonged drug trcatnlent and such a combination um is highly lethal to the animal resulting in mortality of um experimental groups. So. to summarize then, the nude mouse is an important um - is important to.biologists because um first of all it’s eaby to obtain relative to the experimentally induced condition and since it doesn’t have a thymus it’s a useful animal becasuc. i t doesn’t respond immunologically and it is this last condition which is in much demand in biological research. ~
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provides an opportunity for trying out opening moves, summarizing a topic and generating interest. Furthermore, lecturing may be conceived of as a set of linked explanations. If you devote some time to improving the structure of some of your explanations, then you will also improve your lecturing.
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Using Audiovisual Aids The term ‘audiovisual aids’ refers to any equipment or materials lecturers use to enhance their message. Handouts, the blackboard, overhead transparencies, models, slides, audiorecordings, videorecordings and films may all be used in this way. There is little doubt that effective use of these aids sustains attention and improves achievement amongst secondary school pupils (Turney et al. 1975). Skilful use of these aids is also likely to be effective in medical schools. Audiovisual aids may be used (as the handout or blackboard summary often are) to confirm and reinforce the main points of a lecture, or as explanatory devices in their own right. For example, an overhead transparency which shows simplified diagrams of biochemical reactions or anatomical structures may be used in this way. Short extracts of films, videorecordings or sequencies of slides, also enrich lectures. Precautions We do not propose to outline all the methods, problems and pitfalls of using audiovisual aids. Some of these have already been covered in Medical Teacher (e.g. EssexLopresti 1979). Other aids and their advantages and disadvantages will be considered in forthcoming issues. However, there are a few precautions we would like to mention : 1. Illustrations, diagrams and summaries should be simple, brief and readable from the back of the lecture class (Figure 4). If the illustrations are important, give
the students time to look at them and, if necessary, to copy them. If the illustrations are available in a book, give the title and page number. There is no need always to speak whilst members of the audience are looking at the illustrations; indeed if you want them to look intensively, tell them what to look for, then shut up! 2. Handouts should be brief and well structured. They should contain key references and, if necessary, definitions of new terms. Lengthy handouts become substitutes for lectures, not adjuncts to lectures. It is probably best to give students a few minutes to read through the handouts just before you begin lecturing. If the handout is likely to pre-empt the excitement of the lecture then distribute it afterwards. Many experienced teachers would assert that ‘skeletal’ handouts, i.e. those which require completion by students and hence their active participation, are superior to comprehensive abstracts. 3. Slides, audiorecordings, films and videotapes can be effective ways of maintaining interest and attention. But their excessive use may induce sleep. One should indicate clearly to which features of the material attention should be given. If possible, one should pose questions for the students to answer whilst they are watching the
Figure 4. Illustrations, diagrams and summaries should be simple, brief and readable f r o m the back of the class. (Based on Meyer-Hartwig et al., How to Compose Slides for Lectures, Gerhard Witzstrock, Baden-Baden, New York, 1977, p . 9.)
. . . as you can easily see here!
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audiovisual materials, give them an opportunity to discuss briefly the materials, then summarize the main points and link them to the relevant parts of the lecture. These guidelines are important. Without them a potentially valuable learning experience can be reduced to the level of home movies.
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Lecture Methods Our studies of lectures in various Faculties at Nottingham have revealed a wide variety of methods of structuring lectures. Most lectures contain segment or subtopics which usually take four to seven minutes to relate. The degree of complexity and clarity of these methods varies from lecturer to lecturer. The three most common methods are the classical, problem-centred and sequential methods.
The Classical Method Here, the lecture is divided into broad sections. Each broad section is divided into separate subsections and, perhaps, each subsection into smaller units (Figure 5). Each of the sub-sections may be what we call a key. That
Figure 5 . Example of the classical method of lecturing. The subject is ‘design of a drug trial and statistical analysis of its results’. The talk is divided into three main sections, two of which, in turn, are subdivided into
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is to say it will contain main points and perhaps examples, qualifications, elaborations, reservations and a brief summary. The classical method is by far the most common form of lecture. It appears to be easy to plan, it is probably the easiest to take notes from and it is particularly useful for outlining such topics as ‘The main effects of cholesterol’, ‘Renal functions’ or ‘The endocrine system’. A slight variation on the classical method which is used extensively in medical schools is the recursive classical method. The recursive classical method is divided into broad sections and each broad section is presented in the same order. For example, a lecturer might outline four related diseases along the lines, ‘Presenting symptoms’, ‘Signs evident on examination’, ‘Provisional diagnosis’, ‘Planned management’, ‘Statement of prognosis’. If the recursive method is to be used it is helpful for students to know this at the beginning of the lecture. It is also helpful if the lecturer does not deviate from the recursive cycle or, if he does deviate, then a signpost statement such as “As an aside, it is worth pointing out that . . . .”, or “If I can just deviate for a moment . . . .” alerts a student to variations in the recursive cycle. Good use of the classical method is not as easy as it may
subsections, or keys. The subsections in ‘Clinical trial’are further divided into smaller units. (CSM=Committee on Safety of Medicines.)
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appear. First, you must have a clear grasp of what you propose to tackle - and ignore -in the lecture. Second, you need to classify each main section clearly. Third, you need to indicate clearly when you are beginning and ending each section and main section. This may be done in blackboard summary or by verbal markers such as “So (pause) the main point is . . . . Now let’s turn to the next subsection on . . . .” Without these simple signposts, what began as a clasical method of lecturing becomes a confused mish-mash. The classical method has one other major pitfall for the unwary-boredom. Because it is relatively easy to catalogue and recite fact after fact, it is easy to grind on relentlessly, generating ennui not understanding. Thus, you need to use apt examples and illustrations and to present them in an interesting lively way. This requires thought, planning and attention to detail in presentation.
