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If you are referring to Kaplan, the lectures are conducted by PhD's and MD's. From my experience, the profs spoke very clearly and the only accent I heard was the southern drawl which you get used to pretty quicky even it you aren't from the south!
Each prof lasts about 4 to 5 days for about 8hrs each day, depending on the subject they teach.
They choose the topics and tend to lecture on high yield topics.
As far as how useful it is, it all depends on your study style. I must say though, a couple of the profs were really good, so studying was definately made easier. A couple of the profs, I'd say, were not so good and I feel as though my time would have been spent better studying those topics on my own.
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