Should Medical Students Bring Laptops to Lectures?

You can file this under, “Old man yells at cloud,” but here goes.

Twice a year now for over a decade, I’ve been lecturing the senior medical students in a therapeutics and pharmacology course. It’s an elective, but it’s very popular — most of the class takes it.

Not surprisingly, my topic is Treatment of HIV(duh) and my goal is to convey the “big picture” themes of HIV treatment and prevention — who gets treated and when, what we choose and why, the basics of pre- and post-exposure prophylaxis, the remaining challenges.

Since most of the students will never become ID or HIV specialists, I don’t go into much minutiae — no molecular diagrams of mechanisms of action, or complex resistance patterns, or immunology flow charts, or phylogenetic trees.

As a result, I stopped using Powerpoint years ago in this talk, instead making it as interactive as possible. I put a few key principles up on a white board as take-home points, and use cases to illustrate each one.

There’s only one problem — a few of the students never look up from their laptops, and hence don’t join in the process.

And nearly all of them now have laptops; the laptop-to-student ratio is very close to 1. It’s much greater than 1 if you count the other screens periodically appearing in the room (phones, tablets, etc).

It might be my teaching style that’s boring these laptop lovers, of course, or the topic (you could imagine that treatment of HIV isn’t high on the list of must-know items for future orthopedists), or some combination.

But there is evidence that laptops in classes and lecture halls impair learning. In this piece just published in the New York Times, the author cites several such studies:

A growing body of evidence shows that over all, college students learn less when they use computers or tablets during lectures. They also tend to earn worse grades. The research is unequivocal: Laptops distract from learning, both for users and for those around them.

It’s not just that some are checking emails, messaging friends, or engaging in whatever social media is currently vogue among their demographic. Their laptop activity is also making it harder for others in the class to concentrate, according to some studies.

Finally, the note-taking process itself is less effective at storing new material when it’s typed rather than written.

So “No laptops” is a “No brainer”, right?

Wait — it’s not quite so simple.

I’m one of those terrible-handwriting sorts for whom learning to type opened up a whole new way of communicating. I type much faster than I write, and my handwritten notes are often illegible. During our weekly case-conference, I type the details of the case into my laptop because I could never write fast enough longhand to get the details down.

I’m also the first to admit that the internet is the most extraordinary resource. If I mention the START study (which I inevitably do), the students can find the original reference instantaneously.

Plus, there’s the paternalism issue cited in the Times piece, which even more strongly applies to medical students:

Most college students are legal adults who can serve in the armed forces, vote and own property. Why shouldn’t they decide themselves whether to use a laptop?

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