The Problem-centred Method This is useful for examining views on and solutions to such problems as the need to diagnose a patient presenting with symptoms of acute muscular weakness. Here, the lecturer might concentrate on the use of a short-acting anticholinesterase to distinguish myasthenia gravis from disseminated sclerosis and present the underlying pharmacology in the context of the problemsolving method. All problem-centred lectures contain a statement of a problem, some indications of what counts as a satisfactory solution and an evaluation of the solution proffered - its strengths and weaknesses. We prefer the indications to be stated explicitly so that confusions and ambiguities may be minimized. However, not all lecturers agree with this view. The solutions may be presented in the form of keys as in the classical method. Figure 6 shows an outline of the problem-centred approach. A necessary, but not sufficient, condition of success of this method is a clear, brief statement of the problem. Without this the structure of the lecture crumbles. The problem-centred method also requires selection of the main alternative solutions and clear statements of the main points or evidence in favour of the solution followed by an equally clear statement against it. The approach can be intellectually stimulating, particularly if it is combined with expressed enthusiasm for the problem and the use of rhetorical devices such as: “So, Pasteur demonstrated to his own satisfaction that . . . . Now, (pause) some of you may think he was right. But was he? Let us take a look at what Koch had to say
Figure 6 . The problem-centred method of lecturing. The ‘keys’ contain clear statements of the main points or evidence in favour of the solutions, examples, qualifications and reservations. cross-referencing alternative solutions is in the final summary. At that point one can also ask a question for the students to think about in their own time, such as “Now, the really interesting question is: Were Pasteur’s methods, after all, the best ones?”.
The Sequential Method The sequential method consists of a series of linked statements which usually lead to a conclusion. This method is used in historical accounts, which are given in medicine as well as in history and other Arts subjects. It is important to highlight and to emphasize the main Figure 7 . The sequential method of lecturing is most commonly used for mathematical topics. In these subjects it looks easy. You simply fill the blackboard with symbols and talk to them, not the students.
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..... The problem-centred method is not only intellectually stimulating, it is also, alas, easy to fudge. Common errors are unclear, excessively lengthy statements of the problem, confused statements for and against a solution, the introduction of several asides and frequent impulsive cross referencing of alternative solutions. Stick to the main lines of enquiry if you use this method and be sure to summarize at the end of each alternative and again at the end of the lecture. The most appropriate point for Medical Teacher Vol I No 3 1979
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points. A lecturer who merely recites the research literature in sequential order without indicating the importance of various contributions is likely to be neither interesting nor illuminating. The sequential method is the common one in mathematical topics. In these subjects it looks easy. You simply fill the blackboard with symbols and talk to them, not to the students (Figure 7). In fact, it is the most difficult method to make meaningful and interesting and it is the easiest to fudge. T o make it meaningful you have to ensure the steps are within the students’ grasp. You also have to summarize frequently the main steps and procedures. To make it interesting, you can show the relevance of the proofs or procedures to other topics and problems, perhaps indicate their historical origins, their application and even the elegance of the proof or procedure. T o avoid confusions, be sure that the summaries on the blackboard or overhead transparency can be clearly seen. Figure 8 gives an example of the sequential method. You might like to sketch examples of the various methods of lecturing from your own subjects. Preparing Lectures So far we have concentrated on what educationalists call ‘process’. We have attempted to examine three methods of structuring lectures. However, the lecturer must give some attention to the intended result of his or her instruction. In medical teaching the aim of instruction is to impart the skills, knowledge and attitudes students might have to acquire in order to become accomplished physicians. These aspirations might involve ‘understanding‘, ‘feeling’, ‘stating’, ‘writing’, ‘palpating’, ‘ausculating’, ‘cutting’ and so on. Some of them can be written down and most people call them ‘objectives’. The nature of the lecturer’s objectives influences the design of the lecture. Thus, if you want a student to be able to identify a collapsed lung on a radiograph, you must show radiographs of collapsed and expanded lungs. That is obvious, but at a more subtle level, suppose you want your students to understand the fetal circulation at term. Perhaps you will agree that it would be desirable if they could draw two simple, but accurate, diagrams illustrating the two sides of the heart and the important vascular connections. Would you, therefore, show them a beautifully drawn slide copied from one of the books? Or would you draw the diagrams de novo, as you would like the students to be able to do, on the board or overhead projector?
Steps in Preparing a Lecture T o try to amalgamate our considerations of ‘process’with attention to the intended result of instruction, we suggest you follow the procedure below when preparing a lecture: 1 . Write down the title of the topic in the middle of a blank sheet of paper. Then write down ideas, facts, questions etc. which are related to the topic. Place related ideas and facts close to each other. Continue
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I Process: information gathering I I
Definition of problem (provisionaldiagnosis)
1 Prognosis statement I\ Management plan I
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Emergency treatment Management and monitoring
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Symptoms Breathlessness and chest pain Signs on examination Asvrnmetrv of ventilatorv movements Unilateral absence of breath sounds Hyperresonant percussion note one side 7Displacement of trachea and apex beat 7 Cyanosis Definition of problem Simple or tension pneumothorax (decidefrom signs) due to bronchopleural fistula as a result of rib fracture Tension pneumothorax - death due to Prognosis asphyxiation,therefore emergency Simple pneumothorax - no immediate threat to life. but how sure is the diagnosis7 Air in pleural space must be removed Management Valve and tracheotomy needle Referral for rib fracture reduction X-ray chest after tracheotomy Tests Nursing staff assistance Monitoring
lSummaryl Figure 8 . Example of the sequential method of lecturing. This sets out how to cope with a road accident uictim presenting with breathlessness and chest pain after being crushed against the steering wheel of a car.
