Originally published in Independent School, Winter 1998, pp. 84-90.

Robert L. Hampel

The lecture is out of fashion today. Elementary and secondary school teachers know that the aphorism "sage on the stage" is not a compliment; "guide on the side" is. They are embarrassed, not proud, that researchers repeatedly find that approximately 80 percent of classroom conversation is teacher talk. To prompt more student activity, teachers turn to cooperative learning, interdisciplinary units, senior projects, community service, and other techniques which have little place for lectures.

Those strategies make excellent sense, but sometimes we wholly condemn lectures and uncritically celebrate learning by doing. For a reminder of why there's no either/or, right/wrong dichotomy here, the history of medical education a century ago is very instructive. The direction of change at that time paralleled what educational reformers today embrace. Hands-on work in laboratories and hospital wards increased; large group lectures and amphitheater demonstrations decreased. Students spent more time dissecting, running tests, preparing slides, and caring for patients. By the 1920s, medical students immersed themselves in the "practical work," as they called it, much more than their predecessors had in the late nineteenth century. Everyone understood that reading and observing fell short of adequate medical training. As a famous surgeon put it, "one would not expect to play the violin after a course of lectures on music and merely by watching a performer for a few semesters."(1)

Yet students respected and welcomed good lectures. They did not reject lecturing per se as unacceptable pedagogy. Instead they carefully evaluated individual instructors, scorning some, tolerating others, and revering their favorites.

Lectures, Didactic, and Clinical

A student at the Harvard Medical School in the early 1870s, Alfred Worcester later recalled with awe the anatomy lectures of Oliver Wendell Holmes, who would hold up pelvic bones to remind the class that "under this noble arch every human being on entrance to the world reverently bows its head upon its breast." But Worcester also remembered his Obstetrics professor, Dr. Reynolds. "He was a lovable man but a poor lecturer. Fond as he was of metaphors, he often mixed them and not seldom forgot their application. In fact it was not always possible even to guess what he was talking about." Holmes and Reynolds differed dramatically as lecturers.(2)

Another autobiography not only distinguished good from bad lecturers at Harvard, but described the techniques and mannerisms the best lecturers used. Dr. Richardson illustrated surgical anatomy by sketching in colored chalk with both hands; Dr. Ernst relied on "his unusual fund of anecdote"; and Dr. Fitz used surprise—"as we never knew quite what to expect from him, he held the students' attention." All of the stars found ways to engage students. Their methods varied but each stimulated and inspired the class.(3)

Forty years after Worcester's school days, a group of students in 1910 met with Harvard's new President, A. Lawrence Lowell, to lament "sitting and being told about things." Mr. Ryder, the students' spokesman, told Lowell that "one and all say that there are too many lectures." Lowell asked if the problem lay in the sheer amount of lecturing or the manner in which professors lectured. Overload was the major problem. "The men hardly have time to digest things," Ryder replied (and Lowell later wrote that the faculty treated the students like geese to be stuffed). Ryder admitted that the men were "quite enthusiastic" about some lecturers. "In Pharmacology, I think most of the men would like to be talked to even more than they are..." The caliber of the instructors varied markedly from course to course, so "the criticism made most often is personal—men are dissatisfied not so much with the system as with the men who teach."(4)

At Harvard (and elsewhere), students wanted to see fairly basic aspects of good lecturing. They were not asking to be dazzled each and every day. For instance, simple consistency mattered. The senior professor should not let himself be contradicted by his assistants (who often ran "quiz sections"—a legacy of the old nineteenth century you-know-it-or-you-don't "recitation" more than the contemporary discussion section). And professors should not be at odds with one another. One instructor at Harvard in the 1920s criticized prescriptions of sodium bicarbonate for gastric hyperacidity, but his students saw, during hospital rounds, a colleague in his department take it daily for his ulcer.(5)

Students also preferred lecturers who went beyond the textbooks. Reviewing and repeating chapters seemed wasteful rather than helpful; quiz sections could revisit the book. As the Harvard medical students' "Board of Criticism" told the Dean in 1913, "lectures should have as their purpose keeping students abreast of the times, rather than serve merely as a condensed text book." The challenge, then, for the conscientious instructor was to supplement the text without overloading students with even more facts, terms, names, and numbers than the texts already supplied.(6)

That challenge was best met in what was known as the "clinical" lecture (what we today mean by lecture the students then called a "didactic" lecture). There could be a world of difference between those two forms of lectures. The clinical lecture might occur in a classroom, hospital, or "dispensary" (walk-in clinic). Wherever the site, it featured actual cases if possible; specimen, if not. The class was not always small in size, and frequently students had little direct or sustained contact with the patient, but these lectures were usually appreciated for their realism.

Practical Work

The popularity of the clinical lectures would suggest universal enthusiasm for the practical work, the hands-on aspects of medical school, whether laboratory investigation, service in the hospital, independent research, or "clerkships" entailing extended patient care. But just as lecturing drew its share of praise, so too did the practical work incur criticism and challenges.

