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M edical Teacher, Vol. 21, No.

1, 1999

Interactive lecturing: strategies for increasing


participation in large group presentations

YVONNE STEINERT & LINDA S. SNELL


Faculty of Medicine, McGill University, Canada

SUM M AR Y Interactive lecturing involves an increased inter- com monly considered the context for interactive lectures,
change between teachers, students and the lecture content.The use these techniques can also be used effectively with smaller
of interactive lectures can promote active lear ning, heighten atten- groups.
tion and m otivation, g ive feedback to the teacher and the student,
and increase satisfaction for both.This article describes a num ber
of interactive techniques that can be used in large g roup presenta- W hy give an interactive lecture?
tions as well as general strateg ies that can prom ote interactivity Lectures as a m ethod of teaching and transm itting inform a-
during lectures. tion have come under increasing criticism (Bligh, 1972;
Kimmel, 1992; Kroenke, 1984). O ne of the major reasons
Have you ever given or attended an interactive lecture? for this critique is the observation that lectures are less
W hat was it that made it interactive? What were your impres- effective than other methods when instructional goals involve
sions of this method of teaching? the application of inform ation or facts, the development of
W hereas much has been written about effective lecturing thinking skills, or the modi® cation of attitudes (Frederick,
and presentation skills in m edical education (Cox & Ewan, 1987; M cKeachie, 1994; Newble and Cannon, 1994). In
1988; Laidlaw, 1988; Newble & Cannon, 1994), little has addition, students are frequently seen as passive recipients
been written about the bene® ts and strategies of interactive of information, and as a result, not engaged in the learning
lecturing for m edical teachers. The goals of this article are process.
to describe the advantag es and indications for interactive However, while m any teachers accept the notion that
lectures, to discuss com mon fears and concerns about using other teaching methods m ight be better than lectures for
this method of teaching, to outline a number of interactive encouraging students to be m ore actively involved in
techniques that can be incorporated into medical teaching learning , and for promoting the application of knowledge,
at all levels, and to highlight general guidelines for successful few have the time, resources or opportunity to use the sm all
interaction and audience participation. group methods that prom ote such involvement and applica-
tion (Schwartz, 1989). Also, when done effectively, the
lecture can transmit new information in an efficient way,
W hat is interactive lecturing? explain or clarify difficult notions, organize concepts and
Interactive lecturing can be interpreted in a number of thinking, challenge beliefs, model problem solving, and foster
different ways. For som e, interactive lecturing involves a enthusiasm and a motivation for learning (Gage & Berliner,
two-way interaction between the presenter and the 1991; Foley & Sm ilansky, 1980; Frederick, 1986; Saroyan &
participants. For others, it refers to increased discussion Snell, 1997).
am ong the participants. Interaction can also refer to a The value of interactive lecturing rests on the premise
1
student’ s involvement with the m aterial or the content of a that active participation and involvem ent is a prerequisite
lecture; it does not necessarily mean that the audience has for learning beyond the recall of facts, and that students
to do all of the talking. In all cases, however, interactive m ust be attentive and motivated in order for learning to
lecturing implies active involvement and participation by occur. In sum m ary, interactive lecturing prom otes th e
the audience so that students are no longer passive in the following characteristics of effective learning.
learning process.
Interactive lecturing also implies a different way of
A ctive involvement
approaching the teacher’s role. In giving this type of presenta-
tion, the `instructor’ frequently becom es a `facilitator’ or Educational research has shown that students who are
`coach’ , and more often than not, has to modify the lecture actively involved in the learning activity will learn more than
content to allow for discussion and to try new techniques. students who are passive recipients of knowledge (Butler,
For the purpose of this discussion, the term `lecture’ will 1992; Feden, 1994; Kraft, 1985; M urray, 1991). As we have
refer to any large group presentation, at any level of the said earlier, interactive lecturing can promote active involve-
educational system. It is important to note, however, that m ent with the m aterial or the content, with the teacher, or
the num ber of students in the audience does not dictate with classmates/peers. Indeed, even students who do not
whether the lecture can be interactive. Some very sm all
groups can be non-interactive, and certain interactive Correspon dence: Dr Yvonne Steinert, Faculty of M edicine, M cGill University,
techniques can be incorporated into a class of over 200 3 655 Drummond Street, M ontreal, Q uebec, C anada H 3G 1Y6. Tel: 514-398-
stu de nts. M ore over, althoug h larg e classe s are m ost 2 698. Fax: 5 14-398-2231. Em ail: steinert@med.mcgill.ca