doing this for about five minutes and then examine ways in which the clusters of ideas can be linked. 2 . Write down the objectives of your lecture stating what you would like the students to be able to do, know or feel as a result of what you intend to do to them. You might like some help in writing objectives. Mager (1962) has written an informative and very amusing little book on the subject. (How to write objectives will also be described in a future issue of Medical Teacher.) 3 . Write down the steps necessary to realise your objectives, the evidence you think you need to make yourself
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believable and the information and ideas that make the topic interesting. 4. Now you can enhance your authority by reference to the relevant literature. 5 . Finally, formulate your lecture as a series of central questions and plan your visual (or other) aids. This systematic approach makes preparation more efficient. Very often one is tempted to read several books and articles when preparing a lecture on an unfamiliar topic. Far better to begin with a map of what you do and do not know. The map directs your reading and alerts you to issues and their relationships and to what precisely you want the students to learn. Formulating the lecture as a series of central questions provides you with a clear structure. Readers who are sceptical of this approach might like to spend 20 minutes on the following activity: Prepare a brief outline of an introductory lecture to first-year preclinical students on “on-invasive measurement of arterial blood pressure’ or a similar basic topic using the systematic method suggested above. If possible, compare your map and outline with that of a colleague. The five steps we have described are only the start of lecture preparation. You must consider the opening moves, the summaries, ways of involving students and the variety of lecture methods to be used and, if possible, the preparation of a brief lecture handout. If you have written the objectives of your lecture, why not give your students a copy? Helping Students Learn from Lectures Preclinical students spend up to 1,000 hours in lectures. It seems not unreasonable to spend a few hours helping them to improve their learning from lectures. At Nottingham we are developing a simple course on student learning and note taking. The core of the course consists of extracts from lectures or explanations from which students take notes and compare with the transcript and with each other’s notes. Other parts of the course are concerned with helping students to identify signposts in the lecturer’s discourse, to recognize key points and examples, to be sensitive to various verbal cues such as “However . . . .”, “Nonetheless . . . .” and to know the various methods and styles of lecturing that they are likely to experience. The course is not yet fully developed, although pilot trials have yielded promising results. More important than the course itself is the notion that if one wants to improve the effectiveness of lectures one has to improve the learning skills of students as well as the teaching skills of lecturers. References Bligh. D., What:c the Use of Lectures?, Penguin. Harmondsworth. 1972. Bligh, D.. Ebrahim, N., Jaques. D. and Piper, D. W.. Teaching Students. University of Exeter, Exeter. 1975.
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Brown, G. A., Lecturing and Explaining, Methuen. London 1978 Costin. F., Lecturing versus other methods of teaching: A review of research, BrittshJournal ofEducationa1 Technology, 1973, 3 , 1-31, h e x - L o p r e s t i , M., How to use an overhead projector, Medical Teacher, 1979, 1, 9-15. Hartley, J. and Davies, I . K . , Note-taking: A critical review, Programmed Learning and Educational Technology, 1978, 15, 207224. Howe, M. and Geoffrey, J . , Student Note-taking as an Aid to Learning, Universityof Exeter, Exeter, 1977. Johnstone, A. H . and Percival, F . , Attention breaks in lectures, Education in Chemistry, 1976, 13, 49-50. Lindsay, A . H . and Norman, D. A., Human Information Aocessing, Academic Press, New York, 1972. Lloyd, D. H . , A concept of improvement of learning in the taught lesson, VisualEducation, 1968, Oct., 23-5. McLeish, J.. T h e lecture method, in N. L. Gage (Ed.), The Psychology of Teaching Methods, 75th Yearbook of the National Society for the Study of Education, Chicago, 1976. Maddox, H . and Hoole, E., Performance decrement in the lecture, Educational Research, 1975, 28, 17-30, Mager, R. F., Preparing Instructional Objectives, Fearon, Palo Alto, 1962. Rosenshine, B., Enthusiastic teaching: a research review, School Review, 1970. 78, 499-516. Reproduced in A. Morrison and D. McIntyre (Eds), The Social Psychology of Teaching, Penguin, Harmondsworth, 1972. Spence, R. B., Lecture and class discussion in teaching educational psychology, Journal of Educational Psychology, 1928. 19,454-462. Turney. C . , Clift, J . C. et al., Sydney Microskills Series 9 , Sydney University Press, Sydney, 1975. Verner. C. and Dickinson, G . . T h e lecture, an analysis and review of research, Adult Education, 1968, 17, 85-100.
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ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
How To: Improve Lecturing George Brown & David Tomlinson To cite this article: George Brown & David Tomlinson (1979) How To: Improve Lecturing, Medical Teacher, 1:3, 128-135 To link to this article: http://dx.doi.org/10.3109/01421597909023826
Published online: 03 Jul 2009.
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HOW TO...
