More About Medical Students’ Attendance at Lectures

To the Editor: Kanter’s comments about medical student attendance at lectures raise questions that have been a concern for decades.1 The decreasing attendance in formally scheduled educational sessions is not unique to undergraduate medical education and has permeated conferences such as grand rounds.2 Kanter asks some provocative questions about the learner–teacher relationship that need to be addressed, since I believe, as I think he does, that the solution to the underlying problem rests in that relationship. There are additional questions that must be posed if we are to get to the root of the problem. For example, What is the value-added benefit to students of attending a lecture, from their point of view? The answer must confront the syndrome in which faculty transmit low-level information (such as “knowing” in Bloom’s taxonomy) to learners who behave as passive receptacles waiting to be filled with factoids by faculty experts. How do faculty establish a connectedness to students that can help to dissipate this syndrome? Some of this happens through modeling humanistic behavior in teaching and creating a nurturing environment where the overall goal is to help every student attain maximal contextual learning.3 Activating students in the classroom creates a student-centered learning environment that diffuses responsibility for learning and teaching, fosters a dialogue between students and teacher, and cannot be replicated when one sits alone watching a podcast. Using team-based learning, group and dyad discussions, prelecture readings with accompanying challenging questions, and translation of theory into contextual practice are all ways that could attract students back to the lecture hall. All of these interactions require higher-level thinking and go beyond textbook reading, transcribed notes, and podcasts. So, I think Kanter’s approach is on target. The question is, What effort will it take to change our current environment to one where collaboration in learning is the major focus? Larrie Greenberg, MD Senior consultant in medical education and clinical professor of pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC; [email protected]