LLSAslideHave you ever been at a lecture where the audience didn’t seem in ‘sync’ with the speaker?  Or perhaps as a junior presenter, some of you may have been at a lecture or two that just didn’t seem to work. This month, we ask you to advise Dr. Xiu, a presenter who is experiencing this exact problem. Come out and discuss the Case of the Absentee Audience.

MEdIC Series: The Concept

Inspired by the Harvard Business Review Cases and led by Dr. Teresa Chan (@TChanMD) and Dr. Brent Thoma (@Brent_Thoma), the Medical Education In Cases (MEdIC) series puts difficult medical education cases under a microscope. On the fourth Friday of the month, we pose a challenging hypothetical dilemma, moderate a discussion on potential approaches, and recruit medical education experts to provide “Gold Standard” responses. Cases and responses are be made available for download in pdf format – feel free to use them! If you’re a medical educator with a pedagogical problem, we want to get you a MEdIC. Send us your most difficult dilemmas (guidelines) and help the rest of us bring our teaching to the next level.

The Case of the Absentee Audience

by Teresa Chan (@TChanMD)

The view from the lectern was less than inspiring. Dr. Nelly Xiu, a newly appointed Associate Professor, stood in front of a half filled lecture hall. Of the nearly forty residents and medical students who were supposed to be at the Emergency Medicine conference day*, only about half were physically at the talk. Nelly viewed the learners, watching them pull out their computers, smart phones, and the occasional journal, and wondered if any of them were mentally present.

At the end of her lecture, the tepid applause from the audience further reinforced her impression. Nelly was surprised when the chief resident, Andrew Smith, came up to chat with her after her lecture.

“Hey Dr. Xiu, good talk. Therapeutic Hypothermia is a really important topic,” he started. “I was wondering if you’ve ever thought about doing this topic as a workshop instead?”

Nelly looked at him, perplexed by his question. Clearly the students and residents had been wholly disengaged with her lecture, couldn’t he see that?

“Andrew, this was a mandatory class, and only 20 of the 40 learners on our teaching unit came. And then the half that did come were too busy texting and emailing to listen.”

“Well, I don’t think that’s fair.  A bunch of them are post-call, some of them were still rounding with their attendings, and some of them were sick. You’re right – this is mandatory – but sometimes that isn’t enough to get people in seats anymore. And it’s definitely not enough to make sure they’re paying attention.”

Nelly pondered this thought for a moment. If the word mandatory wasn’t enough to ensure learner attendance and attention, then what would she need to do to reach her audience?

Key Questions

  1. Andrew says: “…sometimes that isn’t enough to get people in seats anymore. And it’s definitely not enough to make sure they’re paying attention.  Is he correct in his statement? Why or why not?
  2. What are some issues that occur when you make a session ‘mandatory’?
  3. As a teacher, are there any preventative measures that you can use to prophylax against an absentee audience?
  4. What are some strategies that you might advise Dr. Xiu to use in her future sessions?

Weekly Wrap Up

As always, we will post the expert responses and a curated commentary derived from the community responses one week after the case was published. This month the two experts are:

  • Dr. James Ahn (@AhnJam) is an emergency medicine physician in Chicago, IL. He is the associate program director and medical education fellowship director at the University of Chicago. His areas of interest include curriculum development and competency testing.
  • Dr. Stella Yiu (@Stella_Yiu) is an emergency physician in Ottawa, ON, Canada.  She is an assistant professor in the Department of Emergency Medicine at the University of Ottawa. She is the brains behind the Flipped EM Classroom.

On August 1, 2014 the Expert Responses and Curated Community Commentary for the Case of the Absentee Audience was posted.  You may continue to comment below, but your commentary will no longer be integrated into the curated commentary which was released on August 1, 2014.  That said, we’d love to hear form you, so please comment below!

All characters in this case are fictitious. Any resemblance to real persons, living or dead, is purely coincidental. Also, as always, we will generate a curated community commentary based on your participation below and on Twitter. We will try to attribute names, but if you choose to comment anonymously, you will be referred to as your pseudonym in our writing.

Teresa Chan, MD, MHPE
ALiEM Associate Editor
Emergency Physician, Hamilton
Associate Professor, McMaster University
Assistant Dean, Program for Faculty Development, McMaster University Ontario, Canada
Teresa Chan, MD, MHPE


ERDoc. #meded #FOAMed Own views expressed. Contributor to @ALiEMteam, @WeAreCanadiEM, ICE Blog, #FeminEM. @MedEdLIFE founder. Works @McMasterU & @HamHealthSci