Improve Lecturing
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GEORGE BROW” and DAVID TOMLINSON George Brown, B.SC, D. PHIL, is Senior Lecturer in University Teaching Methods, University of Nottingham, and David Tomlinson, B.SC, PH.D, is Lecturer in Physiology and Pharmacology, University Hospital and Medical School, Clqton Boulevard, Nottingham. This article outlines a simple model of the way students learn from lectures and describes nine basic skills of lecturing. I t goes on to explore three lecture methodsthe classical method, the problem-centred method and the sequential method-from the point of view of their usefulness, requirements and pitfalls. Finally, it proposes five basic steps in the preparation of a lecture. Why Improve Lecturing? Lecturing is just one of many methods of teaching. However, whereas newer methods, such as games, tapeslide programmes or computer-assisted learning, are planned and evaluated systematically, lecture methods are rarely subjected to such rigorous planning and analysis. This lack of attention to the lecture accounts, in part, for its apparent relative ineffectiveness as a teaching method. It is true that lectures are not usually as effective as small-group methods for solving complex problems or changing attitudes. Nor are they as effective as laboratory classes for developing psychomotor skills. For imparting ideas and information, however, lectures are at least as good as other methods (Costin 1972; Bligh et al. 1975; McCleish 1976). It is also true that there are psychological gaps between lecturers’ intentions, what they transmit and what signals students receive from them. The proportion of points made during lectures which are written down in students’ notes may vary from 11 to 40 per cent depending upon the method used for analysing lecture notes (see Howe and Geoffrey (1977) and Hartley and Davies (1968) for reviews of student note-taking). However, lectures are at least as effective as other methods of teaching for outlining a field of knowledge, for enunciating and applying general principles and for generating understanding. Perhaps most important of all, lectures can be used for generating enthusiasm and interest in a subject (see Verner and Dickinson 1968; Rosenshine 1970). For if a student is motivated by a lecturer and provided with guidelines, then the student will become self-motivated and goaldirected. What some researchers do not point out is that lec128
turing is an economical way of teaching which has been in use for some 2,500 years. There are many methods of lecturing and many possible uses for lectures. They are likely to remain one of the essential methods of medical education. Rather than bemoaning the deficiences of lectures one should seek ways of improving their effectiveness. As Spence (1928) observed, “The decrying of the wholesale use of lectures is probably justified. The wholesale decrying of the use of lecturing is just as certainly not justified .” One way of improving the effectiveness of lectures is to introduce lecturers and students to the processes of teaching and learning that go on in lectures. Associated with these processes are various skills and methods of lecturing, strategies for improving the preparation and structure of lectures and ways of helping students learn from lectures. Interested readers are referred to Bligh (1972) and Brown (1978) for further information. Learning from Lectures Students learn from lectures by listening, observing, summarizing and note-taking. A hidden variable in their activities is understanding. Sometimes understanding is gained during the lecture, sometimes it emerges after the lecture when the students pore over the lecture notes they have taken. Figure 1 sets out a simple scheme for examining the processes of learning from lectures. It is derived from studies of human information processing (Lindsay and Norman 1972). A lecturer sends messages verbally, extra-verbally, non-verbally and through his or her use of audiovisual aids. The verbal messages may consist of definitions, descriptions, examples, explanations or comments. The ‘extra-verbal’ component is the lecturer’s vocal qualities, hesitations, stumbles, errors and use of pauses and silence. The ‘non-verbal’ component consists of his or her gestures, facial expressions and body movements. All of these types of messages may be received by the students who may sift, perhaps store and summarize, and note what they perceive as the important messages. A lecturer transmits not only information. His or her
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Figure 1. Learning f r o m lectures. Messages transmitted by the lecturer may pass directly f r o m students’ shortterm memory (STM) to their notes, or the messages may be ‘processed’ in their long-term memory (LTM) and thereby understood before they are taken down in the students’notes. (A V A =audiovisual aids)
non-verbal cues may convey meaning and attitudes which highlight, qualify or distort the essential messages. The latter may be clearly structured and meaningful or they may be confused and seemingly meaningless. The information, meaning and attitudes conveyed by the lecturer may or may not be attended to by the students. Attention fluctuates throughout a one-hour
Table 1. Some basic skills of lecturing. 1. Explaining
2. Orientation 3 . Closure 4. Liveliness
5. Using audiovisual aids 6 . Varying student activities
7. Giving directions 8 . Comparing
9. Narrating
Giving understanding, using examples and illustrations Opening a lecture, introducing a topic or theme Summarizing and linking topics and themes Generating interest and enthusiasm, gaining and holding attention The effective use of blackboards, overhead projectors, slides, models and handouts Listening, observing, note taking, brief small-group discussions, simple problem solving and even laughter Indicating how to carry out procedures or how to solve various types of problem Comparing and contrasting. Giving similarities and differences or advantages and disadvantages of various methods, approaches and perspectives Reading from an article, or a text to illustrate or exemplify a point of view
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lecture. After 20 minutes there is a marked decline in attention followed by a peak of attention just before the lecture ends (Lloyd 1968; Maddox and Hoole 1975; Johnstone and Percival 1976). This decline in attention is less likely to occur if the lecture includes some short activities for students such as brief small-group discussions or simple problem solving. Any change of activity is, in fact, likely to renew attention. Hence, some lecturers slip in occasional amusing slides, tell anecdotes or just give their students a two-minute break. Messages that are received by the students are filtered and stored temporarily in the short-term memory. They are forgotten after about 30 seconds if they cannot be rehearsed (kept in mind) or noted or if they cannot be transferred to the long-term memory. The long-term memory most readily receives messages which are closely related to the network of concepts and facts which are already stored in the long-term memory. The long-term memory will also store new messages which are only loosely associated with existing facts and ideas. Facts and concepts that are incomprehensible are most likely to be forgotten. Competing messages are also difficult to cope with. If a lecturer shows a complicated diagram and talks at the same time, should students note what they see or what is said? It is unlikely that they will have time to do both. Practical Implications
The implications of this simple model of learning are that if you want students to learn from lectures and to take good notes, you must structure your presentation so that it is meaningful and interesting and you must ensure that you gain and sustain the students’ attention. In addition the ideas and facts which you present must be capable of being assimilated readily into the students’ existing store of knowledge and skills. You might also spend some time helping students directly to improve their learning from lectures. A student’s response or ‘output’ is not only a set of intelligible notes which may be understood and, if necessary, restructured and learnt. It also consists of reactions to the lecture and lecturer. These reactions are usually non-verbal signals and may be received, interpreted and acted upon by a lecturer who is not solely occupied with reading aloud from his notes or writing on a blackboard. Perhaps more important than immediately observable responses are the longer term changes which may occur in a student. A lecture may change a student’s perceptions of a problem or theory, it may increase the student’s insight and it may stimulate him or her to read, think and discuss ideas with others.
