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Lecture skills in medical education.

The lecture is the most common method of transmitting information in medical schools and continuing medical education. In recent years this educational method has received considerable criticism because of poor lecturers and poor learning. The major advantage of the lecture is the ability to teach pertinent up-to-date information in an efficient manner. The major limitation is the passivity of the method with the teacher speaking and the listener passively receiving the material with considerable opportunity to be bored. The effective techniques of lecturing are: 1) environment aids learning: 2) an introduction perks interest; 3) stating objectives helps audience to respond analytically; 4) outlining a lecture helps clear thinking; 5) non-verbal behavior increases learning; 6) use of voice shows interest and clarity; 7) content is understood if it fits objectives; 8) organized lecture fits the time available; 9) visual aids used should be clear and understandable; 10) a summary helps to retain what is learned; 11) closure should be upbeat and should restate objectives; 12) questions should be answered succinctly. The medical lecturer can improve his skills by studying them, rehearsing while being observed by colleagues and by performing a self-analysis of video-taped lectures.

Communication↗

Lectures by neurosurgery and neurology faculty at U.S. medical schools.

The lecture activity of neurology and neurosurgery faculty at allopathic medical schools during the academic years 1985-1986 through 1987-1988 was surveyed. Lectures were categorized into three combinations for analysis: first- and second-year basic science, first- and second-year clinical, and third- and fourth-year clinical lectures. Both faculties delivered more hours of clinical than basic science lectures, and this held true at most schools. Neurology provided lectures at more schools in each of these categories, as well as offering more hours of lecture per student (school medians: 11.5, 18.0, 13.8) than did neurosurgery (school medians: 6.0, 5.5, 8.0). However, neurology faculty number two-and-a-half times neurosurgery faculty. Lectures given per teaching neurology faculty member (12.2) averaged approximately the same as per teaching neurosurgery faculty member (11.5). Increased exposure to the lectures of neurology or neurosurgery faculty did not increase subsequent student enrollment in a first clinical clerkship in that discipline when students had a choice of clerkships.

Clinical Clerkship↗

Co-opting colleagues: appropriating Dobzhansky's 1936 lectures at Columbia.

This paper clarifies the chronology surrounding the population geneticist Theodosius Dobzhansky's 1937 book, Genetics and the Origin of Species. Most historians assume (a) Dobzhansky's book began as a series of 'Jesup lectures,' sponsored by the Department of Zoology at Columbia University in 1936, and (b) before these lectures were given, Dobzhansky knew he would produce a volume for the Columbia Biological Series (CBS). Archival evidence forces a rejection of both assumptions. Dobzhansky's 1936 Columbia lectures were not Jesup lectures. The book he intended to write from his lectures began as a stand-alone text in evolutionary genetics; the CBS had been defunct since 1910. In May 1937 - seven months after Dobzhansky's Columbia lectures - Leslie Dunn lobbied Columbia University to revive the CBS and the Jesup lecture series. He then quietly back dated, naming Dobzhansky a Jesup lecturer and co-opting his book manuscript as the first volume in the revived CBS. A detailed chronology of this 1936-1937 period is provided. This relocates the CBS and Jesup revivals within the narrow context of zoology at Columbia University. These helped Dunn and colleagues define cutting edges and define themselves as managers and promoters of those edges.

Biological Evolution↗

Lecturer practitioners: a literature review.

Much of the existing literature on lecturer practitioners to date is comprised of the perspectives of individuals within the role and how they function in their specific setting. It is surprisingly difficult from this work, however, to define the role of lecturer practitioner. The authors were commissioned by a regional health authority to undertake a study of lecturer practitioners within that region. In the process of undertaking this study, a literature review was carried out. Whilst the authors found an abundance of literature surrounding the theory and practice gap, and the development of the lecturer practitioner role as one possible solution, they were not able to find a comprehensive review of the multifaceted aspects of the lecturer practitioner role. This paper is an attempt to provide such a review, and will address the following aspects: the need for lecturer practitioners; their origin within nursing and midwifery education; the development of the lecturer practitioner role; the debate surrounding academic and clinical credibility; and finally, the current situation for lecturer practitioners.

Clinical Competence↗

Stress in student teachers during real and simulated standardized lectures.

This study describes and compares the intensity of stress responses, both psychologically and physiologically, to a real and a simulated stressor. The real stressor involved lecturing to a class of students in a post-secondary institution during a practice teaching course. The simulated stressor was a simulated, standardized lecture given in a lecture room to 6 fellow students and 2 members of the university staff. To gain insight into the intensity of the stress responses, the measurements took place before, during, and after lecturing. The adaptation to the stressor after a teaching practice period in which the student teacher gave at least 20 lectures was also studied. Subjective anxiety scores were obtained in both situations from 26 subjects. For 12 of these subjects, heart rate responses were also obtained. The psychological and physiological data indicated that lecturing imposes a severe load on the student teacher, especially at the beginning of the teaching experience. At the end of the practice course, all stress indices showed lower values. Heart rate and subjective anxiety scores indicated that the standardized lecture is experienced as more ego threatening than the real lecture.