0142-159X/99/010037-06 $9.00 ½ 1999 Carfax Publishing Ltd 37


Y. Steinert & L. S. Sn ell

talk in class are often stimulated by questions or problem- At the sam e time, experienced teachers will tell you that
solving exercises as they think about what they would answer once you have tried an interactive lecture, it is difficult to go
in a particular situation. back to a more traditional style where the audience is more
passive and less involved. In many ways, interactive lectures
keep the teachers interested and awake as well!
Increased attention and motivation
In sum m ary, interactive lecturing encourages active
Other studies in education have demonstrated that increased participation on the part of the teacher and the student.
attention and motivation enhance memory (Gage & Berliner, This method of teaching arouses student attention and allows
1991; M annison et al ., 1994; M eyers & Jones, 1993). In for instant feedback on whether the lecture material has
fact, some authors have said that increased arousal and been understood. It also promotes a higher level of thinking,
motivation are the essential ingredients for learning, and problem solving and application of material taught. Indeed,
often are more important to retention than intelligence. interactive lecturing is a way to capitalize on the strengths of
Attention span studies have shown that students’ interest small group learning in a large group format (Butler, 1992).
and attention in the traditional lecture diminishes signi® -
cantly after 20 minutes (Frederick, 1986; Foley & Smilansky,
1980; Stuart & Rutherford, 1978). Energy shiftsÐ or changes W hat prevents us from giving interactive lectures?
of paceÐ are essential if student attention is to rem ain
Fear
focused. By changing pace and incorporating a variety of
techniques that arouse attention, interactive lectures can Whereas most teachers accept the theoretical bene® ts of
stim ulate interest and help to m aintain attention. By interactive lectures, m any will not engage in such lectures
encouraging applications to `real life’ situations or focusing for a number of reasons. M ost frequently, teachers report a
on controversial issues, interactive lectures also m otivate fear of losing control when giving such a lecture. They fear
students to read and learn more. that if the class is allowed to participate actively and ask
questions, the presenter will no longer be `in control’ , of
A `different’ kind of learning either the students or the m aterial, and that chaos may
reign. Fear of not covering all of the material , or of sacrificing
In addition to increasing student involvem ent, attention impor tant content, is anoth er com m only encountered
and motivation, interactive lecturing promotes a `higher level’ lament. It is true that the `num ber of facts’ need to be
of thinking (Low m an, 1984; M ichaelsen et al ., 1982; reduced in order for a lecture to becom e interactive; we also
Ramsden, 1992). This includes the analysis and synthesis of know that if we present too much information, students will
material, application to other situations and evaluation of retain less (McKeachie, 1994; Newble & Cannon, 1994;
the material presented. Interactive lecturing can facilitate Russell et al ., 1984).
problem-solving and decision-making, com munication skills Additional fears include anxiety about not knowing the
and `thinking on your feet’ . This is particularly important in answer to a question posed by the students, concern that a
medical education where the application and use of informa- `dominant’ group will take over and apprehension that no
tion is as important as the retention and recall of facts. one will respond to a question asked.

FeedbackÐ to the teacher and the student


The `context’ of lear ning
The importance of feedback to learning has been frequently
Time constraints are frequently mentioned as a reason for
noted (Jason & Westberg , 1991; Lowman, 1984). Interac-
not giving an interactive lecture; but again, this concern is
tive techniques allow teachers to receive feedback at a
more commonly related to the fear of not `covering’ all of
number of levels: on student needs (at the beginning, middle
the material. Audience expectations, the subject m atter and
or end of a lecture), on how the inform ation has been
the physical setting m ay also hinder an attempt to be interac-
assimilated, and on future learning directions. Students, on
tive. M any teachers believe that the basic sciences cannot be
the other hand, can get feedback on their own knowledge or
taught interactively, and that it is easier to teach the clinical
performance. For example, computerized audience response
sciences using this format. Others believe that undergraduate
system s allow for the rapid collation and broadcast of
students, because of their more lim ited knowledge, cannot
students’ responses to questions (Jason & Westberg, 1995).
participate in an interactive lecture, which m ay appear more
Quizzes at various intervals during the lecture also allow for
appropriate for postgra duate students and practicing physi-
imm ediate feedback.
cians. A nd yet, teaching experiences and th e relevant
literature do not support this position.
Increased studentÐ and teacherÐ satisfaction

