Do medical students really need lecture handouts?

Dear Sir

In their recent paper entitled ‘What happens when teachers do not give students handouts?’, the authors (Wongkietkachorn et al. 2014) present interesting findings that could influence the decision-making of medical teachers on lecture preparation, which could in turn lead to changes in the learning performance of medical students. I agree with the authors that pre-clinical students are more handout-dependent than clinical students. However, there are critical points that should be addressed before deciding to give handouts in lectures.

What competencies do teachers want their students to develop for fostering self-directed learning? Reading is one of the important skills for medical students. In that paper, only 4.7–9.7% of students were provided handouts read textbooks after lectures and before examinations. The advantages of reading are supported by a recent study showing that the percentage of expected reading is a factor involved in producing good academic results in the first pre-clinical year (Sitticharoon et al. 2014). Proper assessment drives proper learning styles. To improve reading skills, teachers should provide their students with more skill-based activities and monitor their progression with regular assessment.

It is interesting for further research to understand why, in Wongkietkachorn et al.’s work, handouts but not textbooks offer qualitative improvements to lectures. Additionally, why do students search for complete peer lecture notes instead of textbooks for topic reviewing? Detailed information for deeper comprehension of topics cannot be acquired from handouts. Indeed, their finding that GPA is not associated with any attitude towards handouts implies the existence of self-directed learning among students. Motivation may be the most important factor for learning success. A medical teacher should develop the ability to motivate students for self-directed learning, probably via intrinsic goal orientation, extrinsic goal orientation and task value.

Schedule organization may also influence learning behaviors in students. A huge amount of lecture-based teaching reduces the time for self-study and even for active-learning in class. With limited time, students would pay more attention only on the specific content their teachers talk about in class rather than seeking any content that may not be included in the examination. A recent meta-analysis of 225 studies in undergraduate science students showed that examination scores improved in active learning students, while students with traditional lecturing were more likely to fail (Freeman et al. 2014). To facilitate higher-order thinking, learning through activities with engaged students must be utilized as opposed to passively listening in class with lecture handouts.

Teaching styles change learning styles. Let us give students the opportunity to cultivate their own independent learning.

Declaration of interest: The author reports no conflicts of interest.