Adaptation, Psychological↗

The validity of lecturer ratings by students and trained observers.

This study sought to determine to what degree student ratings of specific lecturer characteristics relate to trained observer ratings of such characteristics and to identify the distinguishing delivery characteristics of highly rated lecturers. The 15 lowest-rated lecturers and the 15 highest-rated lecturers, based on the mean ratings of students from two consecutive years (1982 and 1983) in a large multi-instructor course, served as the target group. Blinded non-student raters observed the lectures in 1984 (two per lecture) and completed quantitative and qualitative forms. For all six subscores from the quantitative form, statistically significant differences between the lecturers given the highest and lowest ratings were obtained. It is concluded that the students' ratings were stable across the three years; the independent observers discriminated between the lecturers the students rated the highest and the lowest; voice presentation characteristics discriminated the most effectively; and nonmedical non-student observers are potentially a useful source of information regarding faculty teaching skills.

Education, Medical, Undergraduate↗

Recall of lecture information: a question of what, when and where.

In this paper we report on a study in which both immediate and long-term (4-month delay) recall of lecture information was tested in a group of preclinical medical students. Comparisons were made of the recall of visually and verbally presented lecture information and of information presented during different time periods in the lecture. A clear superiority of visual information over verbal information was found in both immediate and long-term recall. Information presented between the fifteenth and thirtieth minutes of the lecture was recalled best whereas the worst recall was found for information presented in the first 15 minutes. The seating position of the student in the lecture theatre was also found to be associated with the level of immediate recall but this may be a reflection of motivational factors which determine where students choose to sit rather than of seating position per se. The overall pattern of results indicate that the level of recall of lecture information by medical students is therefore a function of what type of information is presented, when during the lecture it is presented and where the student sits in the lecture theatre.

Education, Medical, Undergraduate↗

A comparison between lecture and videotape inservice for certified nursing assistants in skilled nursing facilities.

OBJECTIVE: Certified Nursing Assistants (CNA) provide most of the direct patient care in skilled nursing facilities (SNF). CNAs undergo mandatory inservice education regarding a variety of clinical conditions, but high CNA turnover and diverse cultural and educational backgrounds are persistent obstacles to overall staff education. A standardized, easily administered, highly reproducible training intervention would be valuable. We compared the efficacy of videotape versus standard lecture for inservice education relating to topics of dementia care, restraint use, and falls. DESIGN: A prospective randomized study. SETTING: Certified Nursing Assistants were recruited from three SNFs in San Diego County California between November 1997 and August 1998. PARTICIPANTS: The 82 CNAs who participated in the study were all CNA certified in California, employees of the study SNFs, and provided direct clinical care to SNF residents. All participants received regular inservice training. INTERVENTIONS: (1) Standard inservice lecture, (2) Videotape of inservice lecture material supplemented with brief clinical video vignettes. MAIN OUTCOME MEASURES: Scores on a 72-item multiple choice/true-false examination. MAIN RESULTS: Both lecture and video inservice education were effective in this CNA population. Test scores were significantly higher for both inservice groups compared with the control group (P < 0.001). There was no statistically significant difference between test scores for the two intervention groups (control = 63.1 +/- 8.2%, lecture = 78.2 +/- 8.9%, video = 77.9 +/- 11.2%). Knowledge retention was similar between the two intervention groups at 4 months. Lecture subjects who scored highest were more likely to have family members with dementia (P = 0.037), and video subjects who scored highest were younger (P = 0.007). CNA video subjects who scored highest on the examination were more likely to have English as their primary language compared with the highest scoring CNA lecture subjects (P = 0.012). CONCLUSIONS: Compared with control group scores, videotape and lecture inservice interventions were equally effective at increasing and maintaining test scores. The ease of frequent video intervention and the identification of learner characteristics most suited to the video format make audiovisual education a potentially powerful medium for CNA training. These data have important implications for future educational interventions in the SNF.

Journal Article↗

[On line ophthalmologic education. Live transfers and on demand lectures via Internet].

