Delivering Effective Lectures

JHPIEGO Strategy Paper • December 1996

Introduction

The lecture in its many forms is the most commonly used method for transferring
information in medical education. There are, however, serious questions regarding the
effectiveness of the traditional lecture approach. Arredondo et al (1994) point out that,
although the lecture method is used extensively in medical education, academic physicians
often are not trained in giving effective lectures.

There presently are many calls to move away from the traditional lecture to interactive
computer learning systems that allow students access to information when and where they
need it (Edlich 1993; McIntosh 1996; Twigg 1994). While this shift to “just in time”
information provided by computer is occurring, there is, and will continue to be, a need for
educators who are prepared to deliver lectures.

According to Swanson and Torraco (1995), the lecture was established formally centuries
ago as a teaching process that began with a literal reading of important passages from the
text by the master, followed by the master’s interpretation of the text. Students were
expected to sit, listen and take notes. In writing about the lecture method in medical
education, Vella (1992) defines the lecture as the formal presentation of content by the
educator (as subject matter expert) for the subsequent learning and recall in examinations
by students. Ruyle (1995) describes the lecture simply as an oral pre-sentation of
instructional material.

The purpose of this paper is to:

• examine the characteristics of a lecture,

• offer suggestions for planning and delivering more effective lectures, and
• recommend ways to evaluate lectures.

Characteristics of the Lecture Method

Lectures in medical and healthcare education often have a poor reputation. Edlich (1993)
argues that the lecture format for large classes is outdated and ineffective. McIntosh (1996)
observes that lecturing is frequently a one-way process unaccompanied by discussion,
questioning or immediate practice, which makes it a poor teaching method. So why do we
lecture? Most educators learn how to teach based on their experiences as students. This
“teach as I was taught” approach tends to perpetuate the lecture as a passive, one-way
method of transferring information. The lack of faculty training in presenting effective
lectures, rather than the method itself, may be the greatest weakness of the lecture.

Lectures are generally described from the instructor’s point of view, and the student’s need
for interaction with the instructor is not addressed. In fact, lack of interaction is considered
one of the major limitations of the traditional lecture (Munson 1992). Furthermore, when
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students have copies of the lecture notes or a text, a significant percentage would prefer
reading them rather than attending classes that offer little or no interaction (Edlich 1993).

In a 1993 study of the clinical teaching skills of medical student tutors, Price and Mitchell
suggest that, “Clinical teaching and learning must be an intellectually challenging
experience whereby students, through extensive interactive teaching, are able to gain
thorough conceptual understanding.” Price and Mitchell also cite evidence that interactive
learning is enhanced through the effective use of key teaching skills including questioning,
demonstrating, providing positive reinforcement and reviewing.

Similarly, in support of the lecture method in medical education, Vella (1992) recommends
the use of active learning activities including analysis of case reports, problem-solving
exercises, student presentations and students working cooperatively in groups. According
to Twigg (1994), recent studies have shown that the majority of college students are active
learners requiring learning experiences that engage their senses. Cavanagh, Hogan and
Ramgopal (1995), in assessing learning styles of student nurses, recommend using a variety
of teaching styles with an emphasis on participatory and experiential learning.

Table 1 compares the effective to the ineffective lecture. In the effective, active lecture the
instructor involves students through a highly interactive and participatory approach using a
variety of teaching techniques. Because of the questioning, interaction and involvement,
students are actively engaged and connected to the educator. By contrast, in an ineffective,
passive lecture, the instructor stands at a lectern and speaks with minimal student
interaction. Not surprisingly, after a few minutes students find it difficult to concentrate, as
there is little or no stimulation.

Table 1. Characteristics of the Effective and Ineffective Lecture

Characteristics of the Effective Characteristics of the Ineffective Lecture

Lecture
Educator-student interaction 100% educator talk, with limited or no
interaction
Two-way communication One-way communication
Educator-student questions Few if any questions (educator or student)
Shared responsibility for active learning Student depends on educator for all information
Small group, problem-solving activities No student activities
Variety of supporting media No supporting media
Limited note taking required (students Extensive note taking required
have copies of lecture notes)

Efforts to improve the teaching of medical and other healthcare professionals must focus on
changing the role of the student from passive observer to active participant. In this
approach, the responsibility for meeting learning objectives is shared by the instructor and
each student. One of the most important steps in achieving this shared responsibility is
careful planning. First, however, the instructor must be sure that the lecture is appropriate
for the particular learning situation (Table 2). When properly planned for the appropriate
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type of material, the lecture can be a very effective method of transferring information to
students.

