presentation skills for doctors

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3 Public Speaking and Presentation Skills

• Published: August 2019
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Physicians, throughout their training and careers, are often asked to do a variety of different types of public speaking—from large academic settings and videotaped seminars to informal informational settings or impromptu discussions. Doctors are asked to speak on important clinical topics at hospital grand rounds; discuss preventative health with patients in the community; lecture about their research at a professional conference; respond at a press conference about a controversial issue; conduct a job interview through video broadcast; Skype with a team of academic researchers from around the world; or conduct themselves on camera for a telemedicine interaction with patients and colleagues. Individuals are usually filled with apprehension about speaking in front of a group. More often than not, many people will avoid talking in front of a live audience or a video camera if they possibly can. But opportunities to speak are important to take advantage of, whether self-directed or prompted by a request from a superior or an organization. Professional careers and personal connections can be enhanced by giving an outstanding presentation with excellent skills. Whether the goal is to slightly improve physicians’ presentation and communication skills or to perfect their public speaking performances, this chapter will help them. Today, many careers in medicine and throughout the healthcare profession require not only that physicians make presentations in person to large and small live audiences but also that they are camera-ready and know how to successfully perform in a video presentation or broadcast interview.

We spend a good part of our lives trying desperately to convince ourselves as well as everybody else that we know more than we really do. —Charles Osgood

There are only two types of speakers in the world, the nervous and the liar. —Mark Twain

Introduction

As a former television reporter and a current medical educator and practicing medical internist, I have taught many sessions and seminars on public speaking and presentation skills. I have met physicians, clinical researchers, executives, and other health professionals who know that their skills and training in this area are deficient and are very interested in learning how to improve. The good news is that most people are much better at public speaking than they think they are. However, no matter what your current competence level is, you can always do better. After you learn how to identify and tap into your natural personality, attributes, and communication style, you will begin to feel more comfortable.

At some point during your professional life, someone will ask you to give a presentation. You may be honored and elated. But like many people, including many physicians, you may also be nervous and even terrified. There are few activities other than skydiving, rock climbing, and public speaking that can squeeze your adrenal glands, raise your blood pressure, and cause more of an overwhelming sense of doom than public speaking. In fact, many people will go to great lengths to avoid speaking in front of an audience altogether.

Physicians, throughout their training and careers, are often asked to do a variety of different types of public speaking—from addressing large academic settings and videotaped seminars to speaking in informal informational settings or leading impromptu discussions. Doctors are asked to speak on important clinical topics at hospital grand rounds; discuss preventative health with patients in the community; lecture about their research at a professional conference; talk to medical students or residents at a noon conference; speak to a television reporter about a timely topic; respond at a press conference about a controversial issue; conduct a job interview through video broadcast; Skype with a team of academic researchers from around the world; or conduct themselves on camera for a telemedicine interaction with patients and colleagues.

On September 14, 2018, Dr. Allan Tunkel, Senior Associate Dean for Medical Education at the Warren Alpert Medical School of Brown University, gave the White Coat Address at Cooper Medical School of Rowan University. It was one of the highlights of his professional career. He told the personal story of his near-death experience while suffering from septic shock and pneumonia in the intensive care unit (ICU). He shared important take-home lessons about healthcare for the medical students present that day. The twenty-minute talk was brilliant and well-received by the audience despite the fact that Dean Tunkel committed several errors in public speaking that day. Specifically, he read most of his talk word for word, was hidden behind a podium, and only looked up at the audience occasionally. But Dean Tunkel is a natural storyteller, and what made his talk so effective were his honesty, humor, and true emotion. He tapped into his personal communication style to tell a thoughtful message about his experience. 1

Examples of Public Speaking Opportunities for Physicians • Grand rounds lecture • Community talk to patients • Professional medical conference presentation • Noon conference lecture for students or residents • Television interview • Press conference appearance • Video or Skype job interview • Skype with research team members • Telemedicine interaction with patients and colleagues

Whether you are asked to speak in one of these varied venues with different media platforms, to different audiences about different topics, or in another type of setting, many of the essential communication skills are the same. Fortunately, they are skills and can be learned, practiced and even perfected. Whatever presentation you give, your communication skills, or lack thereof, will be readily evident to your audience. But you will reduce your anxiety and heighten your performance if you have an increased awareness of your natural skills, knowledge of the mission of your talk, and thorough preparation and practice. I have heard many common misgivings about public speaking.

