Randomized comparison of student-activating and traditional lecture: no learning difference

Dear Sir

New forms of inter-active lecturing have been integrated in problem-based curricula. The assumption is that this is superior to the traditional lecture format with regard to learning efficacy. However, few comparative studies have been published. We have performed a randomized study of immediate recall of subject matter and understanding comparing a student-activating and a ‘traditional’ lecture format. Our hypothesis was superiority of the student-activating lecture format.

Half of the students (n = 50) had a dialogue-type lecture with problem-solving breaks. A case was presented for peer discussion with neighbours (‘bee-hive discussion’). A general discussion in the whole group was then led by the lecturer, who also elaborated. This cycle was repeated 7 times during a 1.5 hour lecture. The problems discussed were both clinical (diagnosis and treatment of inflammatory-induced anaemia) and theoretical (pathophysiology, erythropoiesis homeostasis and iron metabolism).

The other half of the students had a ‘traditional’ lecture with the same slides that were used in the student-activating lecture with questions encouraged.

Both lectures were given by the same experienced senior professor who previously used both formats for this subject. At the end of the lecture, a 15 minute written MCQ test of understanding and knowledge capture was given with questions both on details and more complicated issues on a higher taxonomy level.

No significant difference between the groups (n = 50 in each group) could be seen in the total score (mean 101.5 vs 101.6 points, p = 0.12, NS) or for any type of question, be it simple facts or more complicated mechanisms, which also means that there was no correlation with the taxonomic level of the questions. Student satisfaction with form and content was high and similar for both formats (5.0 and 5.2 out of 6). Self-rated learning efficacy was similar in both groups. Several explanations for the lack of difference are possible, including the possibility that there actually is no difference in efficacy between a good ‘traditional’ lecture with questions encouraged and a peer-interactive format with plenty of interaction with the subject matter. It is still possible that long term retention would differ between the groups. The results indicate that the presently accepted assumption needs supportive evidence.