Many clinicians knew very little of the basic sciences that had made dramatic strides in the late nineteenth and early twentieth century. The senior professors' ability to link practice and theory was shaky. As Dr. J. Collins Warren recalled, the older clinical faculty "clung to master-and-apprentice training methods that passed on the fruits of experience rather than scientific principles and systematized knowledge." The best history of medical education reports that "a schism arose, with practitioners viewing the researchers as impractical, and the laboratory workers disdainfully considering ordinary clinicians as unscientific."(7)

Practice by itself did not automatically reveal underlying principles. Dr. Walter Cannon, a Harvard professor who worried about the gap between theory and practice, urged Abraham Flexner, author of a landmark report on medical education, to add the words "properly conducted" after a reference to "the practical exercise" because it "may be carried out by the student in such a way that he merely follows the directions without being enlightened or stimulated." The head of the American Medical Association told Cannon's Dean, David Edsall, that the "continual insistence upon practical instruction by practical men who are to become practicing physicians" was suitable only in the unlikely event that the fundamental sciences stood still in the future.(8)

There was also the risk that students could be exploited.

Small inconveniences were hard to avoid—travel back and forth between the school and hospital fragmented the day, and the availability of "material" (as patients were called) was hit-and-miss, not always aligned with the week's reading. More complaints arose when teachers treated the students as aides rather than apprentices, "as helpers to dispatch the routine work of the clinics."(9)

Faculty more than the students worried about another problem—grade inflation in clinical course work. In the era when a B still represented honors work and A marked high honors, the B averages in most third and fourth year clinical courses alarmed the Committee on Examinations, which annually reviewed tests and grades. In 1920 the committee plotted the grades against the bell curve (which they liked) to show the "leniency" of third and fourth year grading "in an informal manner is very comfortable for the students but not conducive to real standards of scholarship." Too many B's meant that "students are deceived into believing that their clinical work does not demand the same intensity off application required by the fundamental subjects of the first two years."(10)

Lectures in American High Schools Today

If lectures were to trade on a stock exchange, their price would be lower in secondary schools than in colleges and universities. High school teachers rarely stand in front of a class and present fifty minutes of information in the fashion of so many college and university instructors. Other methods to rouse student interest—cooperative learning, cross disciplinary projects, peer coaching—define good instruction. Sometimes it seems as if the lecture has been written off entirely, rejected as unworkable in practice and unsound in principle.

I base my claim on my work with the School Change Study, an examination of how five schools in Theodore Sizer's Coalition of Essential Schools persevered and sustained momentum past the third and fourth years of reform, the time when initial efforts and first steps often collapse. From the fall of 1991 through the spring of 1994, I spent six different weeks in "Lincoln" high school, a midwestern public school well known regionally and nationally as innovative.(11)

At Lincoln High, remarkably few teachers devoted a period to lecture. How rare to see a podium, lecture outline chalked on the board, or student notebooks, all sights I notice every day where I teach. The stereotype of a teacher relying on notes, covering material which students dutifully transcribe, fit far fewer rooms in Lincoln High than it did in my won university.

That is not to say that teacher talk has stopped. In fact, it still pervades high schools. But what form does it take? Often it is off the cuff, ad hoc, and improvisational, less focused and organized than the typical college lecture. As a result, teacher directed classes do not feel as austere as high school classrooms a generation ago. On the other hand, they also lack the structure and coherence of a thoughtful college lecture.

Here is an example of a popular class filled with spur-of-the-moment teacher talk:

The students drifted into Junior Humanities in twos and threes, asked David if he had a nice spring break, and commiserated when he told them he had an earache.

For this period, David had several dozen art slides to show. "We're not testing on these, but I want you to see them. What is their value?" One student tentatively said, "so we know real art?" Instead of answering that intriguing question, David referred to a handout he'd previously given on the periods of modern art. "Don't take it out now. But remember, art will be on your final test. There will be an item about your personal style and choices in art and architecture. Keep that in mind as we look at these slides. If you were buying which would you purchase? Don't answer me right now." Then the slide show began.

He turned out the lights and flashed the slides quickly, with a few words about each. Here is a sample of his commentary:

MATISSE: "This is called red studio It's definitely red! Keep in mind Van Gogh, we are jumping from him to this."

CHAGALL: "What's that in the background?"

DUCHAMPS: "One day I had this slide in backwards and I didn't even know it!"

GRIS: "What do you think this is called? It's called breakfast."

KANDINSKY: "He died a poor man."

LEGER: "What do you think? Could you do this? Maybe on the final we should try it. My wife isn't too crazy about modern art. She bought some oils but can't do too much yet."

MONARD: "These are trendy colors people buy to put in their homes."

BIRCHFIELD: "Now who does this remind you of? Do you see texture? I sort of do. I'm not sure why."

GRANT WOOD: "This reminds me of Hallmark cards."

DeKOONING: "David gave the title (Woman II). "Maybe it was the second woman lie ever painted, I don't know. Does anyone like it.?"

MIRO: "What's dominant here? Color? Line? I don't know."

STELLA: "There's some pattern here, isn't there? Well maybe just a little bit."

ALBERS: "Why do we even need art? Does it make you smile? Can you relate to it? Why would someone pay money for this?"

