Abstract
As a doctor, you are likely to be invited to present cases, papers, research, advocacy materials, and so forth, to a variety of audiences: from the general public to experts, peers, patient and community groups, various disciplines, policy makers and others. So how do we prepare and present?
Some presentations are focused and straightforward as the audience may be our peers with a basic knowledge of what we are being asked to cover and share the knowledge, terms and jargon. I have attended lectures where the speaker knows their material extensively and in depth, but something is lost in communication, and I find myself unable to understand what is being said. On occasion, we may be asked to talk to people who may be unfamiliar with the topic. Under these circumstances, it is essential that we know our audience and be familiar with the topic that we are being asked to talk about. We may be invited to give general lectures, lectures on very specific technical topics or present cases in the ward rounds, Grand Round or journal club. We shall discuss the various options below.
Lectures/talks/presentation
When we are invited to speak, it can be very flattering in that people are willing to listen to what we have to say, so it is imperative to know why you have been asked. The key is to decide what needs to be said and how to communicate those ideas, research findings, policy highlights, and so forth, to the intended audiences. As clinicians, most of us are aware of communication skills, how we share information with patients, their carers and families. There is of course a difference between conveying research findings and clinical information. When looking at the target audience, it becomes clear what type of language needs to be used. There may be several issues. It may be that you are speaking at an event where people’s first language is different from yours, so you need to check if there is simultaneous interpretation that may mean that your delivery may need to be modified accordingly. Another factor worth considering is that the language may be simple, complex, technical, or a mix of these. Communication may be only oral, a mixture of oral and visual, or with additional written information.
It is always helpful to have certain basic points cleared before you start. These include, as mentioned previously, the type of audience you are addressing. In addition, knowing the size of the room, acoustics, IT arrangements as well as the purpose of the talk will be helpful for you to prepare. When addressing the audience, it is important to recognise that often attention spans do not last for the duration of the talk. If it is a long lecture (say 45 minutes or more), then you may wish to consider short concentration breaks, each lasting a few (two to three) minutes only to energise and enthuse the audience. This may be in the form of a question of the audience, a chat between two or more members of the audience depending upon the size of the audience, a poll, and so forth. Depending upon whether the session has multiple speakers, as in a symposium, seminar or a workshop, the task must meet the needs of the audience. The role of the Chair has been previously discussed, so we will not look at it here.
It is important to stick to the time allocated, starting on time, finishing on time – with time for questions and answers if allocated. Plenary lectures may not have time dedicated to questions and answers. This will need to be discussed and confirmed with the Chair beforehand. A rule of thumb using PowerPoint slides is one minute per slide. However, you must be aware that the presentation slides are for the audience while they remind you of key points you wish to communicate, but the story is yours to tell.
Technology has made lectures and talks easy to convey messages but also, at the same time, more complex, in that the technology may fail so it is helpful to have other means of communication ready as backup. In addition, if you are running a workshop or teaching a small group, it may be helpful to use flip charts or whiteboards. Sometimes slides can be full of data and become too crowded and people at the back in a large room cannot see or follow that. These must have findings in big, clear and simple script so that they are visible from a distance. In many presentations, The presenter crams the slide, which they may be able to read from the dais, but the audience may find it difficult to read even from the front row. Lecturers who may be experts in their fields may find it difficult to engage non-specialists if they continue to use complex language and crowded slides.
While presenting, it is important to get your appearance, posture and position right, dress the part and speak clearly by projecting your voice to the back of the room. Sometimes, it helps if the speaker checks with the audience if they can hear them at the back. Communicating clearly, addressing your audience, looking them in the eye, facing them and not turning your back to read your slides and authoritative posture can help in audience engagement. Slides may have words that can steer you with the dialogue. In certain academic disciplines, such as sociology and anthropology, many lecturers have their lectures written and they read these. In medicine, often it is not the case. While giving a talk, be aware of the tone of your voice, volume and variance and ensure that you are not too slow or too fast. With simultaneous interpretation, it is helpful to check with the interpreters beforehand to see what speed they would be comfortable with. It is important to ensure clear delivery, articulation and pronunciation. Do pause to catch a breath as well as for impact. Your posture should be comfortable with open body language, smile, eye contact and confidence.
Arrive early, load your presentation, talk to the technician, look at the room, be comfortable with the tools such as the clicker and make sure they work. Check your position – where to stand and if there are opportunities for you to look at your slides or whether you need to keep looking back at the screen. Some speakers prefer to walk around on stage, so ensure that you are not likely to bump into things, if that is the case.
There may be occasions when the audience may be bored or restless. It is entirely possible that they are showing their professional composure so acknowledge (to yourself) and move on. Some speakers may crack a joke to lighten the mood but jokes may not carry well across cultures so be careful. If you are interrupted with a question, you decide whether you want to answer it there and then or leave it to the end of the talk. You or the Chair might have decided earlier on whether questions can be asked mid-lecture or at the end. If a question is irrelevant, you can offer to take the question outside the lecture over coffee or during the break. If the audience are restless and talking among themselves, you can gently tap and attract their attention to what you are saying.
If you are not knowledgeable enough to answer a specific question, feel free to say that, as you must be aware of your limits. You can explain your lack of awareness or say something akin to: Let’s take this elsewhere and we can catch up in the break.’ If the audience are restless and start to heckle, remember that a majority of the audience will still be with you. You as speaker can choose whether you respond or ignore, try and answer their question or reframe it. A consultant I trained under would use the words: ‘What you seem to be saying is’ … and thus, reframe it. If there are challenges, there is no harm in asking the Chair to step in.
These days, in many meetings and conferences, people livestream and also use social media. Be aware of what you may be saying and what can be quoted.
Grand Rounds
It has been said that case presentations in Grand Rounds can be of three varieties: first, it is about a rare diagnosis where the clinicians show how clever they have been; second, it is I need help and don’t know what to do; and third, failures in diagnosis and management from which others can learn. Good presentations start with choosing the patient carefully, getting their consent, involving them from the start, and then recoding history, investigations and differential diagnosis. Be respectful of the patient and keep them informed and engaged.
Webinars
Prepare early and do a trial run. Choose a room with a neutral background, good lighting, reliable internet connection and make sure the space is available when you are due to present. If you have chosen to wear a headset or headphones, make sure they are compatible with the computer you are using and you have tried them out beforehand. Ensure that your phones are on mute and dedicated time for the webinar is protected so that you are not disturbed. Personal interactions may be limited due to large numbers, so the Chair will decide whether questions are in the chat box or in the Q & A and depending upon the options you can respond at your pace. Again, as a communication break you can use short polls to engage your audience but ensure that these are not disruptive. Stick to time, if these are global live webinars, time difference can influence engagement. Always have a Plan B if things go awry. Be careful that ‘Zoom bombing’ (an unwanted intrusion from uninvited guests into your video call or webinar) does not occur by ensuring apps and anti-viral programmes are up to date. Be careful and sensitive to patient-identification in your discussions and presentations.
Both for presentations in person and for webinars, it is important to dress in sober business manners. It is important to plan ahead, rehearse, know your audience and keep your presentations big lettered but simple. Remember, you are the one telling the story: be clear, stick to your message and time, but most importantly, enjoy.