Skills of Lecturing The processes of learning may be conveniently classified into nine overlapping clusters of component skills (Table l ) , each of which may be a target for improvement by a lecturer seeking to better his or her technique. Skills 1 and 5 are probably the most important. 129
Explaining
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Put simply, explaining is giving understanding to others. Some people explain aptly, getting to the heart of the matter. Others explain ineptly, using analogies, concepts and procedures that cannot be understood without an understanding of the very thing they are trying to explain. All of us can improve our ability to explain if we analyse what, precisely, we wish to explain. Unfortunately, we sometimes do not do this until after our first attempt at explaining. An example of a first attempt is given in Figure 2. You may like to read the transcript and try to improve upon it before reading the next sections of this article. Figure 2. Tapescript of a first attempt at explaining. Er- the - the title of my talk today is why nude mice are important to biologists.
O.K. Well, the thymus as most of you probably know is- e r - a large-er-organ -that is located in the-em-upper part of the chest. It’s referred to as a lymphoid organ because most of the cell-cellspossessed by the organ-most of the consituent cells in this- in the thymus are lymphocytes- a specific cell type. It’s importance lies in the fact that lymphoid cells processed by this by this organ- e r m - are cells which control the mechanism of graft rejection. This is important in transplantation. Erm they also have a specific role in immune responseserm -and the role here is one of control. It’s the thymocytes. the lymphoid cells rising from this organ, which determine the pattern of an immune response. Now, one way of studying the importance of such an organ is to remove it and to see what happens in its absence, so that surgical ablation or thymectomy. as it‘s known in this particular instance. has become quite a widespread procedure by (tape inaudible). What happens is the thymus is removed. This is a procedure normally combined with irradiation e r - irradiation of sufficient intensity to destroy- erm other lymphocytes present in the body since lymphocytes are particularly sensitive to irradiation, erm- the procedure doesn’t unduly affect other cell types but erm - in particular instances where irradiation has to be given of - enn a lethal quantity then the erm problem is that the- erm animal has then to be reconsitituted with marrow cells and kept on a variety of antibiotics to prevent infection since lymphocytes have such a-a-an important rolefunction in erm immune responses. An animal deprived of these lymphocytes then has to be kept artificially to ensure its survival. by the administration of antibiotics and so on. Such a mouse, anyway is known as an immunologically deprived animal and it is an extremely valuable erm it’s an extremely valuable- enn animal to the biologists because it provides a sort of tool whereby the role of other cell types can be assessed. You’ve destroyed the lymphocytes in-in this particular animal, You can then re-inject other erm - specific cell types and see how they function in when various stimuli are given to them. Organs, for insta’nce can be erm transplanted back into the animal and their role can be assessed in the absence of other interfering factors. So where does the nude mouse come into all this? Well, in 1966- erm Flanagan first described a creature “The nude mouse is a homozygous recessive condition” and I think one ought to explain here using the blackboard, -ermthe nude condition-erm-is governed by a single gene and since each gene is -is-is represented by two in each cell of the body you have three possible combinations. You have a d - a plus, plus combination (writes on board). This is known as the wild type, -
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The lecturer who gave the explanation in Figure 2 was young and inexperienced. It was his first attempt at explaining a topic to an audience of intelligent nonspecialists. He viewed the videotape of his efforts, commented negatively and set about improving his explanation. He did this by asking himself the questions:
1. What precisely do I wish to explain? (expressed in the form of a question). 2. What other questions are hidden in the question I wish to explain? It is clear that the question “Why are nude mice important to biologists?” contains within it some hidden questions such as “What are nude mice?”,“What features of nude mice make them important”, “Why?”. Having formulated these questions, the lecturer produced the explanation which is given in Figure 3. It is not perfect, but most people think that it is better than his first attempt for an audience who knewqnothing about nude mice, The structure of an explanation is probably more important than any other of its features. Hence the emphasis on this aspect in our article. Explaining
Figure 3. Tapescript of a second attempt at explaining. T h e title of my talk is why nude mice are important to biologists. The term the ‘nude mouse‘ is used to describe a strain of mouse which arose by mutation from normal laboratory mice u m . It’s a condition which is characterized by two main features. These are, first of all, absence of hair, hence the term the ‘nude mouse’, and the second feature is the absence of a thymus and it is the second property, the absence of a thymus, which is the subject of my talk. Now, the basic point is going to be summarized in this first table. So. there are two conditions possible, either the thymus is present or it is absent. Thymus present, a naturally occurring condition. leads to an ability to respond. (Perhaps I should stand on this side.) T h e absence of a thymus which either can be experimentally induced or i t can occur naturally in the nude mouse leads to inability to respond immunologically. T h e question then rephrased is why is the absence of a thymus a useful condition and the answer - um -simply is that animals without a thymus cannot respond immunologically and therefore such animals can be injected with foreign cells um and the role and the function of these cells can then be studied without the interference of immune response, T h e second table then once again summarizes this main. this-um-this statement of mine. No thymus results in no immune response, therefore there is no interference from the immune response, hence injected cells can survive and can be studied-a very useful experimental situation. Going back to the first table u m , the last point which I want to make is that the natural condition, i.e. the nude mouse. is preferable to the experimental condition um - because in order to achieve the experimental condition complex surgery is involved. This needs to be followed by prolonged drug trcatnlent and such a combination um is highly lethal to the animal resulting in mortality of um experimental groups. So. to summarize then, the nude mouse is an important um - is important to.biologists because um first of all it’s eaby to obtain relative to the experimentally induced condition and since it doesn’t have a thymus it’s a useful animal becasuc. i t doesn’t respond immunologically and it is this last condition which is in much demand in biological research. ~
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provides an opportunity for trying out opening moves, summarizing a topic and generating interest. Furthermore, lecturing may be conceived of as a set of linked explanations. If you devote some time to improving the structure of some of your explanations, then you will also improve your lecturing.