In a recent study of surgical teaching, Papp & M iller (1996)


W hat are com m only used interactive tech niques?
found that faculty who involve students in their lectures by
questioning were perceived m ore favourably by students The following section provides an overview of the m ost
than those who did not. These authors also report that commonly used interactive techniques in medical educa-
students who attend lectures by faculty who ask many ques- tion. Although the indications and limitations of these diverse
tions believe that the lecture is more stimulating. Butler methods may differ, the common ingredient to all is the
(1992) found that student satisfaction with the lecture format goal of increasing student participation, attention and
increased when the students were actively involved in the motivation in the lecture process. These methods include
teaching session. the following.

38
Interactive lecturing

1. B reaking the class into smaller groups tions. It is far more useful to intersperse the lecture with
time for questions, from both the teacher and students.
Small group teaching has distinct advantages over lecturing
· B ra instor m in g : brainstor m ing refe rs to that process
in term s of promoting comprehension, application and
whereby students generate a list of issuesÐ in response to
problem solving (Butler, 1992; M cKeachie, 1994). Yet, for
a sp eci® c question or topicÐ and judgem ent of th e
m any of its proponents, small group teaching is not a cost-
responses is initially suspended (Newble & Cannon, 1994;
effective method of teaching. Incorporating small groups
Schwenk & W hitm an, 198 7). O nly after th e list is
into lectures can, therefore, be bene® cial for promoting the
completed are comm ents or critiques invited.
discussion of ideas and concepts, for exam ining issues and
Brainstorming can be used at different points in the
presenting alternatives, for encouraging the application of
lecture. At the beginning, it can be used to invite everyone
new concepts, and for foster ing problem solving and
in the group to participate and to put them at ease. For
com m unication skills. G roup discussions also give th e
example, the lecturer might start a presentation by asking
teacher an additional way of assessing student attitudes and
the class to list all the possible complications of diabetes.
beliefs.
While this is happening, the teacherÐ or a studentÐ can
Two interesting examples of this technique have been
scribe these responses on a ¯ ipchar t, blackboard or
presented by Schwartz (1989), teaching biochemistry to a
transparency, for critical review after an initial phase of
large number of students, and by Stein et al . (1990), who
accepting all ideas and statem ents. In reviewing the list,
incorporated small group teaching methods in a large group
the lecturer may decide to organize his/her presentation
setting in clinical pharmacology. The general strategy is to
around com ments made or highlight the key issues that
break the class into small groups, using a judicious rearrange-
will be addressed. Brainstorm ing at the beginning of a
m ent of seating if necessary (Gibbs et al ., 1988; Newble &
session has the added bene® t of providing an evaluation
Cannon, 1994). Small groups of between two and four
of the students’ knowledge of a particular area prior to
people may be formed among neighbours without any move-
teaching.
m ent while larger groups can be formed quite quickly. The
Brainstorming in the middle of a lecture can be helpful
selection of the most appropriate grouping will largely
to change the pace, to regain the group’ s attention, or to
depend on what you wish to achieve. Small groups may be
apply certain `facts’ presented so far. For exam ple, the
asked to discuss a limited topic for a few minutes (in what
teacher might ask the following: `What are the common
is often called `buzz groups’ because of the noise in the
side effects of antidepressant medication?’ Brainstorming
room ) or they may consider broader issues for a longer
at the end of a lecture allows the students to summ arize
period of tim e.The sm all groups can also join to form larger
the information discussed, to develop a fram ework for the
groups to further discuss the same topic or to consider a
material covered, and to provide feedback on what was
different approach to the same task (Gibbs et al ., 1988;
understood or learned.
Jackson & Prosser, 1989; M ichaelsen et al ., 1982).
· Rhetorical questions : rhetorical questions have been defined
A lthough breaking the class into sm all g roups is a
as those questions that are asked merely for effect with no
powerful and very effective technique, it is not frequently
answer expected (Webster’s Dictionary, 1977).
attempted. Once tried, however, more traditional lectures
Rhetorical questions stim ulate thought without
seem far too silent!
requiring an answer. They are frequently introduced at
the beginning of a lecture or particular segment of the
lecture, to stimulate interest in the subsequent presenta-
2. Q uestioning the audience
tion. For exam ple, one might start a lecture on Sur viving
Q uestioning the audience is probably one of the most Chan ge by asking the audience whether any of them have
frequently used interactive techniques. It is also the easiest experienced a change in the last yearÐ and whether any
to implement. Questions can stimulate interest, arouse atten- of them have survived.
tion, serve as an `ice breaker’ , and provide valuable feedback · Su rveying the class: this technique is particularly useful for
to the teacher and student alike (Knox, 1986). Q uestioning identifying audience needs and interests, for allowing
can take many forms. teachers to assess the students’ baseline level of knowledge
around a particular topic, and for arousing motivation.
· Straightforward questions: the value of effective questioning
For example, asking the students how many of them have
has been highlighted by many authors (Foley & Smilansky,
ever ha d a fracture at th e beg inning of a class on
1980; Schwenk & W hitman, 1987). Some examples of
orthopaedic trauma gets their attention very quickly!
straightforward questions include the following: `What
· Quizzes and short answers : Q uizzes or short answers can
are the common causes of right lower quadrant pain?’
be used at the beginning or end of a class to provide a
`Which therapy would you choose for the treatm ent of
`check-up’ on learning, to summarize or synthesize the
hypertension, and why?’ In asking questions of the audi-
information presented, and to point out gaps in under-
ence, it is important to remember to pose them in a
standing for both the teacher and the student. Testing
non-threatening way, to wait for a response, and to make
students at the end of a lecture can help to increase their
sure that m ore than one student has an opportunity to
retention of the information covered (Bligh, 1972; Gibbs
respond!
et al ., 1987).
Another way of using questions is to allow students to
ask questions of the teacher. The majority of lecturers
3. U sing audience responses
save time at the end of their presentation for questions
from the audience, and yet, m any of these presenters are Interactive computer systems are one of the newer ways by
often disappointed by the lack ofÐ or quality ofÐ the ques- which to promote interaction in a large group (Jason &