Table 2. When to Lecture

Lecture is appropriate when: Lecture is not appropriate when:

Disseminating information quickly to a Presenting complex, detailed or abstract
large audience information
Presenting new information before using Dealing with information concerning
other media or activities (e.g., a brief lecture feelings and attitudes
before playing a videotape)
Providing an overview of a topic Training in psychomotor (hands-on) skills
Arousing interest in a topic Teaching high-level cognitive skills (e.g.,
synthesis and evaluation)

Adapted from: Renner 1993; Ruyle 1995.

Planning Interactive Lectures

Effective lectures do not just happen—they are planned. The educator must:

• Establish the purpose of the lecture

• Consider the logistics of the lecture
• Plan a variety of approaches (e.g., use of questioning, media, small group
activities)
• Prepare a set of lecture notes

Purpose of the Lecture

The primary purpose of the lecture is to transfer information from the instructor to the
student. Before developing the content of the lecture, it is a good idea to clearly state the
purpose of the lecture. The purpose should describe in general terms what the students will
learn during the lecture. It usually is not written in measurable terms. By contrast, an
objective is a precise and measurable statement describing what the student will learn by
attending the lecture. Depending on the design of the lecture, there may be a purpose,
objective or both. In some situations the objective will also describe the criteria students
must meet in order to demonstrate they have learned the content of a lecture. Following is
an example of a lecture topic with both a purpose statement and an objective.

Lecture Topic: Development of the placenta

Purpose Purpose: The purpose of this lecture is to acquaint students with the development
of the placenta. Students will identify the placenta, types of placentation, the embryology
of the placenta and the functions of the placenta.

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Objective: After attending this lecture, the student will be able to locate the placenta,
identify the types of placentation, describe the embryology of the placenta and match the
functions of the placenta to their correct description.

Lecture Logistics

After determining the purpose and objective of the lecture, the instructor should next
consider its length. In a study of the use of videotaped lectures in surgical oncology,
Arredondo et al (1994) set the recommended lecture time at 45 minutes, including
approximately 15 minutes devoted to audience interaction. Renner (1993) recommends that
lectures last no longer than 30 minutes. Interactive lectures should last no longer than 60
minutes without giving the students a break, based on the authors’ experience.

The number of participants attending a lecture has a significant impact on how the lecture
is presented. Group size determines the use of questions, amount of interaction, selection
and use of media (e.g., overhead transparencies, slides, computer-based projections, video,
audio) and use of small group activities such as case studies, role plays and problem-
solving exercises.

The most common form of interaction during a lecture is questioning. Table 3 shows
estimates of how the number of participants can have an impact on the use of questioning.

Table 3. The Effect of Group Size on Questioning Techniques

Number of
Description of Questioning Techniques
Participants

1–20 Both educator and students ask many questions. Students discuss
lecture content with educator and among themselves.

21–30 Educator asks questions, which students answer. Students ask some
questions. There is some discussion among students.

31–50 Educator asks questions, which students answer. Students ask some
questions. There is limited discussion among students.

51–100 Educator asks questions, and only a small number of the students
answer them. Students ask some questions. Students are able to discuss
content only with other students seated near them. There is little or no
feedback to the educator.

> 100 Educator asks questions, and students raise their hands to either agree or
disagree. There are very few comments or questions from the students.
Students are able to discuss content only with other students seated near
them. There is little or no feedback to the educator.

It is important to keep audience size in mind at every step of designing the lecture. Failure
to do so will undoubtedly have a negative impact on its effectiveness.

The size and shape of the lecture room size and shape of the lecture room also influence
the design and delivery of the lecture.

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Consider several common situations.

• A room with tables arranged in a U-shape and chairs for 20 students is an ideal
format for small group lectures. It allows the presenter to interact extensively with
the students and use a variety of small group methods and media.
• A large room with 100 chairs arranged theater-style with an aisle down the middle
makes it possible for the lecturer to move up and down the aisle to interact with
students. The lecturer can ask students to turn their chairs around to form small
groups for discussion.
• A lecture hall with a sloped floor and 200 seats firmly anchored in place makes it
difficult to divide students into small groups. In this situation, one of the few
alternatives is to ask students to turn to their neighbor to discuss a question, react to
a slide or solve a problem being shown on the projection screen.