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Using Audiovisual Aids The term ‘audiovisual aids’ refers to any equipment or materials lecturers use to enhance their message. Handouts, the blackboard, overhead transparencies, models, slides, audiorecordings, videorecordings and films may all be used in this way. There is little doubt that effective use of these aids sustains attention and improves achievement amongst secondary school pupils (Turney et al. 1975). Skilful use of these aids is also likely to be effective in medical schools. Audiovisual aids may be used (as the handout or blackboard summary often are) to confirm and reinforce the main points of a lecture, or as explanatory devices in their own right. For example, an overhead transparency which shows simplified diagrams of biochemical reactions or anatomical structures may be used in this way. Short extracts of films, videorecordings or sequencies of slides, also enrich lectures. Precautions We do not propose to outline all the methods, problems and pitfalls of using audiovisual aids. Some of these have already been covered in Medical Teacher (e.g. EssexLopresti 1979). Other aids and their advantages and disadvantages will be considered in forthcoming issues. However, there are a few precautions we would like to mention : 1. Illustrations, diagrams and summaries should be simple, brief and readable from the back of the lecture class (Figure 4). If the illustrations are important, give
the students time to look at them and, if necessary, to copy them. If the illustrations are available in a book, give the title and page number. There is no need always to speak whilst members of the audience are looking at the illustrations; indeed if you want them to look intensively, tell them what to look for, then shut up! 2. Handouts should be brief and well structured. They should contain key references and, if necessary, definitions of new terms. Lengthy handouts become substitutes for lectures, not adjuncts to lectures. It is probably best to give students a few minutes to read through the handouts just before you begin lecturing. If the handout is likely to pre-empt the excitement of the lecture then distribute it afterwards. Many experienced teachers would assert that ‘skeletal’ handouts, i.e. those which require completion by students and hence their active participation, are superior to comprehensive abstracts. 3. Slides, audiorecordings, films and videotapes can be effective ways of maintaining interest and attention. But their excessive use may induce sleep. One should indicate clearly to which features of the material attention should be given. If possible, one should pose questions for the students to answer whilst they are watching the
Figure 4. Illustrations, diagrams and summaries should be simple, brief and readable f r o m the back of the class. (Based on Meyer-Hartwig et al., How to Compose Slides for Lectures, Gerhard Witzstrock, Baden-Baden, New York, 1977, p . 9.)
. . . as you can easily see here!
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audiovisual materials, give them an opportunity to discuss briefly the materials, then summarize the main points and link them to the relevant parts of the lecture. These guidelines are important. Without them a potentially valuable learning experience can be reduced to the level of home movies.
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Lecture Methods Our studies of lectures in various Faculties at Nottingham have revealed a wide variety of methods of structuring lectures. Most lectures contain segment or subtopics which usually take four to seven minutes to relate. The degree of complexity and clarity of these methods varies from lecturer to lecturer. The three most common methods are the classical, problem-centred and sequential methods.
The Classical Method Here, the lecture is divided into broad sections. Each broad section is divided into separate subsections and, perhaps, each subsection into smaller units (Figure 5). Each of the sub-sections may be what we call a key. That
Figure 5 . Example of the classical method of lecturing. The subject is ‘design of a drug trial and statistical analysis of its results’. The talk is divided into three main sections, two of which, in turn, are subdivided into
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is to say it will contain main points and perhaps examples, qualifications, elaborations, reservations and a brief summary. The classical method is by far the most common form of lecture. It appears to be easy to plan, it is probably the easiest to take notes from and it is particularly useful for outlining such topics as ‘The main effects of cholesterol’, ‘Renal functions’ or ‘The endocrine system’. A slight variation on the classical method which is used extensively in medical schools is the recursive classical method. The recursive classical method is divided into broad sections and each broad section is presented in the same order. For example, a lecturer might outline four related diseases along the lines, ‘Presenting symptoms’, ‘Signs evident on examination’, ‘Provisional diagnosis’, ‘Planned management’, ‘Statement of prognosis’. If the recursive method is to be used it is helpful for students to know this at the beginning of the lecture. It is also helpful if the lecturer does not deviate from the recursive cycle or, if he does deviate, then a signpost statement such as “As an aside, it is worth pointing out that . . . .”, or “If I can just deviate for a moment . . . .” alerts a student to variations in the recursive cycle. Good use of the classical method is not as easy as it may
subsections, or keys. The subsections in ‘Clinical trial’are further divided into smaller units. (CSM=Committee on Safety of Medicines.)