“If I could improve one thing about my public speaking, it would be to engage more with my audience. I tend to get very nervous and stick to what I need to say, and I want to get the process over with as quickly as possible. This comes at the cost of not reading the audience or being able to make adjustments and tweaks as needed.”

“Something negative about my public speaking is that if I make one mistake, I struggle to let it go and come back from it. I focus on the mistake that likely nobody else noticed, and it becomes a positive feedback loop of continuing mistakes.”

“Something positive that people have told me is that my pace is good and I seem confident in what I’m saying, which I think is pretty funny because I tend to be nervous in public speaking contexts and not feel confident at all.”

Individuals are usually filled with apprehension about speaking in front of a group because they do not realize how good they can be by making minor adjustments and how easy it really is. More often than not, many people will avoid talking in front of a live audience or a video camera if they possibly can. But opportunities to speak are important to take advantage of, whether self-directed or prompted by a request from a superior or an organization. Professional careers and personal connections can be enhanced by giving an outstanding presentation with excellent skills.

I have heard many stories from individuals about avoiding public speaking, from turning down invitations to talk to audiences of patients, to turning down media interviews and even professional opportunities to speak at important conferences. One therapist whom I know declined to be listed on a popular physician referral site simply because she did not want to talk about herself and her work in front of a video camera.

She wrote to me in an email, “I don’t like the idea of having to do the video, but that’s just me. I am shy.”

Unfortunately, medical school, residency, fellowship, and other medical and science graduate trainings offer little if any specific instruction or formal guidance about the topic of presentation skills. Studying science courses, doing well on multiple-choice exams, and memorizing mountains of basic science data may produce knowledgeable doctors and successful researchers but not individuals who are excellent communicators. Although training in this area is changing and more education is becoming available, on the whole there is still little instruction or guidance for healthcare professionals who want to present themselves and their work in the most optimal way.

Whether your goal is to slightly improve your presentation and communication skills or to perfect your performance so that you can become an engaging or even motivational speaker, the rules are the same. Yes, you can become a top-notch communicator and effective speaker. Yes, you should care because if you cannot communicate to an audience about your work, then your knowledge, advice, insight, and opinions will not be heard. And unfortunately, your work may be lost, and your experience and wisdom may never be acknowledged or remembered. Your mission may never get off the ground. The spotlight will shine on others with excellent speaking skills and their work. Those with better presentation skills are often more likely to be promoted, funded and rewarded.

Communication and presentation skills are critical for a successful career. Today, many careers in medicine and throughout the healthcare profession require not only that you give presentations in person to large and small live audiences but also that you are camera-ready and know how to successfully perform in a video presentation or broadcast interview.

Ninety percent of how well the talk will go is determined before the speaker steps on the platform. —Somers White

Analyze Your Communication Style

So where should you begin? Unfortunately, the first problem comes with thinking about yourself and your individual communication style. It seems that just thinking about how we speak in front of another person or in front of a group of people, camera, or microphone can cause anxiety. Thinking about our communication is a little like thinking about breathing: all of a sudden something so natural that you have done all of your life becomes awkward and foreign when you focus attention on it or try to analyze it. All of your negative self-damning thoughts, your inner and outer critics, and the memory of individuals in your life who may have put you down, or even your own baseline nervousness, can come back to haunt you and limit your performance.

You may envision yourself as a poor speaker with all of your weaknesses present instead of beginning to see yourself as an articulate and compelling presenter. Knowing your material and the reason you are presenting it and recognizing your skills as a natural communicator are the first steps to helping your performance. Realizing that you have many talents and assets from different aspects of your life and applying those experiences and confidence to your presentations can also be helpful. Just like you have done in other areas of your life, you can apply these inherent human communication and life skills to improving your presentations. Remember that your work and your knowledge are both important. Your audience needs to be informed about your work and what you need to say.

Think about the traits and skills you appreciate in a speaker. Do you like when the person is passionate, clear, understandable, succinct, and comfortable? Would you prefer a presenter who connects with the audience, stays on message, and is able to successfully tell a story or use humor?

