Out with the Old – In with the New

It’s been three years since I last went to a national conference aimed at primary care clinicians in Australia. Workshops aside, I was so disappointed with the content and general lack of engagement with attendees at RMA2012 that I vowed never to return and even blogged about the experience in “is the medical conference dead?

Please – no more turgid medical conferences with poorly delivered powerpoints [image courtesy Dr Andy Buck @edexam]
My negative experience in late 2012 meant that I was ambivalent about attending smacc2013 in Sydney – but curiosity got the better of me.  Suffice it to say, the smacc experience was a revelation as well as a revolution.  Short talks from experienced clinicians.  Story telling interspersed with science.  Innovative ideas.  And the whole edifice built upon relationships engendered through the FOAMed community using social media. Since then I’ve spoken at smaccGOLD and smaccUS – although I’ve opted to have a break and not to speak at smaccDUB next year. On the way my presentation skills have improved – but I still have a lot to learn.  You can see some of the smacc talks here.

This week I am in Melbourne at the GP15 conference. I was pleased to see that GP15 has a fairly active social media engagement, with many attendees (particularly those from the GPs Down Under Facebook group) tweeting about their experience. But one common theme stood out – apart from the workshops, the vast majority of the conference presentations were abysmal.

I should qualify that – the speakers were clearly highly-educated researchers and passionate about their work…but the delivery SUCKED. With a few exceptions, most talks were characterised by dense slides packed full of text, complicated diagrams and a complete failure to engage with the audience.

Be very clear, if you get up and say “I am sorry but this is a busy slide” you are actually saying “I don’t give a **** about my audience”

Ditto if the presenter over runs time, cannot control the AV equipment or reads the words on the slide aloud…word…by word….

As a result, audiences were bored and many of us frustrated with the experience.

I appreciate that very few of us have any training in presentation – and some clinicians are naturally gifted orators.  Sadly many (I am one) have to work at it. But it’s worth investing the effort – otherwise perhaps you shouldn’t be presenting!

The New?

I would really like there to be clear instructions to future presenters at such conferences – as well as to offer workshops in different topics – presentation skills, use of social media and clinician self care being some obvious ones.

Of course some of the problems with a turgid conference aren’t on the presenters – the organisers need to be clear about WHO the audience is.  They also need to ensure that content is themed into appropriate streams (as I found out at GP15, there’s no point talking on rural emergencies in the middle of a session on diabetic eye disease!).  A diligent organiser would also ensure that speakers understood the basics of presentation and vetted their slides prior.

It’s a year to the next GP16 Conference in Perth.  Plenty of time to implement some preventative medicine. In the meanwhile, here’s a quick run down of do’s and don’ts…

Know your audience

It’s old advice, but I am not sure people pay enough attention to this.  Consider carefully:

  • What are they like? Imagine them on a personal level. Are they old clinicians, weary from life at the frontline? Are they new doctors thirsty for knowledge? What experience do they bring to the room?
  • Why are they here? What do they think they’re going to get out of this presentation? Why did they come to hear you? Are they willing participants or mandatory attendees?
  • What keeps them up at night? Everyone has a fear, a pain point, a thorn in the side. Let your audience know you empathize—and offer a solution.
  • How can you solve their problem?What’s in it for the audience? How are you going to make their lives better?
  • What do you want them to do? Answer the question “so what?”—and make sure there’s clear action for your audience to take
  • How can you best reach them? People vary in how they receive information. This can include the set up of the room to the availability  of materials after the presentation. Give the audience what they want, how they want it.
  • How might they resist? What will keep them from adopting your message and carrying out your call to action?

I can almost hear some of the speakers at GP15 whine “But that sounds like a marketing pitch – I was there to tell everyone about my research data“. You know what? I don’t care about your research.  And if I don’t care, the presentation is doomed.  The star of the presentation is the AUDIENCE – the speaker is merely there to facilitate their knowledge, feeding into existing experience and offering a solution to a problem that they can connect with.

To put it bluntly, if you cannot deliver your message in a three sentence “elevator pitch”, then you shouldn’t be speaking.  Which leads nicely on to…

Presentation is about story…

My mate Ross Fisher at P3 Presentations explains this well.  Start with a piece of paper. Tell a story.  Make sure your talk will engage the audience at an emotional level – make them WANT to listen.


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 Ross blogs under P3 Presentations – Ross’ site is a wealth of resources and thoroughly recommended.

