We've all sat through lectures while struggling to keep our eyes open. Is anyone really learning anything? Probably not. However, we don't have to throw the lecture format out altogether — after all, that's what attendees expect, and they can get a little peeved when you inject too much peer-to-peer learning. “I came to learn from the experts, not Joe Schmoe,” some physicians will complain. But there is a happy middle ground, as Beverly Wood, MD, and Dixie Fisher, PhD, both with the University of Southern California, demonstrated with a lecture that was anything but a snoozer at the Alliance for Continuing Medical Education annual conference, held in January in Phoenix.

Check Those Heart Rates

Wood and Fisher explained the dynamics of group attention spans. Participants are not fully engaged at the beginning because they're trying to figure out if the speaker is authentic and knows what he or she is talking about. Once the speaker establishes credibility, after about two or three minutes, attendees' attention peaks. The bad news is that the group immediately starts to lose focus again.

“That's why it can be good to have more than one speaker,” said Wood, “because you may be able to get another 10-minute window of peak attention again” when the second lecturer takes the stage.

They also explained that a study on student heart rates in class showed they drop as time goes on until, Wood said, “if [a class continues] for 90 minutes, you have to worry that they'll be dead by the end.” Heart rates rise when someone asks a question, and at the beginning of a discussion period, but drop off fast. In order to keep those heart rates up, speakers need to break up lectures with a variety of interactive techniques.

10-minute Lectures

One common mistake speakers make is to try to cram 10 days' worth of material into an hour-long lecture, Wood and Fisher explained. Attendees get cognitive overload — that fuzzy-headed, “I know I just learned a ton of stuff, but I couldn't tell you what it was” feeling that's all too common post-lecture. Wood explained that it will be a much better learning experience if speakers pick three or four main ideas, and put them into three or four mini-lectures of 10 to 15 minutes each. In between each mini-lecture, they should insert some form of interactivity. “Active learning is more than listening,” Wood said. Speakers can present a case study and ask attendees to write down their solutions, then share the solutions with each other. “If they don't apply what they learn, it won't get cemented into their long-term memory.” The way to get that cement to stick, they said, is to have attendees analyze, read and/or write, evaluate, problem-solve, and apply the learning.

Another way to get people to synthesize the information is to ask them to take what they learned in that 10-minute mini-lecture and boil it down to just 10 words. Audience-response systems can also be good tools to use, but not if the questions being asked have only a right and a wrong answer, said Fisher. Speakers should ask controversial questions and have participants talk to their neighbor about why they answered the way they did. Whatever methods speakers choose, it's important to stimulate participants in a variety of ways — through speech and visuals, by introducing novelty, or by giving participants a chance to relax and then demanding more from them.

To demonstrate interactivity with their audience, Wood and Fisher asked attendees to identify the 10 most important roles of teachers in a lecture setting, had them write their answers on a card, then had them partner with a neighbor to share their thoughts. Then each pair reported their findings out to the group as a whole. As Fisher explained, just asking the group as a whole to raise their hands can satisfy the extroverts among attendees, who have no problem coming up with an answer off the bat. But introverts need a little more time to process their thoughts, and giving them a few minutes to write down their answers caters to their needs as well as those of extroverts, who have a grand time reporting out to the larger group.

Interaction Phobia

Wood and Fisher asked their session attendees if their speakers embrace this type of instructional change, and attendees just laughed. Obviously, there are obstacles that prevent speakers from injecting interactivity into a lecture. Again practicing what they preached, they asked attendees to partner with a neighbor and come up with 10 barriers to change. Then they asked attendees to exchange their list with a different pair's list, critique it, add anything else they could think of to their new list, and share the results with the larger group.

Attendees said that speakers were reluctant to deviate from lectures because they haven't been exposed to interactive techniques, they were concerned they didn't have time to incorporate interactivity and still get all their points across, and they were afraid of doing something different. Some thought there was an ego factor involved (speakers are, after all, the experts), and that some speakers might be afraid they couldn't come up with answers to attendee questions. Here are a few tips: To encourage speakers, give them a format sheet that outlines what you expect them to do, and ask them to prepare several case studies that can be injected into the talk every 10 to 15 minutes. Explain that speakers who use these techniques generally get the highest ratings from attendees, which could appeal to their egos.

Goose Their Memory

“We work with two memory channels: One that deals with the written word and graphics, the other with verbal information,” said Wood. “Using both channels by including graphics increases learning and attention.” She explained that graphics can condense the information in the text, but shouldn't be used as just decoration. Graphics can help people organize their thoughts. Visual jokes are good, but only if the speaker can pull them off (and not everyone can). “Sometimes you will remember a graphic better than the verbal information. And they don't have to be fancy — a line drawing works as well as an artist's rendering” for most lecture topics, Wood said. A diagram, for example, can help people interpret the information in a different way than they would just hearing the words.

Remember that participants don't learn during the lecture, said Fisher, if you don't give them ways to glue that learning into their long-term memories there and then. “Talk no more than 15 minutes, then do something different that engages them. It's during those two or three or five minutes of engagement that they are learning by applying the information you just gave them.” And, she added, “The denser the lecture, the shorter it should be.”

According to Wood, the key question to ask your speakers is, “Can you walk into the room and do what you're going to do even if there are no learners in the room? If so, don't do it.”