Do you appreciate a lecturer who appears to be in charge of the lecture from beginning to end? Are you impressed when the lecturer remains calm and in control no matter what comes up, such as a technical problem with the microphone or a difficult question or comment from the audience?

One truism that may help boost your confidence is the following: remember that, the vast majority of the time, when you are presenting, you will know more about the information than anyone else in the room. There may be some very smart people in the audience, who may ask you some tough questions, but no one knows your presentation and all the information it contains as well as you do. While your audience doesn’t know as much as you know about the topic, unfortunately they also may not care as much as you do. Your job is to make them understand the information and make them care about it as much as you do. That is why clear, articulate, engaging, and passionate talks are the most effective and memorable. Make your listeners learn and share your concern and interests. Ensure that the audience hears your message and becomes as passionate and articulate as you are about it.

If you don’t know what you want to achieve in your presentation your audience never will. —Harvey Diamond

Try to imagine your audience in a positive light. Instead of fearing your audience and imagining a group of enemies, envision the audience as open, accepting, and encouraging. Instead of thinking about the worst-case scenario, imagine yourself giving a great presentation and successfully completing your mission to a group of friends and colleagues. Remember, when you are an audience member, you just want to listen and learn from an informative and accessible presentation. You assume it will go well. Your audience expects you to win, and they are planning for you to give an effective and informative talk.

Another lesson to remember is that practice improves performance. Start accepting opportunities to speak. When asked to do a presentation, don’t say no and avoid it. Force yourself to say yes to invitations to give talks. Also, create your own opportunities and talk to your boss or colleagues who might help make these types of opportunities happen for you. The more public speaking you do, to small intimate groups or to large audiences, the better you will become at it. Do not shy away from speaking engagements. Speak more. Each time you present to an audience, it will become easier and you will enjoy it more.

After you have secured a speaking engagement, you will want to do three things: First, remind yourself why you want to speak and create a mission statement for yourself about the goal of your talk. Remember and articulate why you are the best person to give this talk. Second, become an expert about the topic you are speaking on and know your information well. Third, know who your audience is and what they need from you. Realize your inherent worth and, most important, the inherent worth of the knowledge you need to impart in giving an excellent presentation. Transfer your nervousness into productivity; start researching and writing your talk. Also, try to attend a few live lectures or watch some presentations online. Take notes on things you like and don’t like. Figure out what kind of presentation skills you want to emulate, then you can begin to gain the knowledge you need to begin to practice and prepare.

It usually takes me more than three weeks to prepare a good impromptu speech. —Mark Twain

Even though it is not easy, it is only by focusing on our own communication skills and dissecting them in an objective manner that we can analyze our specific and unique assets and deficits. Then we can begin to learn the important tools to improve. First impressions are key—and that includes first impressions by our audiences about our presentations. Most people make up their minds about us in the first few seconds of meeting us or in the first moments of our lecture; that is why our skills from beginning to end are critical to our success.

There are many common problems people have concerning public speaking. For most of them, there are some easy solutions.

  “I’ve been told I speak too quickly, so I would like to improve this and find a comfortable pace.”

When most people are nervous, they speak too quickly. Remind yourself that it is almost impossible to speak too slowly. Take a breath. Look out at the audience. Utilize pauses effectively. You should know that while it is hard to speak too slowly, it is possible (and a common error) to speak without enough energy or enough passion. One of the most common errors is speaking too quickly—the other common error is speaking without enthusiasm. Don’t commit either of these errors. Try to connect and convince your audience that what you are saying is important. Try to be natural, clear, succinct and make a good impression. Look up at your audience after important points. Have a conversation with them.

  “Sometimes I get so nervous when I am speaking that I sort of black out and really lose my self-awareness. I feel like when I am finished, I have no idea how long I have been talking or if I have even effectively gotten my point across.”

Remember it is not about you. It is about the information you are presenting. If what you have to say is important, then think about how important it is to inform and engage your audience with the content of your presentation. Be organized and engaging. Look out at the audience and build a bridge to them. Make sure they are hearing and understanding your important presentation.