The final logistical consideration is the media equipment available. Most lecture halls are
designed to accommo-date the use of slides, overhead transparencies, video and computer-
based projections. In order to develop an effective lecture, the educator must design and
use a variety of media effectively. An in-depth discussion of developing and using various
forms of media is beyond the scope of this paper.

Lecture Components

Silberman (1990) suggests five approaches to maxi-mizing students’ understanding and

retention during lectures. These can be used to help ensure the effective transfer of
knowledge.

• Use an opening summary. At the beginning of the lecture, present major points
and conclu-sions to help students organize their listening.
• Present key terms. Reduce the major points in the lecture to key words that act as
verbal subheadings or memory aids.
• Offer examples. When possible, provide real-life illustrations of the ideas in the
lecture.
• Use analogies. If possible, make a comparison between the content of the lecture
and knowledge the students already have.
• Use visual backups. Use a variety of media to enable students to see as well as hear
what is being said.

The key to an effective lecture style is to break down the lecture into its component parts
and use a variety of approaches within each component. This is especially critical when a
group of students will be attending a series of lectures by the same educator. The three
main parts of a lecture are the introduction, body and summary.

The purpose of the introduction is to capture the interest and attention of the students. It
can also serve to make students aware of the instructor’s expectations and encourage a
positive learning climate. A good introduction is critical to the success of a lecture.

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Tips for Creating an Effective Introduction

• Review lecture objective(s).

• Ask a rhetorical question.
• Ask for a show of hands in response to a general question.
• Ask a series of questions related to the lecture topic.
• Use an interesting or famous quotation.
• Relate the topic to previously covered content.
• Use a case study or problem-solving activity.
• Use a videotape or other media.
• Show an appropriate cartoon with the overhead or slide projector.
• Make a provocative statement to encourage discussion.
• Give a demonstration.
• Use a game or role play.
• Relate the topic to future work experiences.
• Share a personal experience.
• Relate the topic to a real-life experience.

Source: Sullivan and Wircenski 1996.

The instructor can then make a smooth transition into the body of the lecture once the
attention of the students has been captured with an interesting introduction . The body of
the lecture contains the core of the information to be transferred to the students. Beitz
(1994) recommends that the instructor use brain-storming, discussions, problem-solving
activities, case studies and games to make the lecture more interactive.

The purpose of the lecture summary is to draw together the critical information presented
and ensure that students leave the lecture with a clear under-standing of this information.
The summary should be brief and address only main points. There are several techniques
which can be used to summarize a lecture:

• Ask the students for questions. This gives students an opportunity to clarify their
understanding of the content.
• Ask questions of the students. Several questions which focus on the main points of
the content may be used to summarize the content of the lecture.
• Use a transparency, slide or flipchart to review the summary points.

Lecture Notes

Many lecturers make the mistake of thinking that they know their content well enough to
deliver a lecture without notes to guide them. This is very difficult for most instructors and
usually results in an unsatisfactory experience for both the instructor and the student.
Instead, the instructor should prepare lecture notes to serve as a script or set of cues to
follow during the lecture. Lecture notes are key words, phrases and other reminders (e.g.,
audiovisual cues, questions, examples, notes for activities) organized into an outline
format. If a text rather than an outline format is used, the lecturer may begin to read the
notes and the students will become bored.

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Lecture notes help the instructor:

• Stay on topic and prevent getting lost.

• Cover the main points without forgetting anything.
• Glance at a specific point and quickly return attention to the students.
• Relax and focus on delivery instead of worrying about what point to make next.

Source: Sullivan and Wircenski 1996.

There are seven basic approaches the instructor can use to outline key points:

• Standard sheets of paper (full-page or two-column)

• Note cards
• Overhead transparencies
• Flipchart pages
• Slides
• Computer-based projections
• Pages from a report, text or manual (with notes added and key terms highlighted)

Presenting Interactive Lectures

An effective lecture can be one of the most exciting and rewarding aspects of an educator’s
responsibilities. The instructor who is able to maintain participant interest with an exciting,
dynamic delivery using a variety of instructional methods is more likely to be successful in
helping students reach the learning objectives. The time and effort invested in planning pay
off as the instructor and students interact, discuss, question and work together.

