Lecture Halls Without Lectures – A Proposal for Medical Education

This commentary, which was published in the New England Journal of Medicine, is a must read for all educators.

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The authors make the statement that there are “…unprecedented opportunities for technological support of learners…” and we have to “…make better use of our students’ time.”

Their solution, based on Heath’s book Made to Stick is to make ideas “stickier” by capturing curiosity and using stories to create an emotional response. (click here for a great review of the book by Michelle Lin, M.D.) The third part of their solution is to embrace a flipped-classroom model (see below).

This model, which uses digital learning outside of the classroom supplemented by active learning activities during class time, has already been adopted by many programs to varying degrees. For example, the University of Wisconsin’s EM program is currently producing content from their regular didactics to be released on iTunes U. This model also has some research support, as the article itself cites. According to a meta-analysis by the Department of Education, “on average, students in online learning conditions performed modestly better than those receiving face-to-face instruction.”

I use this article in almost all of the classes, lectures, and workshops I teach about presentation design, and integrating technology into education. The challenge for most of us will be HOW do we integrate these principles into our teaching. One of the things I warn my learners about frequently is:


So, the goal isn’t to just start recording the lectures for students to watch at home. The goal is to create materials to promote learning. Presentation design principles are at the heart of this endeavor.

Embracing a flipped-classroom and developing high quality materials for learning both in the classroom and outside of class will change the educational process for the better.

“Teachers would be able to actually teach, rather than merely make speeches.”

Crazy talk!


Prober C, Heath C. “Lecture Halls without Lectures – A Proposal for Medical Education.” NEJM. 2012;366(18):1657-9

Heath C, Heath D. Made to Stick: why some ideas survive and others die. New York: Random House, 2007

Evaluation of evidence-based practices in online learning: a meta-analysis and review of online learning studies. Washington, DC: Department of Education, Office of Planning, Evaluation, and Policy Development, 2010 (http://www.ed.gov/rschstat/eval/tech/evidence-based-practices/finalreport.pdf)

Flipped Classroom

Created by Knewton and Column Five Media

Evidence-based Presentation Design: Still “Anemic”

Soon after I became interested in presentation design, I began reading everything I could find on the subject. This first led me to books like Slide:ology and Presentation Design, but I then started to find some of the original literature the principles are based on.

In March of 2007, the AAMC’s Institute for Improving Medical Education published the recommendations of a colloquium on the use of educational technology in Medical Education.

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The key finding in regards to presentation design can be summarized in the following quote:

“…participants agreed that the current evidence base for educational technology in medicine is anemic. Although numerous publications have documented the feasibility of technology to enhance learning in various settings, little is established about precisely when to employ technology during medical education, and how best to use it when it is employed.

Fast forward 3 years, and we are still looking for the answers.

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According to the author, “the majority of medical school lectures run contrary to best practices in instructional design.” I would argue this is true of the majority of ALL presentations.

What does this mean for us?

As educators, we need to challenge the current educational practices and conduct research to find the best ways to educate our learners. It also means that it is our job to incorporate best practices into our teaching. This is especially important for medical education as enhancing the learning, skills, and retention of our students may lead directly to better patient care and patient outcomes.

We can definitely cure our anemia.


AAMC. Effective Use of Educational Technology in Medical Education. March 2007. Available at: aamc.org. Downloaded May 22, 2013

Levinson, A. Where is the evidence-based instructional design in medical education curriculum development? Medical Education. 2010;44:536-7