Continuing medical education for ophthalmologist is important and demanded from the board of ophthalmic organizations. The use of new multimedia possibilities provided by the internet, offers an alternative to acquire the training sessions requested by the board. Aim of the paper is to show the efforts made, to place an internet-based training website for ophthalmologists by transferring live ophthalmology events via the internet. The live-transfers of selected lectures is realized by transferring the original sound compatible to the software "Real-Audio-Player" with an rate of 8000 Hz (encoding-depth 14 bits). By using this software it is possible to follow the lectures live. It includes also 2 live-pictures of 2 digital camcorders to show the appropriate slides from the lecturer. The live broadcasted lectures were afterwards revised and are available at any time as "on-demand lectures" with original sound and slides. Since November 1997, 15 continuing medical education events for ophthalmologists of the University Erlangen-Nürnberg, Germany and from other universities were live broadcasted covering all aspects of phthalmology can be viewed as "on-demand lectures" with original-sound and slides under the internet-addresse http:¿www.onjoph.com/deutsch/live.html. The broadcasted events of workshops were watched via the internet with the appropriate software by 3500 persons, and approximately 5200 persons were listening at least one of the lectures since 1997.

Education, Medical, Continuing↗

The computer-based lecture.

Advancing computer technology, cost-containment pressures, and desire to make innovative improvements in medical education argue for moving learning resources to the computer. A reasonable target for such a strategy is the traditional clinical lecture. The purpose of the lecture, the advantages and disadvantages of "live" versus computer-based lectures, and the technical options in computerizing the lecture deserve attention in developing a cost-effective, complementary learning strategy that preserves the teacher-learner relationship. Based on a literature review of the traditional clinical lecture, we build on the strengths of the lecture format and discuss strategies for converting the lecture to a computer-based learning presentation.

Computer-Assisted Instruction↗

Problem-based learning within health professional education. What is the role of the lecturer? A review of the literature.

With the increasing popularity of using problem-based learning (PBL) within health professional curricula, it could be argued that the health lecturer's role in education is changing. As a lecturer, I have only recently become involved in using PBL. With increasing exposure to the process and through reviewing the literature, I have come to realise that the role of the lecturer is fraught with difficulty. The literature is often conflicting with PBL meaning different things to different people (Barrows 1986). It provides no consistent guidelines as to how the lecturer should adapt to undertake this new role. This article explores the issues around the role of the lecturer within PBL and through reviewing the literature, investigates the level of intervention the lecturer should provide when students are undertaking the PBL process. Suggestions will be made to 'facilitate' the lecturer into facilitating an effective teaching strategy.

Education, Nursing, Baccalaureate↗

Lecture versus Web tutorial for pharmacy students' learning of MDI technique.

OBJECTIVE: To compare pharmacy students' acquired knowledge and ability to assess metered-dose inhaler (MDI) technique after a traditional lecture versus a Web-based MDI technique tutorial. METHODS: All 42 third-year PharmD students completed a baseline MDI technique knowledge test and were then randomized into 1 of 3 groups. The Web group completed the tutorial on the college dispensing laboratory computers; the lecture group participated in the MDI technique excerpt of the asthma therapeutics lecture; and the control group participated in a 15-minute discussion of participants' hobbies. Afterward, participants in each group completed an identical MDI technique knowledge posttest. Students then observed a standardized mock patient perform MDI technique, documenting steps that were conducted incorrectly. MDI technique knowledge test and MDI technique evaluation test scores were compared between groups using repeated measures ANOVA. RESULTS: There was no significant difference in the baseline MDI technique knowledge test scores between groups. The post-MDI technique knowledge test scores for the Web and lecture groups did not differ significantly (p = 0.38), and both were significantly different from the control group (p < 0.001). MDI technique knowledge scores increased significantly for the Web and lecture groups from pre- to post-assessment, but did not change for the control group. A 2-way repeated measures ANOVA analysis demonstrated no significant interaction of subject and group characteristics. The MDI technique evaluation scores for the Web and lecture groups were not significantly different (p = 0.50), and both were significantly different from the control group (p </= 0.001). CONCLUSIONS: The Web-based MDI technique tutorial was as effective as the standard lecture format in pharmacy students acquiring knowledge of MDI technique and in evaluating a mock-patient exhibiting incorrect MDI technique. Further testing is required to assess the longitudinal effect of the program.

Curriculum↗

Learning to lecture: exploring the skills, strategies, and practices of new teachers in nursing education.

A common experience among new teachers is learning how to lecture. Lecturing is a skill, a strategy, and a practice. As a skill, lecturing is learned over time. For example, teachers learn how to select content to hold students' attention. Lecturing is a strategy teachers use when they want to efficiently cover a great deal of content. In addition, it is a practice that has shared meanings, practical knowledge, and language. Exploring how new teachers learn to lecture clarifies the nature, meaning, and significance of lecturing in nursing education. The study described in this article used Heideggerian hermeneutic analyses to explicate the common experiences (i.e., themes and patterns) of new nurse teachers. Learning to Lecture as a theme is described, and implications for teacher preparation and future research are offered.

Attitude of Health Personnel↗

The Dr. Fox effect: a study of lecturer effectiveness and ratings of instruction.