P3 (presentation) is the product of  story (p1) x supportive media (p2) x delivery (p3)
Nancy Duarte builds upon this, emphasising the need for the content fo a presentation to resonate with the audience
  • Connect with your audience empathetically
  • Craft ideas that get repeated
  • Rely on story structures inherent in great communication
  • Create captivating content
  • Inspire enthusiasm and support for your vision

Of course a good presentation needs a beginning, a middle and an end – that goes without saying.  But PLEASE resist the temptation to use a standard powerpoint template and the curse of bulletpoints.

If you have any doubt, read this on burning your powerpoints.  As Gracie Leo (below) speaking is all about PURPOSE – PASSION – PRACTICE.

Creating a killer slide set

Actually, you don’t NEED to use slides. Some of the best presentations might be someone speaking – or a video…or as demonstrated by Paul Grinzi at GP15, modelling behaviours and facilitating discussion)

If you DO need to use slides, then make them elegant.  Big pictures, large text. Focus on the ONE message you want to get across. Text alone means 10% recall at one week – pictures increase this to 60%. Do the math.

Screen Shot 2015-09-24 at 8.04.02 pm

There are some great image banks out there to mine for pictures – I use Google Images and select ‘filter’ to ‘large’ – also worth looking online at free stock image libraries such as MorgueFile, Getty  Images etc. I am sure I don’t have to tell anyone not to use clip art! Some links are at the bottom under Resources.

I am a HUGE fan of Gracie Leo (a medical student who delivered a powerful talk on creating powerful presentations at smaccGOLD).  See her work here (includes free handout and podcast)


Remember that people will only remember a maximum of THREE things from your talk.  Do them a favour – tell them up front why your message matters to them – then tell the audience a story about how they can achieve this.

Lastly – remember the 10-20-30 rule (like all rules, it can be broken): 10 slides, over 20 minutes with a minimum of 30 point font.

Once you have completed your slide deck, practice. Then practice some more.  Then practice again.

Technical Considerations

I was amazed to see speakers arrive at a conference session late, then fumble with the AV kit.

Preparation to give a talk starts from the moment you receive conformation of a speaker slot.  In general, a good presentation will require approximately one hour preparation for every minute of speaking.  I reckon some of the smacc talkers put in more (although some of the natural talents would have basked it out a few hours before – looking at YOU Mark Wilson!)

First up, find out how long is allocated to your talk.  Do NOT exceed this.

Secondly, find out the format of the display – will the conference prefer 4:3 or 16:9 format? This matters, as otherwise your sides will not be congruent with the other speakers.

Thirdly, scout the room well in advance – think about the size.  The lighting.  Will your slides project best on a black or white background? Can you adjust lighting?

Next, introduce yourself to the tech guys – they will usually want you to upload your presentation to a conference file so it can be accessed by AV tech.  A quick word on Mac vs Pc here – a good conference facility will cope with either – sadly many conference facilities seem to think that only Powerpoint exists.  Don’t sweat it – just explain that you will be using a Mac and ensure you ave appropriate adaptors (if needed) for video and audio. HDMI is your friend, although some venues will still have VGA adaptors. The tech guy is the most important person – make friends with them as they will troubleshoot any issues. A lot of this can be sussed out via email beforehand.

I carry a small organiser bag with spare laser pointer, adaptors, HDMI and other cables etc if travelling to an interstate or overseas conference – it ensures no surprises.

It’s worth having a backup on the Cloud and USB stick – just in case.

Some presentations will require internet access.  Make sure it works!  I was shown a platform called Glisser last night (thanks Andy Buck of ETMcourse for putting me onto this) – allows interactivity with audience by online polling instantaneously, with results embedded into your presentation, Powerful stuff!


The Glisser platform takes audience interactivity to a new level – needs WiFi though!

Putting it all together

Obviously practice makes perfect.  I would recommend giving our talk out loud at least 3-5 times. Check that the timing doesn’t overrun and that the ‘flow’ of the talk appears natural.

In fact, be sure that the content IS organic – don;t fall into the trap of reading a script, supported by slides.  If you are telling a story, from the heart, then the content will change slightly each time, but the flow and supporting media will be congruent.

Next, think about your body language – are you a nervous pacer? An arm waver? Do you need to red slides aloud?

I am a fan of abandoning the podium and using a roving mic – this allows me to engage with the audience (eye contact helps) and wander around…

But ultimately do whatever you are comfortable with. Walt Disney had it right – a good presentation is about entertainment, with the audience as the focus, not the speaker!

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Suggested resources

The SMACC talks – http://www.smacc.net.au/the-talks/

Presentation Zen – http://www.presentationzen.com

P3 Presentations (Ross Fisher @ffolliet) – http://prezentationskills.blogspot.com.au

Grace Leo on Powerful Presentations – http://intensivecarenetwork.com/leo-powerful-presentation/

Teresa Chan from Academic Life in EM – http://www.aliem.com/duarte-meets-foamed-learned-can-give-better-presentations/

Nancy Duarte TEDx on presentations https://youtu.be/UfQF3DXG-S4

This on the “Powerpoint -presentation flaes and failure – a psychological analysis” (reference very kindly supplied by Ross Fisher) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398435/

The Nicolas Pineda talks on iTeachEM http://iteachem.net/2015/04/the-nicolas-pineda-series/

Image Banks – MorgueFile, Corbis Images, iStockphoto, Getty Images – and more

Alternatives to PowerPoint – Mac Keynote and Glisser are my preferred platforms. Prezi makes me reach for the ondansetron wafers.

Finally, read this on simplicity in presentation style – it changed the way I present!

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11 thoughts on “Out with the Old – In with the New”

  1. Good advice there Tim. Nothing is worse than being trapped in a room with someone on stage having no insight into the fact that they are boring the socks off everyone. When I taught in uni’s I noticed that ‘younger’ docs often had better presentation skills because they were more in touch with how to spice up presentations with media. But that’s no excuse for the rest of us not learning and keeping people engaged!

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  3. Nice Blog Tim. I agree with a lot of what you say. I wonder if some of these tips are more suited to a sales pitch than an educational talk though. Scientific data is nuanced, complex and can’t always be conveyed in a three word slogan. I must have gone to different talks than you. One or two were on the dry side, but mostly the presenters I heard were passionate, knowledgeable, and good communicators and gave about the right amount of information, educating without overloading. I felt engaged, enthused and informed for the most part. In fact it was one of the better conferences I have attended. The most disappointing talk was the one by Jessica Rowe. She was dynamic, worked the audience, told a good story, but on reflection there was something distasteful about a very wealthy women telling a bunch of other highly paid people that they ought to be paid more. I found it distasteful anyway.

    1. Many sessions and perhaps I lucked out – although seems odd that others felt same way.

      Of course science is nuanced and complex – however dry delivery and complex data dumps don’t work. I am certainly not advocating a ‘sales pitch’ type approach

      …but look at how smacc and other conferences have changed their delivery methods to ensure effective communication of cutting edge innovative research

      – ditch the podium
      – tell a story, engage the audience
      – convey good take home messages for implementation in practice

      Nope, sorry – much room for improvement. I understand there are discussions on ways of improving GP16, as per threads in “GPs Down Under”

  4. Great post, Tim, though I wouldn’t restrict the advice just to conference presenters.

    I’ve seen exactly the same issues in some of our regular registrar teaching sessions. A lack of passion for a topic seems to lead to an over-reliance of cutting and pasting from Up to Date without considering context. I’ve sat through many talks in which the speaker reads our tables of differential diagnoses lifted directly from an American textbook.

    Speakers need to consider the cost to the learner. If you have 20 audience members that could have earned $100/hrs and you give a so-so talk then you have just wasted $2000 that could be better spent elsewhere.

    If I turn up to a teaching session and could have been better served by spending 10 minutes reading the same chapter in Rosen then why did I drag myself out of bed? I want to learn something new, hear your insights and perspective and (occasionally) be entertained.

    1. Thanks Andy – I hear you. But also hear the concerns from Kathleen – need to ensure presentations don’t become ‘froth and bubble’ but also deliver effective academic info.

      The question is, are the two mutually exclusive – I do not think so….

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  6. Love this post Tim! Had a talk at the weekend, first time I used Ross’ P cubed principles. I think it worked and definitely less nervous but probably cos I put lots of practice into it!
    Love your advice about the 10-20-30 rule and audience needs map in particular. Good idea also re tech stuff – I brought my own slide changer so no surprises on the day. Also important to design your slides in optimal screen ratio in keynote if you know ahead of time (I emailed conf organisers).
    Looking forward to my next talk in November – have started the brainstorming process now!
    Thanks mate

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