Teaching large groups
BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7386.437 (Published 22 February 2003) Cite this as: BMJ 2003;326:437
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Cantillon claims “Whatever their reputation, lectures are an
efficient means of transferring knowledge and concepts to large groups.”
Not only does he disarmingly beg the question, but where is his evidence
of this claimed efficiency? Traditional lectures are like radio
broadcasts: somewhere, somebody may be listening.
My father, an anatomist, equipped with a class list, would ask a
question, get everyone to write down their answer, then pick a name and
ask what they had written down. Made everyone think .
His mentor was a surgical anatomist in London in the 30s, whose first
lecture consisted of three sentences: “Gentlemen, today we will discuss
the surgical anatomy of the stomach? Are there any questions? If not,
tomorrow we will discuss the surgical anatomy of the breast.” Never was so
much learnt by so many in so short a time as in the succeeding sessions.
Considering the number of man- and woman- hours they consume,
traditional lectures should be regarded like truffles or caviar and
indulged in as rarely.
Competing interests:
None declared
Competing interests: No competing interests
If the lecture's strength is its ability to simply and quickly
disseminate information to learners, it should proceed without
interruptions. Strategies that invite learner participation such as
brainstorming, asking questions of students, having students ask
questions, and buzz groups better fit in small group sessions.
These strategies undermine the suggested efficiency of the lecture
strategy, diminish the emphasis on quality of the lecture, and
ignore the fact that the student too has responsibility for getting the
most out the lecture. Active learning strategies in the lecture hall
such as note taking are waning with the advent of electronic slide
presentations that can be sent electronically to the student.
However, diminishing the emphasis on excellence in organization,
content, and delivery of the lecture by promoting interactivity is not
a good tradeoff. Only with continued emphasis on the best
practices in lecturing can we then capture the worthwhile lecture
for the purpose of sharing it electronically across institutions.
Competing interests:
None declared
Competing interests: No competing interests
Many years ago, a colleague who specializes in adult literacy
teaching told me that one does, indeed, have to wait a considerable time
for an answer to a question posed to a group. To avoid the trap of
answering the question yourself, she advised watching the clock and
waiting for at least 60 seconds before saying anything further. Watching
the clock provides a psychological prop for the questioner. She went on to
say, that if you're really serious about responses to questions, to wait 5
minutes by the clock, because no-one can stand a silence that long. I have
found this technique immensely useful in lectures and meetings
(particularly World Health Organization meetings where participants need
not only to change their thinking from listening to expressing, but also
need often to change their language).
Competing interests:
None declared
Competing interests: No competing interests
For many years in this department, we have followed up lectures with
structured tutorials. A list of questions for each tutorial is given in
the course manual, and students are asked to prepare their answers as part
of the learning process, with the lectures as a starting point, and self-
directed learning as supplementary. Some lectures may be followed by more
than one tutorial, and most answers emerge in the course of lectures.
Feedback suggests that linking lectures with structured tutorials is
helpful to students. Tutorials are also useful for discussing any
misconceptions.
Competing interests:
None declared
Competing interests: No competing interests
Use of cell phone Short Message Service (SMS) for teaching and learning feedback
Lecturing, or large-group teaching, is one of the oldest forms of teaching but tends to encourage passive learning and scant interaction between lecturers and students (1). Feedback systems are necessary to promote highest teaching standards and to ensure students achieve their learning objectives (2). The University of Granada (Spain) has successfully piloted a system for evaluating teaching and learning that takes advantage of the cell phone short message service (SMS).
SMS is widely used by adolescents and university students in Europe. It offers communication via text messages containing up to 160 characters. It is inexpensive and requires no immediate voice response. In Spain, virtually all students own a cell phone, and the University of Granada has developed a service that uses SMS messages to deliver real-time evaluations of the quality of teaching (dichotomous questions or Likert scale) and learning (multiple choice questions), to facilitate lecturer-student interaction, and to transmit news.
Lecturers registering with the service, known as SUMVM (Servicio Universitario de Mensajes Via Movil), are assigned user names to give their students. Students subscribe by sending the text “subscription to user name” to SUMVM. Each user name designates a group formed by a lecturer and the students subscribed to this name. Upon subscription, students receive a message containing seven toll-free phone numbers that can be dialled to register one of the following responses: 1) Yes/True, 2) No/False; 3) A/Very well/Completely agree, 4) B/Well/Agree, 5) C/Average/Indifferent, 6) D/Badly/Disagree, 7) E/Very badly/Strongly disagree.
Lecturers send SUMVM the message for their group (Figure 1), beginning with the user name and the transmission time. Students only dial the appropriate toll-free number in response. SUMVM automatically counts the calls received by each number and immediately sends the lecturer the results in percentages by SMS or e-mail.
Figure 1. Schematic diagram of the use of cell phone Short Message Service (SMS) for teaching and learning feedback. (1) Lecturers communicate to a central communication the question or information they want to transmit to their group of students, (2) the question or information is transmitted to the appropriate student group, (3) students answer to questions by dialling pre-specified toll-free number corresponding to the response of their choice, (4) the central communication unit automatically counts the calls received by each number and sends the lecturer the results in percentage. All the information is handled anonymously and can be processed in real time.
SUMVM is being piloted at the Schools of Medicine, Occupational Therapy, Sport Sciences and Education Sciences. Interim results are highly promising. All (100%) of the 650 students and nine lecturers taking part evaluated the interest and usefulness of SUMVM as very high or high (Likert scale) and all considered it easy to use.
The design of any method for student assessment of teaching must address issues of competence, ownership, anonymity, and feedback (2). SUMVM limits question models to areas in which the students have appropriate competence, and lecturers and students have been encouraged from the outset to feel a part of this service, which is entirely voluntary. Anonymity is preserved because SUMVM only processes cell phone numbers, never names.
The ability to have real-time exchanges of information means, for example, that a lecturer can send brief questions to students the moment the lecture is over and can immediately discover whether learning objectives were met. These data instantly inform the lecturer about the efficacy of teaching strategies and methods and can identify areas for improvement.
Lecturers have also used SUMVM to update students on timetable changes, materials needed for classes and new bibliography, among other information.
Acknowledgements: SUMVM is funded by the University of Granada. SUMVM web page is www.ugr.es/local/sumvm.
References:
1. Cantillon P. ABC of learning and teaching in medicine: Teaching large groups. Brit Med J 2003; 326: 437-440.
2. Morrison J. ABC of learning and teaching in medicine: Evaluation. Brit Med J 2003; 326: 385-387.
Competing interests:
None declared
Competing interests: No competing interests