Questioning Techniques

One of the most effective techniques an educator can use during a lecture to help ensure
interaction is to ask and encourage questions. Questions can be used to introduce lectures,
stimulate interaction throughout the lecture and summarize content. Involving students
through questioning helps to maintain their attention, which is critical when topics are
complex and lectures are long. Suggestions for using questions include:

• Ask questions of the entire group. Those who wish to volunteer may do so,
although the educator must guard against some students dominating the discussion.
• Target a question to a specific student. When the audience is relatively small, this
technique can be used to involve more of the students.
• Use students’ names when asking and answering questions—this recognition is a
powerful motivator.
• Provide positive reinforcement when students respond. This praise will help to
create a very positive climate and will encourage more students to enter into the
discussion.
• Repeat students’ questions and answers to ensure that all students hear the
discussion.

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 • When a student asks a question, the educator can answer the question directly,
respond by asking the student a different, related question or offer the question to
the other students.

The key in asking and answering questions is to avoid a pattern. If the educator always asks
and answers questions using the same pattern, this critically important teaching skill will
have limited impact.

Presentation Techniques

The skilled lecturer uses a variety of approaches to involve students, maintain interest and
avoid a repetitive lecturing style. A number of techniques can be used to make a lecture
more interactive and effective:

• Use the lecture notes prepared during the planning stage. The notes include
reminders and key points in the lecture introduction, body and summary.
• Open the lecture with a good introduction designed to capture the interest and
attention of the students.
• Communicate on a personal level. The educator should attempt to relate to the
students during the lecture.
• Maintain eye contact with the students. Eye contact gives the educator feedback on
how well students understand the content and helps to communicate a caring
attitude on the part of the educator.
• Exhibit enthusiasm about the topic. Smiling, moving around the room and gesturing
with hands and arms project a feeling of energy and excitement.
• Project the voice so that those in the back of the room can hear clearly. For large
lecture halls, use a microphone if necessary, with a long cord that will permit
movement around the room.
• Avoid the use of slang or repetitive words, phrases or gestures that may become
distract-ing with extended use. Avoid the use of fillers (e.g., “um,” “er,” “you
know”).
• Use a variety of audiovisual media.
• Ask a number of questions and encourage students to ask questions.
• Provide positive feedback when students ask questions, answer questions or make
comments. Use students’ names as often as possible.
• Display a positive use of humor (e.g., humorous transparencies or slides, topic-
related stories).
• Make smooth transitions between parts of the lecture. These transitions should be
highlighted in the lecture notes and might include:
o A brief overview of the next topic
o A review of the agenda between topics
o A change of media
o An interim summary before a new topic
o An activity (case study or problem-solving activity)
o Close the lecture with a brief but powerful summary.

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Tips to Reduce Presentation Anxiety

• Avoid eating a big meal before the lecture. Not only will a full stomach make you
drowsy, but it makes it more difficult to move around the room with energy.
• Arrive early to make sure that everything is ready before the first student arrives.
• Make sure all of the media equipment is working.
• Locate and check the lighting and temperature controls.
• Decide where the lecture notes will be placed (e.g., on a lectern, desk, table) when
they are not being held.
• Have a glass of water available during the lecture.
• Go for a short walk just before the lecture.
• Look over your lecture notes one last time.
• Greet students as they enter the room. Shake their hands, welcome them to the
lecture and talk to as many of them as possible.

• Take a few deep breaths to relax before beginning the lecture.

Evaluating Lectures

Evaluation questions are easy to ask and often difficult to answer. The educator would like
to know if the lecture made a difference. How effective was the educator in transferring
knowledge to the students? Will the information have an impact? Did the students enjoy
the lecture? How can the educator improve the next lecture?

There are three formal techniques which can be used to evaluate the quality of a lecture
presentation. The first is feedback from the students and typically involves asking
students to complete an evaluation form. The second is a self-evaluation that uses a video
recording. The third formal evaluation technique involves the use of an observer (Sullivan
and Wircenski 1996). Student feedback forms are used regularly in medical and healthcare
education and will not be described in this paper. The use of video or an observer may be
new to some educators and deserves a brief description.

The most effective technique an educator can use to improve the quality of presentation
skills is to critique a videotape of her/his lecture critique. When video-taping is feasible, it
is strongly recommended that the educator periodically record lectures. Analyzing a video
allows the educator to identify positive and negative behaviors and to set specific goals for
improving the quality of lectures. The educator can do a self-analysis or may sit with an
experienced presenter who will help to analyze the lecture. In either case, the educator may
refer to a lecture skills checklist (see Appendix A) to identify presentation strengths and
areas needing improvement.

Another evaluation approach involves the use of an observer. The observer must be an
experienced presenter who watches the lecture and takes notes using a lecture skills
checklist. The educator and observer may decide to videotape the lecture also. Following
the lecture, the observer provides feedback about aspects of the lecture that were effective
and helps the educator identify those lecture skills needing improvement.
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Once the educator has received feedback regarding one or more lectures, goals can be
established for improving her/his lecture skills. The key to giving successful lectures is
practice. Using this evaluation process will result in the strengthening of positive behaviors
and the elimination of negative ones.

Follow this three-step process to conduct a self-evaluation:

• Arrange to have the lecture videotaped. Explain to the students the reason for the
recording equipment.
• At the conclusion of the lecture, distribute a student satisfaction form (if
applicable).

• Using a lecture skills checklist, watch the videotape (with an experienced presenter
if there is one) and critique the performance.

Summary

With planning and effective presentation techniques, the lecture can be a highly effective
and interactive method for transferring knowledge to students. If the lecture is carefully
planned, the educator will have a clear purpose of the lecture and will have considered the
logistics associated with the number of students, amount of time allocated for the lecture,
room size and available media. Planning will also help ensure that the educator uses a
variety of approaches to introduce, deliver and summarize the lecture. Lecture notes in
outline form will help the instructor give an effective presentation.

Other key points to remember in preparing and delivering a lecture:

• The first few minutes of a lecture are important. Plan them well!
• Verbal communication skills are critical. These include appropriate voice
projection, avoiding fillers, using students’ names, making smooth transitions, using
examples and providing praise.
• Nonverbal communication skills also are very important. These include eye contact,
positive facial expressions, gestures and movement.
• Effective questioning and interaction are critical to the success of the lecture.
Questioning skills include planning questions in advance, asking a variety of
questions, using students’ names and providing positive feedback.
• The lecture should be summarized by asking for questions, asking questions and
using media to review main points.
• An evaluation using a video recording or an observer can assist the lecturer in
assessing the quality of the presentation and improving lecture skills.

References

Arredondo MA et al. 1994. The use of videotaped lectures in surgical oncology. Journal of
Cancer Education 9(2): 86–89.

Beitz JM. 1994. Dynamics of effective oral presentations: Strategies for nurse educators.
AORN Journal 59(5): 1026–1032.

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Cavanagh SJ, K Hogan and T Ramgopal. 1995. The assessment of student nurse learning
styles using the Kolb Learning Styles Inventory. Nurse Education Today 15(3): 177–183.

Edlich RF. 1993. My last lecture. Journal of Emergency Medicine 11(6): 771–774.

McIntosh N. 1996. Why Do We Lecture? JHPIEGO Strategy Paper #2. JHPIEGO

Corporation: Baltimore, Maryland.

Munson LS. 1992. How to Conduct Training Seminars: A Complete Reference Guide for
Training Managers and Professionals. McGraw-Hill: New York.

Price DA and CA Mitchell. 1993. A model for clinical teaching and learning. Medical
Education 27(1): 62–68.

Renner P. 1993. The Art of Teaching Adults. Training Associates: Vancouver, British
Columbia.

Ruyle K. 1995. Group training methods, in The ASTD Technical and Skills Training
Handbook. Kelly L (ed). McGraw-Hill: New York.

Silberman ML. 1990. Active Training: A Handbook of Techniques, Designs, Case

Examples, and Tips . Lexington Books: New York.

Sullivan RL and JL Wircenski. 1996. Technical Presentation Workbook. ASME Press:

New York.

Swanson RA and RJ Torraco. 1995. The history of technical training, in The ASTD
Technical and Skills Training Handbook. Kelly L (ed). McGraw Hill: New York.

Twigg CA. 1994. The need for a national learning infrastructure. Educom Review 29(4–6).
Vella F. 1992. Medical education: Capitalizing on the lecture method. FASEB Journal 6(3):
811–812.

General References

Sullivan RL, L Gaffikin and R Magarick. 1997. Instructional Design for Reproductive
Health Professionals . JHPIEGO Corporation: Baltimore, Maryland. (Forthcoming)

Sullivan RL et al. 1995. Clinical Training Skills for Reproductive Health Professionals.
JHPIEGO Corporation: Baltimore, Maryland.

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