  “I don’t know about my body language when I am speaking. I try not to fidget, but I hear mixed things about using hands versus not or walking around on stage or not—this is something that I know I do.”

The more you can focus on your information and the importance of your talk, the more you will be confident and comfortable with your own body language. The more comfortable you are, the more your body language will follow and display confidence. You won’t worry about your hands, your feet, or your body movements; you will use your posture and gestures like you do when you are calm and in control in other situations. (See section on Nonverbal Communication: Our Body Language in Chapter 1 .)

  “I have been given generally good feedback about my public speaking, but I would say that regardless of external feedback, I tend to feel horrendous while doing it. Some strategies for managing nerves during public speaking would be fabulous. The old ‘picture everyone in their underwear’ trick doesn’t quite do it for me.”

Instead of thinking of people in their underwear (which I don’t recommend), imagine yourself sitting in the audience. What are you expecting from the speaker? You are expecting an informative presentation. You may also be thinking about your next meeting, your daughter’s birthday, and maybe even lunch. In other words, the people in the audience are just like you, they have busy lives and just want to hear an interesting and relevant talk—so give them one.

  “I feel like I can do okay with thoroughly rehearsed material, but I can stumble a bit if I have to come up with the words as I go.”

Some people do need to read a script, but instead try to write down bulleted points and know the structure and flow of your talk. You will be able to have a dialogue with your audience instead of reading a script. Just like when you have a conversation with one person, you are not reading a script—think about having a conversation with your audience, only it’s one in which you get to do most of the talking. When we “read a script” we tend to lose all of our natural voice qualities and become monotone and emotionless. You will want to give a presentation that is directed to real people in your audience—tell them a story and talk to them as individuals. If you must use a script, mark it up with notes and highlights so you can remember to ad lib, pause and emphasize where necessary. Try to make it more conversational and you will have more success.

  “I would love to be able to stand in front of others and speak more clearly. I often lose my train of thought and then become roundabout with my word choice.”

Having notes of exact figures or important percentages or other bulleted points in front of you can help you if you lose your train of thought. If you do use a script, you can mark it up so you have notes for yourself. Make your presentation come to life in any way you can. Also, be confident enough that you can easily say, “I think I just got off-track or misspoke; let me back up.” Or, “Is that clear to everyone?” or “Are there any questions?”

  “I wish I could be more succinct and conclude my ideas better rather than trailing off.”

Just like you do when you are speaking to someone else one to one, make your point and then move on to the next point. Put a period at the end of each sentence. Be confident, clear and concise. Each talk should contain between three and six take home lessons. Write these down beforehand. Make sure you discuss all of them and reiterate them before you finish.

  “I would like to eliminate space-filler words during public speaking. I want to deliver a short speech effectively.”

We all use excess words as crutches or filler words such as “uh,” or “yeah” or “do you know what I mean?” and one way to help reduce these is to audio record or video tape yourself. If you hear yourself using unnecessary phrases or filler words as crutches, it will be easier to eliminate them. Catch yourself saying these words in any way you can and work on stopping the use of them.

  “I would like to have more confidence and focus.”

Think of an activity or hobby you are good at and enjoy, such as golf, tennis, playing an instrument, or another hobby. Transfer your confidence, including body language, tone of voice and other confident mannerisms into your public speaking skills. When you walk onto the tennis court, how confident is your posture? When you play the piano, how peaceful and focused are you? When you are talking to your best friend, how happy and engaged are you? When you are talking to your children, how clear and encouraging are you? Try to emulate these gestures and feelings while speaking to your audience.

  “I would like to know how to make eye contact without making it look like I’m intentionally and deliberately trying to make eye contact with people.”

Look at one face at a time in your audience. Smile and look into people’s eyes while you are talking until you see a nod or smile. Pretend the person you see is the only person in the room, then move on to someone else until you gradually build the number of friendly faces you have connected with to as many people as possible in the room. Their facial expressions should calm you down and give you immediate feedback on how you are doing.

  “People tell me my voice doesn’t sound like it’s shaking, but to me it definitely sounds like it’s shaking.”