39
Y. Steinert & L. S. Sn ell

Westberg, 1995). By using this method, audience attention · Inviting patients to class heightens student interest and
is quickly aroused and the learner can receive immediate m otivation. This is particularly helpful when the learners
feedback on his/her knowledge in an anonym ous fashion. can interact with the patient.
Students can also compare their responses to their classmates
in an easy and effective manner (Ytterberg et al ., 1994).
The disadvantage of this method, on the other hand, is 5. Use of w ritten materials
that it can become too `gimm icky’ and some people only see Written materials are helpful to assist in the organization of
it as a gadget. It also takes more preparation on the part of key concepts, to promote the retention of information, and
the teacher because the questions have to be carefully to remove pressure on the teacher to `cover everything’ . For
selected and programm ed prior to the presentation. Another example, handouts of slides (Amato & Quirt, 1990) allow
disadvantage to this method is the fact that the questions students to participate m ore in thinking about the concepts
are usually closed in nature and spontaneous responses under discussion rather than writing down every word of
cannot be easily incorporated into the pre-set format. the lecture.
An alternative approach to the interactive computer The literature on handouts (Beard & Hartley, 1984;
system, that is much less costly, is the use of ¯ ash cards. For Butler, 1992) suggests that students achieve higher test scores
example, the teacher can project a `multiple choice’ or `true± from lectures accom panied by handouts, that students
false’ question on the overhead projector, and for each appreciate them, and that the design of the handout can
response, the students raise a different coloured card. in¯ uence note-taking practices. For example, in one study,
students preferred to write in the space between headings,
and the more space left, the more notes were taken (Newble
4. Use of clinical cases
& Cannon, 1994). Sim ilarly, Butler (1992) found that
Clinical cases can be used in different ways to bring relevance incom plete handouts promoted greater attention and reten-
to the discussion (Douglas et al ., 1988; Stein et al ., 1990). tion of the material taught. In an interactive lecture, handouts
Indeed, this is probably the second most comm on method can also structure the discussion and/or supplement the
(after questioning) used by medical teachers. The use of lecture content.
cases heightens interest and promotes problem solving in an The timing of when to distribute the handout often
effective manner. It also encourages clinical reasoning and depends on its purpose. It is useful prior to the lecture if the
makes the learning of medicine `real’ , important for junior student is to come prepared with a fund of knowledge; it is
students with limited clinical experience and for seasoned more effective at the outset of the lecture if the handout is
practitioners who can easily see application to their own incom plete; and it is most valuable at the end of the lecture
clinical practices. if the handout contains supplemental information for further
During the lecture, students can be asked to analyze or reading. Critical to its success, however, is the use of the
discuss a case that is presented on paper, on video or live. handout in class.
Case presentations can be structured in different ways, and
the objectives for its use should be clearly delineated
beforehand. For example, a brief case description can be used 6. Organizing debates, reaction panels and guests
to illustrate a particular point or support certain principles Debates can be conducted in a number of ways. For example,
being addressed, at any time during the lecture. It can also the class can be divided in two (e.g. along the two sides of
be used to get students to hypothesize about what is going the lecture hall) and the students on either side can be
on and to problem solve. asked to support two different sides of the issue (Frederick,
Alternatively, students can be asked to work through a 1986, 1987;Wilkerson & Miller, 1984). Assignment of `sides’
case in class, where the lecturer starts by giving some informa- might take place ahead of tim e or students can be asked to
tion, asks students for their hypotheses and areas for further seat themselves according to their point of view. The class
inquiry, provides additional information, and slowly works can then proceed by the instructor asking for several state-
through the case with the students. Examples of this include ments from persons seated on each side. Although neither
the following: side may contain the whole truth, it can be energizing to
· Cliff hanger cases : students are asked to read a case that defend a particular perspective. Students choosing a m iddle
outlines a complex situation and that includes a problem g round sho uld be invite d to de fend th eir reasoning.
calling for decision. The case narrative stops at the deci- Summary arguments could be made by several students
sion point but students are asked what they would do and from each `side’ .
why. In class, students have to defend the factual basis Alternatively, a number of students can be chosen from
and reasoning that led to their decision (Segall et al ., the class to debate an issue in front of the class (Herbert,
1975; Wilkerson & M iller, 1984). 1990). Peer-led debates and discussions have the advantage
· Incident type cases: students are presented with a short of enlisting class support and interest.
description of a problem situation. If they ask the right
questions, they are supplied with m ore information. As a
7. Using sim ulations and role plays
group, the students take the role of the decision maker
trying to sort out the problem. Sometimes they are divided Simulations and role plays allow students to try out a real
into team s and asked to defend their positions. Often they life situation in a `safe setting’ and to receive feedback on
work alone. The class, however, must come to a decision their experiences (Hand® eld-Jones et al ., 1993; Steinert,
that is mutually agreeable (Segall et al ., 1975; W ilkerson 1993a). By presenting students with a situation that they
& M iller, 1984). are likely to face in the future, simulations can heighten