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appear. First, you must have a clear grasp of what you propose to tackle - and ignore -in the lecture. Second, you need to classify each main section clearly. Third, you need to indicate clearly when you are beginning and ending each section and main section. This may be done in blackboard summary or by verbal markers such as “So (pause) the main point is . . . . Now let’s turn to the next subsection on . . . .” Without these simple signposts, what began as a clasical method of lecturing becomes a confused mish-mash. The classical method has one other major pitfall for the unwary-boredom. Because it is relatively easy to catalogue and recite fact after fact, it is easy to grind on relentlessly, generating ennui not understanding. Thus, you need to use apt examples and illustrations and to present them in an interesting lively way. This requires thought, planning and attention to detail in presentation.
The Problem-centred Method This is useful for examining views on and solutions to such problems as the need to diagnose a patient presenting with symptoms of acute muscular weakness. Here, the lecturer might concentrate on the use of a short-acting anticholinesterase to distinguish myasthenia gravis from disseminated sclerosis and present the underlying pharmacology in the context of the problemsolving method. All problem-centred lectures contain a statement of a problem, some indications of what counts as a satisfactory solution and an evaluation of the solution proffered - its strengths and weaknesses. We prefer the indications to be stated explicitly so that confusions and ambiguities may be minimized. However, not all lecturers agree with this view. The solutions may be presented in the form of keys as in the classical method. Figure 6 shows an outline of the problem-centred approach. A necessary, but not sufficient, condition of success of this method is a clear, brief statement of the problem. Without this the structure of the lecture crumbles. The problem-centred method also requires selection of the main alternative solutions and clear statements of the main points or evidence in favour of the solution followed by an equally clear statement against it. The approach can be intellectually stimulating, particularly if it is combined with expressed enthusiasm for the problem and the use of rhetorical devices such as: “So, Pasteur demonstrated to his own satisfaction that . . . . Now, (pause) some of you may think he was right. But was he? Let us take a look at what Koch had to say
Figure 6 . The problem-centred method of lecturing. The ‘keys’ contain clear statements of the main points or evidence in favour of the solutions, examples, qualifications and reservations. cross-referencing alternative solutions is in the final summary. At that point one can also ask a question for the students to think about in their own time, such as “Now, the really interesting question is: Were Pasteur’s methods, after all, the best ones?”.
The Sequential Method The sequential method consists of a series of linked statements which usually lead to a conclusion. This method is used in historical accounts, which are given in medicine as well as in history and other Arts subjects. It is important to highlight and to emphasize the main Figure 7 . The sequential method of lecturing is most commonly used for mathematical topics. In these subjects it looks easy. You simply fill the blackboard with symbols and talk to them, not the students.
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..... The problem-centred method is not only intellectually stimulating, it is also, alas, easy to fudge. Common errors are unclear, excessively lengthy statements of the problem, confused statements for and against a solution, the introduction of several asides and frequent impulsive cross referencing of alternative solutions. Stick to the main lines of enquiry if you use this method and be sure to summarize at the end of each alternative and again at the end of the lecture. The most appropriate point for Medical Teacher Vol I No 3 1979
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points. A lecturer who merely recites the research literature in sequential order without indicating the importance of various contributions is likely to be neither interesting nor illuminating. The sequential method is the common one in mathematical topics. In these subjects it looks easy. You simply fill the blackboard with symbols and talk to them, not to the students (Figure 7). In fact, it is the most difficult method to make meaningful and interesting and it is the easiest to fudge. T o make it meaningful you have to ensure the steps are within the students’ grasp. You also have to summarize frequently the main steps and procedures. To make it interesting, you can show the relevance of the proofs or procedures to other topics and problems, perhaps indicate their historical origins, their application and even the elegance of the proof or procedure. T o avoid confusions, be sure that the summaries on the blackboard or overhead transparency can be clearly seen. Figure 8 gives an example of the sequential method. You might like to sketch examples of the various methods of lecturing from your own subjects. Preparing Lectures So far we have concentrated on what educationalists call ‘process’. We have attempted to examine three methods of structuring lectures. However, the lecturer must give some attention to the intended result of his or her instruction. In medical teaching the aim of instruction is to impart the skills, knowledge and attitudes students might have to acquire in order to become accomplished physicians. These aspirations might involve ‘understanding‘, ‘feeling’, ‘stating’, ‘writing’, ‘palpating’, ‘ausculating’, ‘cutting’ and so on. Some of them can be written down and most people call them ‘objectives’. The nature of the lecturer’s objectives influences the design of the lecture. Thus, if you want a student to be able to identify a collapsed lung on a radiograph, you must show radiographs of collapsed and expanded lungs. That is obvious, but at a more subtle level, suppose you want your students to understand the fetal circulation at term. Perhaps you will agree that it would be desirable if they could draw two simple, but accurate, diagrams illustrating the two sides of the heart and the important vascular connections. Would you, therefore, show them a beautifully drawn slide copied from one of the books? Or would you draw the diagrams de novo, as you would like the students to be able to do, on the board or overhead projector?