Take a few slow deep breaths before you begin speaking. This can help calm your nerves and reduce the shaking. You can try to yawn a few times before you walk on stage. Slow yourself, heart rate and ultimately the speed of your talk down. Think of a person, a situation, a geographic location or an activity you love. Close your eyes for a minute and imagine you are in a serene, confident and happy state. Smiling and stretching your body can help as well. Try not to focus on your voice or yourself. Instead focus on the information and how best you are going to engage and teach your audience.

How to Assess Your Public Speaking

If you want to try to assess your own public speaking and presentations, you will need to be open to acknowledging the areas you need to work on. You will also want to listen and learn from others.

  Make a list. Be honest with yourself about your strengths and weaknesses as a communicator and presenter of information, but do not be hypercritical. Write down a list of your perceived strengths in all areas of communication, not just presentation skills and not just when speaking to an audience. Think about your strengths when speaking to a friend or family member or to students, residents, or employees and write these strengths down. Now think about what you would like to improve in your presentation style. You can write down just one word or make a list. Write down any weaknesses you have when communicating or as a presenter. Try to make your strengths a longer list than the list of weaknesses. Next to any weakness, write down the correction you need to make.

  I mumble . I will learn how to improve my articulation and enunciation with specific knowledge, exercises, and practice. (See exercises in this chapter.)

  I speak too quickly . I will learn how to slow down by focusing on serene thoughts and my breathing. I will use pauses and look out at the audience when I speak.

  I speak too softly. I will learn how to breathe properly using a full diaphragm and speak with enough volume, passion, and energy to be heard.

  I am afraid to look at the audience. I will think of other situations where I am confident and can easily make eye contact with others. I will use this tactic as immediate feedback on how I am doing. Reading the facial expressions of my audience is as important as reading the facial expressions while sitting across from someone while having a face-to-face discussion. There is no better and immediate way to realize your audience is confused, bored, or happily engaged, then looking at specific faces in the audience.

  I am worried about my accent . There are excellent, dynamic presenters who speak in every language and have many different types of accents and different types of voices. I will embrace myself and my beautiful unique voice and use it to my advantage. If I need professional evaluation or help, I will consult a voice coach or speech therapist. There is usually no reason to eliminate accents that may be different from the native language of your audience.

  Ask others . If you need help making a list of your present communication style, talk to a supportive friend or colleague or even a professional voice coach, speech therapist, boss, or superior to help evaluate how you are at communicating and how you can improve. Ask for your reviews after you give a presentation—and ask your colleagues to tell you honestly how you can improve. You can also ask family members and peers about your communication and presentation skills. Compare this list with the one you created for yourself.

  Video yourself . Finally, record yourself doing a one- to two-minute presentation about your work or topic of interest to you with your computer or your phone. You can use some notes but try not to read a script verbatim if you can help it. Just talk to the camera like you are talking to a friend or a student about your topic. When you are alone, just open your laptop or smart phone, push record, and look into the camera and talk about something you know and are passionate about such as your work, sports, a hobby, or a recent vacation you took. Watch and listen to the presentation. Be kind to yourself. Give yourself an honest assessment. Write down what you like and what you would like to do better. Most people can smile and soften their features at the very least—which, believe it or not, helps their voice sound more natural. Another method to evaluate your voice is to record yourself talking on the phone to a friend or your mother. Listen and evaluate your natural tone, inflections, speed, and clarity. Most people have wonderful voices when they are talking naturally to friends or family members.

  Read your reviews . When you do give a presentation to a live audience or a videotaped performance for others to watch, welcome any feedback. Look closely at the audience reviews to see where and how you might improve.

  Watch the experts. Watch people you think are good, whether they are professors, politicians, actors, journalists, or even your colleagues. What makes them so good? Try to figure out what it is they are doing that you like. Are they earnest, confident, and making eye-contact? Are they prepared and knowledgeable but also able to handle spontaneous comments or difficult questions? Are their words and their voice clear, pleasant, and understandable?

Best way to conquer stage fright is to know what you’re talking about. —Michael H. Mescon

Improve Your Voice (Your Instrument)

Your voice is literally your instrument. When you give a presentation, how people feel about your voice will be integral to how they perceive your presentation.

Think about how you react to various types of voices when you hear others presenting. Whether their voices are high and screechy or low and mellow may determine how long you can listen before leaving the lecture or before falling asleep. What about when someone talks too softly? Is that frustrating for you? Or what about when someone speaks indistinctly or incoherently or speaks too quickly or talks too loudly? Is that irritating to you? Besides our body language, our voice quality may have more influence on people’s perception of us and understanding of our presentation than any other aspect of our communication skills.

Mistakes People Make with Their Voices • Pitch too high (screechy) • Volume too soft (inaudible) • Energy too low (too mellow or monotone and without passion) • Poor articulation (mumbling, chewing gum, or fingers in front of mouth) • Speaking too quickly (it is hard to speak too slowly) • No pauses (pauses are important and natural)

Do you remember how annoying it can be during a phone conversation with a bad connection or listening to the radio when the signal keeps cutting out? How does it make you feel when the presenter’s microphone volume is too loud or too soft? Often, when you give a presentation, you will be speaking through a microphone. It is okay to ask the audience if everyone can hear you—ask specifically whether the volume is too high or too low. You may be speaking perfectly, but if the volume of the microphone is off, or worse yet, if the audio transmission is scratchy or a speaker is broken, your audience may become upset with the sound of your voice and it has nothing to do with you. If the sound system is broken, take off the microphone and speak in a volume that is audible (and pleasant) for the entire audience. You may have to increase your volume.

Always look to your audience for feedback. If even one audience member is wincing or cupping an ear, you know something is wrong. Your audience members will let you know how you are doing. You just need to look at them to see their facial expressions and body language to measure their comfort and understanding of your presentation.

What type of voice is most easily heard and understood? In an article published in Science Magazine in 2012, Sabine Louet wrote: “A growing body of evidence from multidisciplinary research in acoustics, engineering, linguistics, phonetics, and psychology suggests that an authoritative, expressive voice really can make a big difference.” 2 Someone who speaks slowly with a low voice and a pleasant intonation can be perceived as someone with a commanding influence. According to Louet’s article, a good example of an authoritative voice is the voice on the New York subway that says, “stand clear of the closing doors.” If you listen closely to professional actors and broadcasters, male and female, as well as different speakers during presentations you attend, you will begin to identify voices you like. Try to figure out what type of voice the person has and what is pleasing, or not pleasing, about it. There are many different voices with different pitches and tones as well as speeds and inflections. The common trait that all successful voices have is that they are authentic and true to the personality of the person speaking. That said, the voice still needs to be supported with a full breath, coming from a confident posture. You need to articulate your important message with the correct volume and energy by properly opening and utilizing your vocal instrument.

Of course, perception of a voice is very subjective. Our culture, geography, gender, age, ethnicity, professional norms, and other biases can influence our perceptions about another person’s voice quality. Overall, it seems that low and slow voices from confident male and female speakers using good volume, inflection, and enunciation are often perceived as the most pleasing and commanding.

However, speaking with your natural pitch is just that—it is YOUR pitch produced by not stressing or straining your vocal instrument or trying to imitate someone else. The phrase “speak low” may make some women, and maybe even some men, try to speak lower than their natural pitch. This is a mistake. You should never try to speak higher or lower than your natural pitch. This will strain your body and make your voice sound unnatural, and it can be harmful to your vocal folds. To find your true speaking pitch, say “ho-hummm,” and the pitch of the “humming” sound is usually your natural pitch.

Similar to the way a singer determines whether they are a soprano, alto, tenor, or base, you can find and speak in your proper range and comfortable pitch. If you are a soprano, your voice can sound wonderful and melodic unless you try to pretend you are a tenor. Many women in the early years of news broadcasting used to speak with an artificially low pitch, and some still do. But speaking with your natural voice and with your natural pitch will help your voice sound the best. If your throat hurts after giving a speech or at the end of a long day of talking, you may not be speaking at your natural pitch, or you may have other vocal problems that a speech therapist or vocal coach could easily identify.

