Class Lectures in Medical School – Nearly Obsolete?

The University of Vermont’s College of Medicine advertises “no lectures required.” And empirical enquires show that content heavy, PowerPoint loaded, lectures are ineffective. But a thoughtful article in the New England Journal of Medicine [1] suggests that the class lecture should change rather than go. In fact, the classroom is well suited to active learning, with students who have already assimilated the core material at their own pace through private study. The lecturer interacts with the students who sit around tables and are provided with opportunities to discuss issues in small groups as the need arises. I learned that this is called the ‘flipped-classroom’ approach. Such an approach resulted in better outcomes when compared to traditional problem-based learning approaches in a randomised trial.[2] So a little bit of this and a little bit of that. And there is still a place for a little theatre. As to problem-based learning as a method to propel a new topic – forget it. It is sub-optimal, as discussed in a previous News Blog.[3]

— Richard Lilford, CLAHRC WM Director


  1. Schwartztein RM & Roberts DH. Saying Goodbye to Lectures in Medical School – Paradigm Shift or Passing Fad? N Engl J Med. 2017; 377(7): 605-7.
  2. Krupat E, Richards JB, Sullivan AM, Fleenor TJ Jr, Schwartzstein RM. Assessing the effectiveness of case-based collaborative learning via randomized controlled trial. Acad Med. 2016; 91: 723-9.
  3. Lilford RJ. Bring Back the University Lecture: More on Evidence-Based Teaching. NIHR CLAHRC West Midlands News Blog. 26 September 2016.

One thought on “Class Lectures in Medical School – Nearly Obsolete?”

  1. Richard, did you mean to say that it is content, not context heavy lectures are ineffective? … and it also interesting that you consider PBL has already become “traditional”. I would argue that if a lecture changes to the style to be used in Vermont (active learning classrooms with students in small groups) then this approach to teaching cannot really be called a lecture. Flipped classrooms are similar to what one might see in a typical primary school – and we would never “lecture” primary school children. Of course, there is no clear line between classroom-style teaching and a lecture and hybrid styles are also likely to be effective. Students may well learn best in small group sessions facilitated/taught/led by a faculty member but this approach clearly has implications for the cost of delivering education. Do they learn so much better that we could eliminate one year from the programme? Or are the gains in student satisfaction so large that universities reap the benefits from improved NSS score?

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