40
Interactive lecturing

attention and clinical relevance, and involve students at a enhance student learning. Identify your fears, be willing
num ber of levels in the lecture format. Role plays can also to take a risk and maintain your sense of hum our. M ost
be used creatively in large classes. For example, students of all, be prepared for the unexpected!
can be asked to role play a doctor± patient encounter and (2) PrepareÐ and practice. M any successful teachers will tell
receive feedback from their peers. Alternatively, the teacher you that it takes longer to prepare an interactive lecture
can role play a particular patient problem (e.g. a 24-year-old than a traditional one because of the need to pare down
wom an com plaining of painful intercourse) and ask the the material and to choose your m ethodology carefully.
students to take a history. Simulations can be used effectively PreparationÐ and practiceÐ is, therefore, the key.
as well. In a presentation on Parkinson’s Disease, the teacher (3) B e clear in your objectives and cut dow n on your m aterial.
can demonstrate a number of abnormal gaits, and students W hereas it is always important to have clear objectives,
can be asked to identify the differences am ong them. this becomes even more important in an interactive
lecture. Remember that less is more; consider your three
most important `points’ and build your lecture around
8. U sing ® lms and videotapes
them . Do not try to cover every topic in com plete detail;
Film clips or videotaped vignettes can be used as a trigger to when worried about `leaving out’ too much material, or
promote discussion or to stim ulate student thinking. M ost not `covering’ everything, provide readings and handouts
often, the objective is to elicit an emotional as well as a to supplement the material. Always ensure that your
cognitive response in the viewer and to `trigger’ meaningful methods match your objectives.
discussion (Segall et al ., 1975). For example, a short vide- (4) Prepare students for their role in interactive lectures. As
otaped segment can be used to illustrate a challenging patient teachers, we cannot assume that students will know
interview and the students m ay be asked to react to what how to participate in a lecture or what behaviour is
they saw. appropriate. Accustomed to being passive, students must
Film s or videotapes used for this purpose should usually learn to become active participants in the process of
be brief in duration and present only part of a situation in learning, and we m ust prepare them to do this over
order to promote further inquiry or discussion. Videotapes tim e. Setting rules at the beginning of your lecture and
are also useful for examining student attitudes and skills outlining how your session will be conducted is one way
(Steinert, 1993b). of preparing your students for taking an active role in
the process of learning.
(5) Remain ¯ exibleÐ and do not overdo it. M any teachers,
9. Audiovisual aids
once introduced to the concept of interactive lecturing,
Certain audiovisual aids facilitate interaction m ore than want to immediately apply their newly acquired skills.
others. Overhead projectors, for example, allow the presenter Remember to focus on one new technique at a time,
to maintain eye contact with the audience, to record audi- and to rem ain ¯ exible. Finally, be prepared to abandon
ence responses, and to change the order of the presentation, your prepared agenda!
which is not easily achieved when using 35 mm slides. Flip-
charts and whiteboards allow for the creation of diagram s
or content during the lecture and easily perm it the scribing C onclu sion
of students’ answers to questions, problem solving exercises
As Frederick (1986) has said, the lecture method is here to
or d ebates. M ultim edia presenta tion s and com pu ter-
stay. By using interactive techniques and strategies, students
assisted learning also promote interactivity.
will becom e more involved in the learning process, retain
m ore information and be more satis® ed. So will the teacher!
10. U sing effective presentation skills

