Innovations in training

The distractions of technology in the classroom are nothing new

Sorcha Ni Dhubhghaill

Posted: Tuesday, October 2, 2018

Our colleagues in psychology describe a dual processing theory where we have two paths to reach an answer. A blazing-fast almost intuitive path, and a slower approach that requires more processing. I am reminded of this duality every time I think about how long ago 1980 was. The year I was born.
Twenty-something years ago? That sounds about right.
What I’m saying is; I don’t feel so different from the students that I teach. Sure, I am a few years older and a bit further along the road. But at the end of the day, we are in a very similar boat.
Until that boat becomes a classroom, and all of a sudden I’m like, who are these people? And would it kill them to look at me for a moment, rather than at their screens?
Nowhere do I feel the generation gap as I do when teaching young(er) students. It is something I struggle with. Not because it makes me feel old – 38 is not old and don’t you dare tell me otherwise – but because I assumed I knew a thing or two about being a student. But I find my personal experience to be increasingly meaningless.
More often than not, while lecturing, I find myself looking into a crowd of students staring into their laptops. There is no eye contact, no tangible feedback to confirm that I’m making sense. Just a sea of glowing apples. I know they are feverishly tapping away taking notes. But part of me wonders; Are they playing Fortnite right now?
I get it. The laptop is an essential piece of kit – replacing not just a pen and paper, but doubling as a storage device and a library of all published medical knowledge. No wonder every student clings to it. I would have too, had it been around.
But it can be difficult as a teacher to connect with students when all you can see is their collection of laptop stickers.
In my days, I came to my lessons armed with binders and at least three colours of pens. If only I could scribble down every word uttered by the lecturer I could perhaps understand it later. My notes were a laborious affair, multi-coloured, sorted in many folders. Yet if you were to ask me what any of them actually said, I would be at a loss to tell you. I think I may have been convinced that note-taking was a valid alternative to processing and thinking. Come to think of it, I wasn’t exactly living in the moment either. And I doubt that my lecturers got a great deal of feedback out of me, hunched over my stack of paper, taking notes as if my life depended on it.
I think the bigger change technology has brought to the classroom is the abundance of available information. The internet is full of YouTube presentations of eye examinations. And anyone who has ever studied for the MRCOphth knows well the Chua Eye Page with hundreds of MCQ self-test questions.
Against this backdrop, the idea of learning off lists of differential diagnoses becomes ever less relevant when all of them are available online. Rote learning is just not that useful any more. We are now more focused on teaching the WHY as opposed to just teaching the WHAT. Most medical schools have transitioned to an integrated curriculum with a problem-based approach. Problem-solving is a critical skill of a doctor and it is best to get them started young. It’s possible to over-correct however. Recent educational theory suggests that focusing only on problem-solving without building a permanent store of memory can hinder creativity by reducing the potential number of links that a student can make. So how can we get this balance right?
Personally, I strive to convey concepts rather than focus on the fine detail. Questions are not only welcome but encouraged. Students are free to find their own footing, and every teacher should be armed with a list of online resources to cater to different learning styles. And every now and then, I simply ask them to actively listen: “Close your laptops, I need you to pay attention to what I’m about to say.” There are other ways to teach of course; perhaps I just like an audience.
Another side-effect of all that available information is the “I read online that…” scenario. Back in the good (?) old days of education there was a joke the anatomy lecturers shared: You only need to be one page ahead of the class.
It’s funny because it was true. Lecturers pontificating from the front of the room often had a de-facto monopoly on information. Students paid better attention, because this was the only source capable of sating their appetite for knowledge.
Today, information is an all-you-can-eat 24/7 buffet, and students aren’t exactly starving. Fighting for their undivided attention is going to be a losing battle. As technology changes, teaching changes with it, and we all have to adapt. That being said, I’m still going to tell them to look away from their screens from time to time.

Sorcha Ní Dhubhghaill MB PhD MRCSI(Ophth) FEBO is an Anterior Segment Ophthalmic Surgeon at the Netherlands Institute for Innovative Ocular Surgery (NIIOS) and Antwerp University Hospital. Contact: