Essential Tips on how to give Professional Presentations (all you will ever need to know and were afraid to ask!) by Dr Neil Port 2011 "If you knew how much work went into it, you wouldn't call it genius." ~Michelangelo. Introduction. The ability to teach and give an effective talk is a core skill for both a Psychiatrist and a Psychiatric trainee. It has an obvious intimate association with the roles articulated by ‘CanMeds’ (Collaborator, Communicator, Manager, Health advocate, Scholar and Professional) 2. ‘Scholar’ of course incorporates an ethical duty of sharing one’s knowledge and promoting the learning of one’s colleagues and others. Before the coming introduction of the W.B.A.’s (Work Based Assessment) module ‘Professional Presentation’, training for some in giving a presentation was limited to watching others give talks and then having a chance to give a talk oneself, with little formal feedback. There was at times a climate where to receive anything but positive feedback was seen as criticism, rather than a routine part of learning. This document is designed to assist a Registrar (or Senior Resident) and their Supervisors to help them think about what may make up a good or even great presentation. It is a guide only! Giving of a talk remains more art than science! It is designed to be succinct rather than exhaustive. It hopes to give some sense of presentations in a range of contexts up to and including more advanced presentations. Everything needs to be taken in context. Some judgement needs to be exercised in applying advanced presentation techniques, how will they be received by the audience? The local ‘TRIP’ (Topical Review in Psychiatry) sessions for example have a degree of informality that is useful to preserve. Like Peer review, it shouldn’t be so formal or competitive that people are reticent to contribute unless it is perfect! That would reduce its usefulness and put a burden on its participants. They are a very different undertaking to, say, being a senior lecturer invited to run a half day or day long post graduate course at an international conference! If there is still confusion about the standard expected for this WBA: it is expected that at the end of training the Trainee will be able to give a talk to the standard appropriate for a junior consultant giving the same sort of talk (e.g. presenting at TRIPs.) There is no substitute for experience but it is hoped that these WBAs will give the trainees a firmer foundation in the art of giving a professional presentation. Journal Club or TRIPs, what’s in a name? As the ‘TRIP’ is the most common one‐person talk for Registrars, we will focus on that a little more, including its evolution from the more familiar ’Journal Club’. Traditionally “Journal Clubs” are focused on the presentation of a single journal article at each session. There was a bias towards research articles as they are considered to represent the cutting edge of medical knowledge. Three years ago HNET replaced the term “Journal Club” with “TRIPs” (Topical Reviews in Psychiatry). The name change intentionally signifies a broadening of the focus of these meetings to better reflect the needs of the audience. The object of a ‘TRIP’ session as the name implies is to give a concise contemporary review of a topic in Psychiatry. There is considerable latitude in how the sessions are organised and run. There is for instance no reason at all that a more traditional “Journal Club” presentation may not be chosen for a particular session. A case may be presented or material from a recent conference may also be reviewed. The extra flexibility allows occasional novel sessions such as a small group discussion on ethics or a demonstration on how to formulate cases as two examples of what has been done. What it does encourage is the selection of a specific topic, say, treating resistant depression and encourages the presenter to access more than one source. Here the focus is on education and review, rather than the ‘latest’ from the journals. Giving a talk and Coping with Anxiety Why put a segment on anxiety and public speaking early in this guide? Because it is something we all experience in these situations, especially at first. For the usual levels of anxiety I. Up to a certain point, anxiety improves performance. Mild anxiety feels a lot like excitement. Just tell yourself you’re excited! II. Try to make sure you’re prepared and practiced III. Focus on what you are trying to say! Not (imagined) audience reactions or real or imagined deficits in your delivery. Enthusiasm for the topic will usually carry your talk beyond the majority of likely mishaps! IV. Slow (deep) breaths. V. You are the expert. VI. You are among friends (or at least you hope so). VII. Be yourself in your presentation, if you are not good at telling prepared jokes normally don’t think this will magically change while you are giving a talk! VIII. A glass of water, taking a sip calms you and gives you time to think of a response to a question….apart from helping with any dry mouth. IX. Dress code: must be comfortable, respectful of audience in formal situations. X. Exposure (to public speaking) should be in a graded way but ongoing! Severe anxiety is an excessive reaction but is also a very common problem. Anecdotally, some masterly stage performers are plagued by severe anxiety. You may feel you are being lead to the gallows. This is not common even after the worst ‘TRIP’ presentations! There will not be sufficient space to discuss techniques in dealing with severe anxiety. Fortunately anyone training in Psychiatry is by definition an expert in treating anxiety either with CBT (identifying dysfunctional thinking, graded exposure), DBT, relaxation or distraction techniques! Unfortunately applying these techniques to ourselves is far more difficult than teaching our patients! Two comments on more severe anxiety will have to suffice: I. The very best way of reducing anxiety of public speaking is the ‘toast masters method’ …i.e. practicing it repeatedly. The ‘TRIP’ sessions are an excellent start... There, see how lucky you all are? II. If you have persistent severe excessive anxiety that impacts on your quality of life and you have difficulty controlling it all by yourself…you don’t have to control it all by yourself! .... According to Sir William Osler, “A physician who treats himself has a fool for a patient”. In the field of psychology and psychiatry this is especially true. In an area where we have a difficulty, it can be hard to be objective! ‘Self help’ does not have the same emotional valence of receiving help from a trusted professional. If you don’t believe Psychiatrists and Psychologists can be helpful, sometimes dramatically so, if you personally need one…why are you in this field? Taking into Account the Type of Talk: The type of talk you give will be influenced by the objective of the talk, the circumstances and, as mentioned above, the audience. Three examples (not limited to the medical field) include trying to interest a prospective customer at a trade fair, giving a talk to motivate a team or giving an update to senior management. To simplify a little, in the first situation you are trying to influence behavior (make a sale), in the second you are trying to influence attitudes and in the third there can be a range of aims, including getting funding, impressing, communicating. Another example might be, for instance, to being at a conference and being given ten minutes to showcase your poster presentation. Here you may only have time to stimulate people to go and read your poster or correspond with you! Each of these situations has different goals and requires a different type of talk. No one talk can achieve too many goals well. You really need to remember these distinctions if you read an article on “how to give that great talk” e.g. by a manager or a salesman! What the Audience wants/ what will impress them. In retail, there is a phrase ‘the customer is always right’. After all, if you don’t satisfy the customer, you may not make a sale and you are working for nothing! This also applies to giving talks. For example, you may be asked by someone else to give a talk. You may wonder what they want you to say and how, but if the main focus is not on what the audience wants or needs, it can never be a great talk! A ‘TRIP’ presentation is (usually) an educational talk on a given topic to a group of mature motivated professionals within their area of expertise and interest. With regards to the target audience, the needs of the Registrars is given a greater weight, others included in the audience (depending on how your service organises their ‘TRIP’ sessions) might be more senior doctors (interested in revision, new material, open discussion, facilitating teaching) other disciplines, medical students etc. If members of your audience have found the session useful and interesting and can remember something of your talk a considerable time later, you have succeeded admirably!! The problem with attention span. One of the problems with giving a talk is limits to an audience’s attention span. Again this will vary with the context and the audience. The more interesting and well delivered a talk is for the audience and the more the audience feels involved and entertained, the better the attention span. Some say the adult attention span is twenty minutes. It most certainly doesn’t work like that! The sales rep presenting to a customer at a trade fair may have only two minutes before his customers attention starts to drift. His next customer might be more attentive but he needs to be prepared to work on a short time frame. The manager giving busy senior management an update on something they are not very interested in may have to similarly work with a short time frame and a limit to the total information his audience is prepared to take in. Some claim that since the start of the twentieth century our attention span as an audience is shortening. Giving a lecture to a motivated audience within their area of expertise means we can plan on a longer attention span and a greater capacity to absorb more information, especially if some of it is familiar. To understand your likely audience attention, imagine a graph. Time of the talk is on the ‘X’ axis and the percentage of your audience paying attention at any one time on the ‘Y’ axis. It may start at 80%, peak at ten minutes into the talk near 100% then decline. At some point, say after twenty minutes, the decline becomes more rapid. Finally attention levels bottom out and then there is a brief sharp rise just near the end of the talk (till people focus on leaving). So next time you are part of an audience, look around after twenty minutes and see if people’s attention has waned. Attention and Capacity of the Audience to absorb information In a fifty minute talk, there is greater capacity to take information in the first ten minutes and just towards the end. The other main thing to remember is that the audience has some overall limit as to how much of your talk they will remember. Again, this may be more if the topic is familiar or there is some sort of follow up learning. If you were giving a talk to students, you may want them to end up with comprehensive notes on a topic they can revise later. If this results in a crowded, poor talk, it might be better to consider better ‘hand‐outs’ or references and a less crowded, better talk that can be remembered better. Most times your audience for a ‘TRIP’ session won’t be using your talk to generate notes for later revision! (If they take notes, it will be to help them attend and remember but they may not read them later). So for some of them you are aiming for them to remember something from the talk without necessarily revising. If you give them too much information or it’s poorly organised, you may dilute what you had hoped they would remember. Experience will allow you to judge this better. Content A ‘TRIP’ is an educational session and you are the teacher. You may decide that you want to stimulate interest in a novel area or in a novel approach, change attitudes or encourage a different viewpoint etc.. Most commonly, though, your aim will be to impart information. The first step is to research the topic. This is where a ‘topical review’ can become more onerous than a ‘Journal Club’ which concentrates on one article. It takes a long time to prepare a review talk on a topic. How long preparation and research takes for a talk will depend on how ambitious your aims are, how much you already know about the topic and your experience. If you want to give a great talk you need to become well informed on the topic and then select what you say. A lecturer at the University would expect a ratio of something like 10‐15 hrs per 1 hr talk to students. An academic speaker on a lecture circuit would research a new topic far more and then review the latest each time they repeat the same talk later. When you give your first talk, preparation will naturally take longer. Don’t worry about spending a lot of time and being a little obsessional, the time won’t be wasted!! Teaching is the best way to learn! Part of the process is also to learn how to give a talk and become less anxious. If you are well prepared you will be less anxious and will give a better talk. This helps with the anxiety next time. Do it properly. Any ‘shortcuts’ can come later. Ideally (as stated above) you will know the topic well, have too much information and be able to choose what will be of best interest to the audience. Then decide what you especially want them to emphasise. If the topic is too broad to reasonably cover in useful depth in the time available you may choose an interesting aspect to concentrate on. Questions and Timing In theory the duration of the ‘TRIP’ is about an hour, but this may vary a little from site to site. If your talk is less interactive (or with a large audience) you may leave questions till the end. Allow a shade over 10% of the talk time depending on the circumstances for questions. As a rule, there may be more questions from a bigger audience. It is a sin to go over time. It is a sin to not allow for questions. It is a sin to go through your talk too rapidly! It is a sin to rub your audience’s nose in the fact that they are missing out by not giving you the extra time you would rather. It is not a sin to finish 10 minutes early! If you have allowed question time and there are no questions, it is usually just a matter of breaking the ice. You could pose a question of the audience, open up the discussion. The “Do’s” of a Good Talk 1. Do highlight your main message(s), have an overall plan of your talk. 2. Do have set goals. Think about why you are talking to the audience. Yes, you are doing it because it is compulsory! No I meant why from the audience’s point of view. At least, try to pretend you are a keen volunteer! (Enthusiasm is a core ingredient of a good talk.) The goals will be determined by what the audience wants and what you want to do. Consider listing the goals ….not too many. 3. Do try to tell a story. A talk is meant to be more informal, narrative and dramatic than a written presentation. 4. Do verbally illustrate your points: anecdotes improve recall of the main points! 5. Do avoid true excess information. Don’t try to make too many points. 6. Do design an opening (remember that crucial ten minutes?) consider the following: I. Introduce yourself. II. Get the audience’s attention early. III. Presents the goals of your presentation. IV. Clarify the benefit to the audience where necessary. V. Explain the layout of the presentation. 7. Do try to capture interest. A catchy title? Consider techniques of delivery: dramatic pauses, rhetorical questions, a topical comment, a show of hands, point dramatically to a paradox, drama….these can all improve attention but it has to fit in with your personal style and the context. 8. Do if you can, entertain. The aim is to inform but it will be better remembered if you enthuse and entertain. 9. Do use fewer points and more examples, anecdotes, pictures. 10. Don’t ever use distracting gimmicks. 11. Do design brief closing remarks (remember the rise in attention towards the end of the talk?) Consider repeat your core message, thanking the audience, chairperson. 12. Do prepare for questions if they are completely obvious. On occasion, fortunately not often, you may (politely) have to take control back from interruptions, distractions or people demonstrating their own knowledge in the guise of a question. You are certainly allowed to say “that’s a really great question”, you “don’t know” or “that may have to be left for a longer presentation” etc! 13. Do be ready and give time to linger for questions or feedback after the talk. 14. Do study other presenters. How does Al Gore present “An Inconvenient Truth”? How do other great speakers, salespeople or educationalists deliver their message? Think about the talk you heard last week. How much do you remember? Why do you remember more or remember less from that talk? 15. Do be prepared for ‘glitches’ technical or otherwise. Backup your notes and presentation. Have your backup with you (not at home or in your check‐ in luggage that headed to L.A. when you have arrived in Washington). 16. Do practice and, for important speeches, memorise your speech. 17. Do make eye contact in small group presentations. Do speak to the audience. 17. Do avoid simply reading your notes or your power point. 18. Do use clear speech and clear language, not “The mean recall was 8.736 and 9.27 which gives an F value of 13.8 with 1 and 14 degrees of freedom…” 19. Don’t talk too quickly. 20. Do attend to body language, enthusiasm. In one experiment students were able to predict reasonably well how a speaker would be rated by looking at a 30‐ second silent clip of their presentation! 21. Do consider as a result coming out from behind the lectern1 if giving a lecture to a large audience. HINTS ON MATERIAL and AIDS Try to make all your PowerPoint slides as unreadable and crowded as possible and make sure you have far too many of them so you can’t possibly finish your talk. Only kidding! 1) Separate handouts are a good idea and may take pressure off you to crowd your talk or slides. They may either follow the outline of your talk (leave space for notes on these) or distract the audience from it. The latter can be distributed after the talk. 2) It really is a talk... not a ‘power point presentation’! The PowerPoint should not be the talk. Power point should be that…a few points and pictures for the audience. (A copy of the ‘power point’ slides is not always the best handout) 3) LARGE fonts! Try to fill the page. Simple (or simplify) graphs. ‘The time needed to decipher a slide is time lost listening attentively to the speaker’ 1 Ariel, Helvetica and Sanserif are common choices of font for PowerPoint. 4) ‘It takes 13% longer to read all capitals ...(than) a mix of upper and lower case letters 1.’ 5) White or yellow for words on a dark blue or black background is easier to read. 6) About one slide every two minutes or so. 7) More pictures, less writing on your power points. Try to aim, say, for less than twelve words per slide, four points. 8) Laser pointers are distracting small dots and wiz around. If the screen is close, point to it! Try to enjoy yourself. With a reasonable amount of preparation you will do better than you expect to do. 1. Resnick, P. “How to give an effective lecture: Pith, Punch and Polish” Seminar, A.P.A. Annual Meeting 2011 2. Royal College of Physicians and Surgeons of Canada.