Lecturers using tablet PCs with specialised pens can utilise real-time changes in lecture delivery via digital inking. We investigated student perceptions and lecturer experiences of tablet PC lectures in large-enrolment biomedicine subjects. Lecturers used PowerPoint or Classroom Presenter software for lecture preparation and in-lecture pen-based inking. Using surveys and lecturer interviews, students and lecturers were asked to reflect on their tablet PC lectures in comparison to non-tablet lectures that used prepared images and a laser pointer. Quantitative survey responses suggested that students felt that the tablet lectures were more interesting, that they were more capable of keeping up with the lecturer, and they enhanced their understanding of the lecture content. Qualitative analysis of written comments indicated that students appreciated the real-time writing and drawings, particularly because these were visible on lecture recordings. When reflecting on their non-tablet lectures, most lecturers used the pen-based writing, drawing and highlighting tablet functions and reduced lecture pace and content for their tablet lectures. Long-term tablet use led to lecturers making more use of digital inking, with less use of prepared images. Our results support the idea that tablet PC-supported lectures are conducive to improved management of cognitive load via reduced lecture pace and content.