Medical students’ perspectives on effective and ineffective teaching behaviors in lectures

Mun, KwangHo; Park, Hye Jin; KwangHo Mun; Hye Jin Park

doi:10.3946/kjme.2025.336

Abstract

Purpose

Lecture-based teaching is widely used in preclinical medical education, offering a systematic way to deliver complex information efficiently. However, its effectiveness heavily relies on the instructional behaviors of lecturers. Despite its importance, limited research has explored the specific differences between effective and ineffective teaching behaviors perceived by students. This study aims to analyze these behaviors systematically to provide actionable insights for enhancing teaching competencies.

Methods

This study surveyed 92 first-year medical students to evaluate effective and ineffective teaching behaviors. A 30-item questionnaire was developed based on existing literature. Data analysis included descriptive statistics to rank teaching behaviors and chi-square tests to examine their correlations.

Results

Effective behaviors included appropriate voice volume, clear pronunciation, error-free lecture materials, clear explanations of learning objectives, and humor. Ineffective behaviors were poor voice clarity, insufficient summarization, lack of follow-up session introductions, absence of online resources, and poor interaction. Significant relationships between effective and ineffective behaviors were observed in some items.

Conclusion

The study highlights those effective behaviors, such as recalling prior learning, utilizing materials, and engaging students, enhance learning outcomes. Faculty development should focus on avoiding ineffective behaviors for novice faculty and reinforcing effective ones for mid-career faculty to improve teaching quality in medical education.

Keywords: Medical education, Medical student, Effective lecturer behaviors, Ineffective lecturer behaviors

Introduction

Despite the continuous emphasis placed on improving the quality of medical education, lecture-based teaching methods remain the primary instructional approach in preclinical curriculum [1]. Lecture-based teaching is particularly effective for delivering factual information or concepts that are uncontested, logical, and objective in a short period. It is also suitable for organizing and explaining complex or novel information in a systematic manner [2], which accounts for its widespread use in medical schools. However, it has been highlighted that the effectiveness of lecture-based teaching heavily depends on the instructional behaviors of educators [1].

The role of medical educators has been explored within the context of their roles [3], as well as their key competencies, which has been of particular interest [4]. However, there is insufficient research on identifying specific instructional behaviors that are effective in lecture-based teaching, the characteristics of such behaviors perceived as excellent by students, and how these behaviors can be effectively integrated into faculty development programs.

Existing studies have predominantly focused on positive instructional behaviors, such as perceptions of excellent teaching [5] or the characteristics of exceptional lecturers [1]. Conversely, research on ineffective teaching behaviors [6] has often been limited to certain aspects such as teacher-student relationship quality, individual teacher traits, or educational professionalism, rather than addressing behaviors directly related to lecture-based teaching. Additionally, studies examining negative instructional behaviors, such as emotional receptivity, praise, and idea acceptance, often lack direct relevance to teaching methods [6], and such research remains relatively scarce compared to studies on effective teaching.

To address these gaps, this study aims to systematically analyze the characteristics of both effective and ineffective teaching behaviors as perceived by students, with a specific focus on lecture-based teaching methods widely employed in medical schools. By identifying and categorizing effective and ineffective teaching behaviors from the students’ perspective, this research seeks to provide actionable insights for the design and implementation of faculty development programs. The findings of this study are expected to serve as foundational data for advancing the quality of medical education and offering a concrete direction for faculty development efforts.

Methods

1. Participants

This study was conducted to analyze the opinions of first-year medical students regarding the behaviors exhibited by effective and ineffective lecturers. A total of 92 first-year medical students participated in the study. All participants were provided with detailed information about the research and gave their informed consent prior to participation.

2. Development of the survey

A medical expert and a medical education expert conducted a review of literature on microteaching, surveys, and studies related to effective teaching and lecturers in medical education. Based on the survey developed by Kang [2], these experts adapted and refined the instrument to align with the context of medical education. The finalized survey consisted of 15 items evaluating lecturer behaviors (Table 1). Inter-researcher reliability was assessed using Cohen’s kappa (κ=0.42), which indicated that the strength of agreement was moderate [7]. Accordingly, students were asked to evaluate these behaviors separately for effective and ineffective lecturers, resulting in a total of 30 items.

To ensure clarity in distinguishing between students’ perceptions of the behaviors exhibited by effective and ineffective lecturers, the survey was designed to allow students to indicate whether each behavior was “exhibited” or “not exhibited” (with an option for “not applicable” when necessary). This approach aimed to provide precise insights into how students judge lecturer behavior in a medical education context.

3. Data analysis

This study employed the following analytical methods to identify effective and ineffective teaching behaviors. for deleting redundancy. First, descriptive statistics were conducted using Excel to rank effective and ineffective teaching behaviors observed during lectures. Second, chi-square tests were used to examine the association between lecturer behaviors and their classification as effective or ineffective.

