Less Pain than Expected: Technology Changes

Technology changes were the most benign of the three, with respondents relating predominantly positive experiences through those changes. Various technology initiatives

frequently emerged as answers to the sub-question about what has been most effective about changes. Faculty have great things to say about several technologies, especially the computer-based exam software and its improved processes for grading and providing students with longitudinal data on their knowledge level in various subject areas related to USMLE Step One areas. The biggest negative around technology was a feeling from many faculty members in both interviews and surveys that since adopting lecture capture to record the majority of courses happening in the auditoria, in most classes, attendance has diminished.

This topic arose frequently enough to warrant further discussion because not all faculty believe the recordings are the root cause to diminished lecture attendance. One faculty member, commenting on the theory of lecture recordings affecting attendance said. “I think that is an urban myth. I don’t think it, in any way, diminishes attendance.” Others noted attendance wanes based on time of the year, and fatigue of students and that also occurred even before lectures were recorded. Some stated there is a certain

percentage of students who don’t go to or watch lectures. Still, these students review materials and do well enough to pass exams with self-study, and this was the same before lecture recording. Students attend less towards the end of the semesters and on weeks when they are prepping for exams.

Other respondents noted low attendance can be a result of faculty not making an effort to make their lecture sessions interactive. Some do not see a decline with students attending lectures in their classes, possibly due to topics of interest, which instructors they have teaching, and the activity happening in the lecture hall to engage students to

participate in different ways. Some instructors go beyond audience responses system questions and have students team up in small groups around the auditorium or have very engaging and participatory small group classes where students work in teams to actively solve problems or discuss a case together. Some instructors feel students will come willingly if their time is spent thinking and engaging with their peers instead of listening and watching an instructor give a talk.

This leads to an ongoing debate about whether students should be required to attend lectures in person. While some faculty recognize the value of lecture capture and recognize it may be helpful for students to have the ability to watch lectures outside of class on their own time and at their own speed, many do not enjoy lecturing to a mostly empty lecture hall. That said, others have no problem lecturing to a sparsely attended classroom, as long as the students who choose to watch lectures on their own are still learning the material. It is apparent that faculty feel differently on this topic and there is a need to come to consensus about the pluses and minuses and to encourage all to align with whatever the school’s decision is on lecture attendance (or any policy decision made related to the curriculum).

A New England Journal of Medicine opinion piece titled: Lecture Halls without Lectures – A Proposal for Medical Education, makes a strong argument for flipping all lecture content to be watched on students’ own time outside of the classroom as their homework so the valued time in class may be spent on activities that connect to higher order thinking and learning (Prober & Heath, 2012).

We propose embracing a flipped-classroom model, in which students absorb and instructor’s lecture in a digital format as homework, freeing up class time for a focus on applications, including emption-provoking simulation exercises. Students would welcome more opportunities for case-based, problem-based, and team-based exercises – strategies that activate prior knowledge. Teachers would be able to actually teach rather than merely make speeches (Prober & Heath, 2012).

Reflecting on the way faculty feel so differently about various topics related to changes and trends in teaching and learning recalls the quote in Chapter Four by an instructor who do not like how laptops have removed student eye contact with the lecturer. Prior to lecture capture’s implementation in 2006 to record the majority of first and second-year lectures, students had their heads down taking notes. When lecture capture was implemented in 2006, faculty needed to adjust to having all of those heads up and eyes looking right at them. In fact, support staff in operational roles recount having some long-time faculty members at the time expressing anxiety about how students had almost stopped taking notes and “they are all looking at me!”

Laptops began showing up on campus more frequently in the years that followed and by 2011 became a requirement for incoming BUSM medical students, which led to faculty now concerned again with students’ eyes diverted away from instructors. This is just an example of how there are always two perspectives; curricular change is an iterative process. Change will continue to occur and there will always be proponents and naysayers to each and every initiative.

As reported in Chapter Four and shown in Figure 4.3, the biggest motivator for faculty to participate in changes related to technology is due to their interest in the

initiative. When faculty experience positive results or see their peers do so after adopting, their interest level increases. Student demand is also a main driver (it was the highest response for the lecture capture initiative). This may show that faculty who are split on how much significance to place on class recordings and often bemoan its potential impact of reducing attendance, still acquiesce to student demand. This fits the theme that

instructors are primarily motivated by students, and want to create the best experience they can for them. That includes taking into account student satisfaction, which was discussed in Chapter 3.3.1.

5.4.2 A Stretch to Engage or Status Quo? – Pedagogy Changes