Various students answered the last question, including one boy who said, "It's a way to invest excess money," a shrewd point David did not pursue. Instead, after he turned on the lights, he continued to toss out questions. "Do you want art in your home?" A few students answered briefly. One said it was "boring" and another felt it "at least takes up wall space." David then asked, "What does art say about you? My wife and I, for instance, have very different tastes. I don't like the painting of a barn that hangs in her office. It's too severe." By this time, the period was almost over. Throughout, three students kept their heads down, and one girl near David was snoring gently. David shook her, woke her up, and said, "That's my good ear you're snoring in." Then the bell rang.

A few clear, organized lectures would help contain the sprawl of David's teaching, but it would not be an easy change for him. He criticizes his instruction as already too traditional because he still tests individual students' knowledge rather than grading group accomplishments. David thinks he should in the future move in the other direction. "I'm not doing enough group work." All his recent changes have been changes have been sincere if modest efforts to loosen up—fewer recall tests, no vocabulary drills, peer revision of writing, letting students drink pop in class. He would see lecturing as regression, not progress.

Furthermore, David could not suddenly begin to lecture well even if tomorrow he decided to do so. For him too expand his instructional repertoire to include decent lectures, his knowledge of art history would have to deepen. The rambling commentary reflected an unsteady grasp of modern art (and it indicated more than the chance he was simply coming down with the flu).

I think his weakness is symptom of a larger problem in current school reform initiatives. If teaching is a triangle bounded by instruction, assessment, and curriculum, the hottest new options for teachers' professional development often focus on instruction and assessment. Experimenting with cooperative learning or trying "open ended response questions" is seductively easy when divorced from the hard work of knowing more about one's field. Curricular mastery, done well, is daunting work, and it is often less visible than instruction and assessment. It is easier to watch students clustered at tables or admire the "scoring rubric" for the state tests than to perceive the best choice of a Chagall slide. Visitors can applaud the cooperative learning and authentic assessment more readily than a deft selection of paintings.

Knowing your field well, lecturing to students: what unfashionable notions! But the history of medical education cautions us not to dismiss what is out of favor. The implication is not to reintroduce lectures into every classroom, day after day. The point is to expand teachers' repertoire, increase the range of techniques they use well, and move away from the simplistic notion that any one instructional method is right . . . or wrong.

Robert L. Hampel is a professor in the College of Human Resources, Education, and Public Policy at the university of Delaware.
 

References

1. Quoted in Gert H. Brieger, "Surgery," in Ronald L. Numbers, ed, The Education of American Physicians (University of California Press: Berkeley. 1980). p. 200. 
2. Alfred Worcester, "Reminiscences," ch. 6 (Archives, Countway Library, Harvard Medical School); for similar sketches of Harvard professors in the 1870s, see John B. Wheeler, Memoirs of a Small Town Surgeon (Frederick Stokes: New York, 1935), ch. 4. 
3. J.M.T. Finney, A Surgeon's Life (G.T Putnam: New York. 1940), p. 59. For lecturers' techniques at other medical schools, see James B. Herrick, Memoirs of Eighty Years (University of Chicago Press: Chicago, 1949), pp. 43, 50, 54, 177-78. 
4. Transcript of student and faculty conversation with President Lowell, in "Students: Comments on Curriculum, 1909-1915" in Dean's Papers (Archives, Countway Library, HMS). 
5. Second Annual Report of the Committee on Examinations (privately printed for the faculty, September, 1921), p. 27. 
6. F. Francis M. Rackemann, The Inquisitive Physician, The Life and Times of George Richards Minot (Harvard University Press, Cambridge, 1956). p. 45; Board of Criticism to Dean E. H. Richards. February 28, 1913, in "Students" file, op. cit. 
7. Edward D. Churchill, ed., To Work in the Vineyard of Surgery Reminiscences of J. Collins Warren (Harvard University Press: Cambridge, 1958), P. 202; Kenneth Ludmerer, Learning to Heal, The Development of American Medical Education (Basic Books: New York, 1986), P. 131. 
8. Walter Cannon to Abraham Flexner, January 2, 1924 (Cannon Papers, Box 92, Folder 1260, Archives, Countway Library); John Dodson to David Edsall, May 5, 1926 (Edsall Papers, Archives, Countway Library). 
9. "Report of the Administrative Board to the Committee of Full Professors in the Questions of Admitting Larger Classes to the Medical School" in "Admissions: Policies—General, 1909-1922" (Archives, Countway Library). 
10. A Critical Review of the Methods of Promotion, Examination and Grading in the Harvard Medical School (privately printed for the committee on Examinations, September 1920), p. 24. 
11. The School Change Study was supported by grants from the DeWitt Wallace Reader's Digest Fund, the Exxon Education Foundation, and the Pew Charitable Trusts. Data collected ran from 1991 to 1994. Snapshots—the feedback each school received at the end of each site visit—are available from the Coalition of Essential Schools, One Davol Square, Providence, RI, 02903. 
12. Patricia Wasley, Robert L. Hampel, Richard W. Clark, Kids and School Reform (Jossey-Bass, San Francisco, 1997), Ch. 2.