Results

1. Ranking of effective and ineffective teaching behaviors

The behaviors of effective lecturers, as perceived by students, are as follows (Table 2). Effective lecturers provide lecture notes with minimal errors and include appropriate content that is not overly condensed. They also maintain an appropriate volume and demonstrate clear pronunciation. Moreover, effective lecturers clearly explain the lecture content and learning outcomes before starting the class and effectively incorporate appropriate humor during lectures.

The behaviors of ineffective lecturers, as perceived by students, are as follows (Table 2). Ineffective lecturers speak with an inappropriate volume and unclear pronunciation. They fail to summarize or emphasize the key points of the lecture at the end of the class and do not properly introduce the next session. Additionally, they neglect to upload lecture materials, questions, or opinions to the online classroom, which is not utilized as a supplementary tool for the course. Furthermore, such lecturers tend not to engage with students through email, online chats, or discussion forums.

2. Differences in perceptions of ineffective teaching behaviors based on effective teaching behavior classification

A chi-square test was conducted to examine the differences in the proportions of students’ perceptions regarding whether effective or ineffective teaching behaviors are exhibited (Table 3). The results showed that, with the exception of three items, no statistically significant differences were observed for the remaining items (p>0.05). In other words, for these three items, students’ perceptions of whether effective teaching behaviors are exhibited significantly influenced their perceptions of whether ineffective teaching behaviors are exhibited (p<0.05).

Among students who responded that the effective teaching behavior, “The lecturer began the class by reviewing the previous lecture’s content to refresh students’ memory,” was “exhibited,” 57 students (74.0%) reported that the corresponding ineffective teaching behavior was “not exhibited,” whereas 20 students (26.0%) reported it was “exhibited”. In contrast, all students (15 students, 100.0%) who responded that the effective teaching behavior was “not exhibited” also indicated that the corresponding ineffective teaching behavior was “not exhibited”.

Among the students who responded that the effective teaching behavior, “The lecturer uploaded class materials and encouraged questions or discussions in the online classroom,” was “exhibited,” 39 students (75.0%) indicated that the corresponding ineffective teaching behavior was “not exhibited,” which was more than the 13 students (25.0%) who indicated it was “exhibited.” In contrast, among the students who responded that the effective teaching behavior was “not exhibited,” 37 students (92.5%) indicated that the corresponding ineffective teaching behavior was “not exhibited,” which was more than the three students (7.5%) who indicated it was “exhibited.”

Discussion

This study aimed to examine medical students’ opinions on effective and ineffective teaching behaviors observed in a lecture-based classroom. By analyzing the differences between effective and ineffective teaching behaviors and reviewing specific teaching behaviors, this research sought to provide insights to support the enhancement of teaching competencies among medical school faculty.

Students’ perceptions of effective and ineffective teaching behaviors were not always observed as being opposites. This finding aligns with previous research stating that the qualities of bad teachers were not always opposed to those of good teachers [8]. Both effective and ineffective teaching behaviors highlighted the importance of appropriate voice volume and clear pronunciation, emphasizing these traits as fundamental behaviors that all lecturers should consider. Ineffective teaching behaviors included performances to be avoided during lectures, such as failing to introduce the next session and not utilizing diverse teaching tools to engage with students. These behaviors could be recommended as areas for improvement, particularly for novice faculty members. On the other hand, effective teaching behaviors encompassed performances to be encouraged during lectures, such as clearly introducing the lecture content and learning objectives before the class begins, as well as incorporating appropriate humor. These behaviors could serve as evaluation criteria for mid-career faculty members aiming to enhance their teaching competencies.

The differences between good teaching behaviors and poor teaching behaviors can be identified through the following items: “The lecturer began the class by reviewing the previous lecture’s content to refresh students’ memory” and “The lecturer uploaded class materials and encouraged questions or discussions in the online classroom.” The first item addresses the importance of highlighting what has been previously studied, which reflects the nature of cumulative and enduring learning activities. Highlighting previously learned information deepens learning by connecting new information with existing knowledge and provides an opportunity for students to assess their mastery of previously studied content [2]. Consequently, it plays a crucial role in stimulating students’ long-term memory and solidifying learning capabilities. The second item highlights the importance of interaction and feedback, whether during or outside class hours. Through such behaviors, students can monitor their progress, identify areas that need improvement, and address their gaps in understanding [2]. This approach not only facilitates the transmission of knowledge but also contributes to the creation of a learner-centered, dynamic, and participatory learning environment. Moreover, these teaching behaviors play a vital role in fostering students’ agency and confidence in their learning process. These two items represent the core aspects of teaching behaviors summarizing and recalling previous content and providing interaction and feedback. These items also demonstrate how such behaviors enhance students’ motivation and maximize their learning outcomes. Compared to poor teaching behaviors, good teaching behaviors hold significant implications for promoting knowledge integration and active engagement in the learning process, ultimately supporting students in achieving deeper and more meaningful learning experiences.