Although the focus of this discussion is not on effective


A cknowledgem ents
presentation skills per se, the presence or absence of such
skills can determine the effectiveness of an interactive lecture. G rateful appreciation is expressed to the members of the
Clearly, if one does not have eye contact with the students M cGill Faculty Development Advisory Com mittee, Drs
or scan the audience, the lecture cannot be interactive! Larry Conochie, Peter M cLeod and Louise Nasm ith, the
Similarly, the physical setting (e.g. a long, steep lecture hall group leaders and co-leaders of our workshops on Interac-
vs one where members of the audience can see each other) tive Lecturing , and the workshop participants, who have all
can hinder or facilitate interaction. contributed to the ideas expressed in this m anuscript.

W hat general strategies w ill help us to becom e m ore


N ote
interactive?
[1] The word `student’ will be used to represent students at
The previous section outlined a number of speci® c interac-
all levels of medical education, including undergraduate
tive techniques that teachers m ay consider using. The
students, postgraduate students or residents, and prac-
following general principles m ay help them to become m ore
ticing physicians. M oreover, although most of the
interactive.
examples used in this discussion refer to undergraduate
(1) B e w illing to take risks and overcom e your fears . As we and postgra duate education, the strategies suggested
have stated earlier, giving an interactive lecture can be apply to continuing medical education and faculty
very risky, but taking the risk is worthwhile if it will development activities as well.

41
Y. Steinert & L. S. Sn ell

Notes on contr ibutors K RAFT , R.G. (1985 ) G roup-inquiry turns passive students active,
College Teachin g, 33, pp. 149± 154.
Y VONNE S TEINER T , Ph.D. is a clinical psychologist in the Depart-
K ROENKE , K. (1984 ) The lecture m ethod: w here it wavers, Am er ican
ment of Fam ily Medicine at the Sir Mortim er B. Davis Jewish G eneral
Journal of M edicine, 77, pp. 393 ± 396.
Hospital and M cGill University and Associate Dean for Faculty
L AIDLAW , J.M . (1988 ) Twelve tips for lecturers, M edical Teache r, 10,
Developm ent at McGill U niversity in M ontreal, Quebec.
pp. 13± 17.
L INDA S N ELL , M.D., M.H.P.E., F.R.C.P.C. is the Director of the L OW M AN , J. (1984) Mastering the Techniques of Teachin g (San Francisco,
Division of G eneral Internal M edicine and Associate Dean for Jossey-Bass).
Continuing M edical Education at McGill U niversity in M ontreal, M ANNISO N , M., P ATTON ,W. & L EM ON , G. (1994 ) Interactive teaching
Quebec. Both authors have been actively involved in planning and goes to U ni: keeping students awake and learning alive, Higher
presenting program s designed to improve the teaching and lecturing Education Research and Development, 13, pp. 35± 47.
skills of health care professionals. M C K EACHIE , W. (1994) Teachin g Tips (Lexington, MA, D.C. H eath
and Co).
M EYERS , C. & JO NES ,T.B. (1993 ) Promoting Active Learning: Strategies
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