Steps in Preparing a Lecture T o try to amalgamate our considerations of ‘process’with attention to the intended result of instruction, we suggest you follow the procedure below when preparing a lecture: 1 . Write down the title of the topic in the middle of a blank sheet of paper. Then write down ideas, facts, questions etc. which are related to the topic. Place related ideas and facts close to each other. Continue
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I Process: information gathering I I
Definition of problem (provisionaldiagnosis)
1 Prognosis statement I\ Management plan I
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Emergency treatment Management and monitoring
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Symptoms Breathlessness and chest pain Signs on examination Asvrnmetrv of ventilatorv movements Unilateral absence of breath sounds Hyperresonant percussion note one side 7Displacement of trachea and apex beat 7 Cyanosis Definition of problem Simple or tension pneumothorax (decidefrom signs) due to bronchopleural fistula as a result of rib fracture Tension pneumothorax - death due to Prognosis asphyxiation,therefore emergency Simple pneumothorax - no immediate threat to life. but how sure is the diagnosis7 Air in pleural space must be removed Management Valve and tracheotomy needle Referral for rib fracture reduction X-ray chest after tracheotomy Tests Nursing staff assistance Monitoring
lSummaryl Figure 8 . Example of the sequential method of lecturing. This sets out how to cope with a road accident uictim presenting with breathlessness and chest pain after being crushed against the steering wheel of a car.
doing this for about five minutes and then examine ways in which the clusters of ideas can be linked. 2 . Write down the objectives of your lecture stating what you would like the students to be able to do, know or feel as a result of what you intend to do to them. You might like some help in writing objectives. Mager (1962) has written an informative and very amusing little book on the subject. (How to write objectives will also be described in a future issue of Medical Teacher.) 3 . Write down the steps necessary to realise your objectives, the evidence you think you need to make yourself
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believable and the information and ideas that make the topic interesting. 4. Now you can enhance your authority by reference to the relevant literature. 5 . Finally, formulate your lecture as a series of central questions and plan your visual (or other) aids. This systematic approach makes preparation more efficient. Very often one is tempted to read several books and articles when preparing a lecture on an unfamiliar topic. Far better to begin with a map of what you do and do not know. The map directs your reading and alerts you to issues and their relationships and to what precisely you want the students to learn. Formulating the lecture as a series of central questions provides you with a clear structure. Readers who are sceptical of this approach might like to spend 20 minutes on the following activity: Prepare a brief outline of an introductory lecture to first-year preclinical students on “on-invasive measurement of arterial blood pressure’ or a similar basic topic using the systematic method suggested above. If possible, compare your map and outline with that of a colleague. The five steps we have described are only the start of lecture preparation. You must consider the opening moves, the summaries, ways of involving students and the variety of lecture methods to be used and, if possible, the preparation of a brief lecture handout. If you have written the objectives of your lecture, why not give your students a copy? Helping Students Learn from Lectures Preclinical students spend up to 1,000 hours in lectures. It seems not unreasonable to spend a few hours helping them to improve their learning from lectures. At Nottingham we are developing a simple course on student learning and note taking. The core of the course consists of extracts from lectures or explanations from which students take notes and compare with the transcript and with each other’s notes. Other parts of the course are concerned with helping students to identify signposts in the lecturer’s discourse, to recognize key points and examples, to be sensitive to various verbal cues such as “However . . . .”, “Nonetheless . . . .” and to know the various methods and styles of lecturing that they are likely to experience. The course is not yet fully developed, although pilot trials have yielded promising results. More important than the course itself is the notion that if one wants to improve the effectiveness of lectures one has to improve the learning skills of students as well as the teaching skills of lecturers. References Bligh. D., What:c the Use of Lectures?, Penguin. Harmondsworth. 1972. Bligh, D.. Ebrahim, N., Jaques. D. and Piper, D. W.. Teaching Students. University of Exeter, Exeter. 1975.
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Brown, G. A., Lecturing and Explaining, Methuen. London 1978 Costin. F., Lecturing versus other methods of teaching: A review of research, BrittshJournal ofEducationa1 Technology, 1973, 3 , 1-31, h e x - L o p r e s t i , M., How to use an overhead projector, Medical Teacher, 1979, 1, 9-15. Hartley, J. and Davies, I . K . , Note-taking: A critical review, Programmed Learning and Educational Technology, 1978, 15, 207224. Howe, M. and Geoffrey, J . , Student Note-taking as an Aid to Learning, Universityof Exeter, Exeter, 1977. Johnstone, A. H . and Percival, F . , Attention breaks in lectures, Education in Chemistry, 1976, 13, 49-50. Lindsay, A . H . and Norman, D. A., Human Information Aocessing, Academic Press, New York, 1972. Lloyd, D. H . , A concept of improvement of learning in the taught lesson, VisualEducation, 1968, Oct., 23-5. McLeish, J.. T h e lecture method, in N. L. Gage (Ed.), The Psychology of Teaching Methods, 75th Yearbook of the National Society for the Study of Education, Chicago, 1976. Maddox, H . and Hoole, E., Performance decrement in the lecture, Educational Research, 1975, 28, 17-30, Mager, R. F., Preparing Instructional Objectives, Fearon, Palo Alto, 1962. Rosenshine, B., Enthusiastic teaching: a research review, School Review, 1970. 78, 499-516. Reproduced in A. Morrison and D. McIntyre (Eds), The Social Psychology of Teaching, Penguin, Harmondsworth, 1972. Spence, R. B., Lecture and class discussion in teaching educational psychology, Journal of Educational Psychology, 1928. 19,454-462. Turney. C . , Clift, J . C. et al., Sydney Microskills Series 9 , Sydney University Press, Sydney, 1975. Verner. C. and Dickinson, G . . T h e lecture, an analysis and review of research, Adult Education, 1968, 17, 85-100.
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