The design and implementation of faculty development programs centered on effective teaching behaviors are essential for enhancing the quality of teaching. However, addressing the avoidance of ineffective teaching behaviors should also be considered a critical theme within such programs. While existing research has predominantly focused on the benefits of effective teaching behaviors and their promotion, systematically identifying and mitigating ineffective teaching behaviors represents additional dimensions of comprehensive faculty development. Integrating these elements into faculty development programs supports educators in not only reinforcing effective teaching behaviors but also preventing ineffective teaching behaviors. Ultimately, this dual approach contributes to the enhancement of teaching competencies and fosters a more inclusive and effective teaching and learning environment.

This study has several limitations. First, as it was conducted at a single medical school, the generalizability of the findings is limited. Second, categorical responses were used to clarify students’ judgments; however, this approach posed constraints on statistical analysis. Third, although the survey was developed based on a teaching checklist [2], its reliable application presented challenges.

Nevertheless, the findings of this study offer meaningful implications. First, it highlights that students may perceive effective and ineffective teaching behaviors differently. Second, it provides valuable insights for designing faculty development programs in medical schools. For instance, training for junior faculty could focus on strategies to avoid ineffective teaching behaviors, whereas programs for mid-career faculty could emphasize discussions about ineffective teaching practices and prioritize the promotion of effective teaching behaviors. Lastly, this study underscores the importance of investigating not only effective teaching behaviors but also ineffective teaching behaviors in medical education, along with exploring the relationships between them.

Notes

Acknowledgements

None.

Funding

No financial support was received for this study.

Conflicts of interest

No potential conflict of interest relevant to this article was reported.

Author contributions

Conception or design of the work; KHM, HYP: data collection; KHM: data analysis and interpretation; KHM, HYP: drafting the article; KHM, HYP: critical revision of the article; KHM, HYP: and final approval of the version to be published; KHM, HYP.

Table 1.

Teaching Behaviors of Medical School Lecturer

No.	Items
1.	The lecturer started the lecture on time
2.	The lecturers explained the content and learning outcomes for the class before proceeding with the lecture.
3.	The lecturer’s voice was appropriately loud, and pronunciation was clear.
4.	A large amount of content was covered relative to the class duration.
5.	The lecturer made appropriate jokes during the lecture.
6.	There was insufficient time during class to take notes on the lecture content.
7.	The lecturer began the class by reviewing the previous lecture’s content to help students recall.
8.	The lecturer ensured students’ understanding by summarizing each topic and explaining it sequentially.
9.	At the end of the lecture, the lecturer summarized or emphasized the key points and introduced the content for the next lecture.
10.	The structure of the lecture was engaging and highlighted important content effectively.
11.	The lecture notes contained numerous errors.
12.	The lecture notes were overly condensed.
13.	The online classroom was used as a supplementary tool for the lecture.
14.	The lecturer uploaded class materials and encouraged questions or discussions in the online classroom.
15.	The lecturer communicated with students using email/online chats/discussion forums.

Table 2.

Top five Effective and Ineffective Teaching Behaviors of Medical School Lecturer

Item	Exhibited	Not exhibited	Not applicable
Effective teaching behaviors
The lecture notes contained numerous errors.	1 (1.09)	91 (98.91)
The lecturer’s voice was appropriately loud, and pronunciation was clear.	89 (96.74)	3 (3.26)
The lecturer’s explained the content and learning outcomes for the class before proceeding with the lecture.	88 (95.65)	4 (4.35)
The lecturer made appropriate jokes during the lecture.	88 (95.65)	4 (4.35)
The lecture notes were overly condensed.	5 (5.43)	87 (94.57)
Ineffective teaching behaviors
At the end of the lecture, the lecturer summarized or emphasized the key points and introduced the content for the next lecture.	11 (11.96)	79 (85.87)	2 (2.17)
The lecturer’s voice was appropriately loud, and pronunciation was clear.	16 (17.39)	76 (82.61)
The lecturer uploaded class materials and encouraged questions or discussions in the online classroom.	16 (17.39)	76 (82.61)
The lecturer communicated with students using email, online chats, and discussion forums.	17 (18.48)	75 (81.52)
The online classroom was used as a supplementary tool for the lecture	18 (19.57)	74 (80.43)

Data are presented as number of frequency (%).

Table 3.

Differences in Perceptions of Ineffective Teaching Behaviors Based on Effective Teaching Behavior Classification

Item	Effective teaching behaviors		Total	χ²	p-value
Item	Exhibited	Not exhibited	Total	χ²	p-value
The lecturer began the class by reviewing the previous lecture’s content to help students recall.				4.98	0.03
Ineffective teaching behaviors
Exhibited	20 (26.0)	-	20 (21.7)
Not exhibited	57 (74.0)	15 (100.0)	72 (78.3)
Total	77 (100.0)	15 (100.0)	92 (100.0)
The lecturer uploaded class materials and encouraged questions or discussions in the online classroom.				4.82	0.03
Ineffective teaching behaviors
Exhibited	13 (25.0)	3 (7.5)	16 (17.4)
Not exhibited	39 (75.0)	37 (92.5)	76 (82.6)
Total	52 (100.0)	40 (100.0)	92 (100.0)

Data are presented as number of frequency (%).

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