Students viewed one of six lectures which varied only in substantive teaching points (content) covered and seductiveness. These 207 students then rated the effectiveness of the presentation (satisfaction ratings) and completed a 26-item achievement test. Students who viewed high seduction lectures performed better on the achievement test than did students who viewed low seduction lectures. Similarly, students who viewed lectures high in content performed better on the cognitive test than did students who viewed low-content lectures. The relationship between staisfaction ratings and student achievement was not perfect. Students gave higher ratings to seductive lectures. However, ratings reflected differences in content-coverage only under low seduction conditions. The ratings were not sensitive to variations in content-coverage when lectures were highly seductive. The "Doctor Fox Effect" appears to be more than an illusion. Seductiveness affects both student ratings of instruction and achievement.

Achievement↗

A comparison of a lecture and computer program to teach fundamentals of the Draw-a-Person test.

BACKGROUND: Although computer-assisted education has been used to augment education in many areas, there are few studies of programs designed to replace lectures in a medical curriculum. OBJECTIVE: To test whether a thoughtfully designed computer program can replace a standard lecture in a pediatrics curriculum while teaching the subject matter equally well. METHODS: A computer program was developed to teach the Draw-a-Person developmental test using the multimedia-authoring tool Director. One of us (A.E.C.) tested and modified the program several times during its creation after submitting it to several objective evaluators. Thirty-nine students taking the clinical pediatrics rotation were chosen by month to interact with the program or attend the lecture. All students then scored 3 drawings and assigned them a developmental age according to the Draw-a-Person test rules. Students assigned to the computer program also completed a questionnaire evaluating the program in several subjective areas. A t test for 2 samples assuming equal variance was used to analyze the test results. RESULTS: Students receiving the lecture (control group) scored the 3 drawings as 5.43 years (age range, 4.5-8 years), 9.08 years (age range, 7-12 years), and 3.5 years (age range, 2-5 years), respectively. Those using the computer program (study group) scored the 3 drawings as 5.91 years (age range, 5-7 years), 7.68 years (age range, 7-8 years), and 4.34 years (age range, 3-5 years), respectively. The correct answers for the ages were 6, 7.75, and 4.25 years, respectively. A t test for 2 samples assuming equal variance showed that students using the computer program performed better on all 3 drawings (P<.05, P<.02, and P<.002, respectively). CONCLUSIONS: Students using the computer program were more accurate than students attending the lecture when scoring drawings and estimating a developmental age from them. These results support the conclusion that a thoughtfully designed computer program can replace a standard lecture in a pediatrics curriculum.

Attitude to Computers↗

Recruitment of college volunteers for community service organizations using the lecture method.

The present study was undertaken to determine those variables which best predict college students' reactions to lectures designed to solicit volunteers for a juvenile corrections program. One hundred and thirty-four students returned mailed questionnaires which assessed multiple variables related to: (1) audience characteristics, (2) recruiter (lecturer) characteristics, and (3) volunteer program (lecture content) characteristics. Results of canonical correlation analysis indicated that 8 of 17 predictor variables accounted for the majority of the variance in the volunteering behavior variate. Age of respondent, previous volunteer experience, overall lecture quality, understanding need for volunteer services, clarity and comprehension of volunteer roles, the value of the lecture as a significant learning experience, the opportunity for personal growth within the program, and the ability to influence existing structures were seen as important variables in predicting three volunteering behaviors. In particular, the data suggest that for recruitment programs using the lecture method recruiter characteristics have the greatest impact on soliciting volunteer personnel.

Adult↗

Stress and coping in lecturing, and the stability of responses across practice.

The central issues of the present paper are the responses to the stress of lecturing in a standardized situation, and the adaptation to this stressor across a period of real-life lecturing practice. Special attention is given to the stability of rank-order in the physiological and psychological responses to the lecturing stressor across practice. Lecturing in the standardized situation involved lecturing at the training institute to six fellow student teachers and two members of the university staff. The responses to be measured were heart rate, cortisol excretion and subjective anxiety. The results indicate that lecturing is stressful for student teachers. The adaptation in stress responses was very significant. Despite the significant reduction in the stress responses, a considerable stability of rank-order was found, indicating that subjects who were the most reactive before practice were still more reactive after practice. The implications of a high stability in reactivity are discussed.

Adaptation, Psychological↗

Listening comprehension and recall abilities in adolescents with language-learning disabilities and without disabilities for social studies lectures.

Listening comprehension and recall abilities for social studies lectures were examined and compared in 20 adolescent males with language-learning disabilities (LLD) and 29 without disabilities (WD). Subjects viewed two social studies lectures with comparison and causation expository discourse structures and verbally responded to literal and inferential comprehension questions. Regardless of lecture type or question type, the group with LLD performed significantly more poorly than did the group WD. Both groups responded accurately to significantly more inferential questions for the causation lecture over the comparison lecture. Neither group demonstrated a significant difference with respect to their response accuracy for the literal questions across lecture types.

Adolescent↗