Listening to a badly tuned voice is like a badly tuned radio. —Alan Mars, Voice coach

The production of voice, while complex, is still a product of our neuromuscular bodies and can be improved with good instruction and practice. Pitch, volume, timbre, speech rate, and articulation are all essential aspects of our voices and all amenable to training. A speech therapist or vocal coach can help you work on any major problems you may have, such as poor pronunciation, lack of breath control or volume, using the wrong pitch or stuttering. For many people, just practicing a few simple daily exercises and following some specific guidelines when speaking can help improve the quality of their voices. You may also consider taking an acting class, signing up for speech therapy or voice instruction, singing in a chorus, joining a debate club, teaching, coaching, leading groups while hiking or exercise, or engaging in any other pursuits that require you to use your voice regularly, publicly, and effectively.

Almost a decade ago, I joined a chorus. I love music, and I have always wanted to sing. But I also hoped that singing regularly at weekly rehearsals and performing concerts throughout the year would improve my vocal quality and speaking voice so it would remain strong, full, and healthy as I aged. It has worked.

I can prove that regular singing in a group has improved my speaking voice quality by simply watching myself on television or on video. Singing has indeed improved my voice by improving my breathing and use of my diaphragm. The pitch, volume, and modulation of my voice are all more natural now. Just like when you are singing correctly, if you are speaking correctly then your throat should not get tired or sore after giving a talk. When I appear in television presentations now, my voice sounds better at midlife than it did during my twenties when I was reporting regularly on television. Back then, the problems with my voice were numerous. I would run out of air at the end of long sentences. When I was tired, my voice sounded weak, hoarse or artificial. Sometimes my throat would be sore after speaking for long periods of time. But I have learned that relaxing my throat, neck, shoulders, and face and opening my jaw and using my full diaphragm and breath to support my voice (as well as speaking with my natural pitch) have helped eliminate vocal problems.

You may be able to think of many other activities or hobbies, including singing or reciting poetry or storytelling, that require good posture and use of full breaths and vocal muscles to help you regularly produce a pleasant and understandable projection of your best vocal speaking voice. Try to engage in these activities as much as possible. Your voice muscles are like other muscles in your body—you need to use them to keep them in shape. Here are some tips and exercises that can help you improve your voice:

Tips to Improve Your Speaking Voice 1. Speak up and project. 2. Smile when you speak. 3. Slow down and enunciate. 4. Practice deep breathing and controlling your breath on the exhale. 5. Speak naturally and avoid being monotone. 6. Do vocal exercises (listed next). 7. Read aloud in front of a mirror. 8. Record yourself reading and listen to it. 9. Hire a voice coach or see a speech therapist.

Exercises to Improve Your Voice 1.   Good posture . Stand on two feet in a confident and comfortable manner. Make sure your weight is evenly distributed over both feet. Make sure your feet are hip-width apart. Do not lock your knees. Make sure your feet do not appear nailed into the ground or that you are frozen in position. You can take a few steps one way or the other if you want. Arms at your side. Your posture will affect your voice, and your body language will reinforce your image of confidence. Before we sing, we always stand and spend a few minutes making sure our posture is good. Our hips are over our knees. Our chests are lifted, ribs are in, and abdomen is soft. Move your head from side to side and drop one ear to one shoulder and the other ear to the other shoulder to loosen your neck. Do not stand on your heels or lean on one hip. You should be upright, strong, and supple like a dancer. Do not fidget or be rigid or appear frozen. Stand, breathe, and move with confidence. 2.   Breathe. Yawn a few times to open the jaw. Now take a deep full breath in on three counts and exhale out on three counts. Now again on five counts in and five counts out. Do this a few times. Diaphragmatic breathing is easy for some and counterintuitive for others. It took years for it to feel natural to me. Singing helped me the most. Put your hand on your belly. When you expand your belly as you breathe in, fill up slowly until you cannot take any more air in; then as you exhale, contract the belly and slowly but steadily breathe out. You will eventually feel the diaphragm literally pulling down and out to fill your lungs with air and then pushing up and inward as you exhale. The expansion as you inhale can be felt around the circumference of the mid-body including the back and the sides. A strong diaphragm and good breath control will give your voice more power and projection. 3.   Relax. Try to remove any tension from your body, especially from your face, jaw, and neck to your shoulders, back, and legs. Just as tension affects our bodies, it certainly affects our voices. The more at ease you are, the better your voice will sound. You should be alert, engaged, and ready to sing (or give your talk). Do a few shoulder rolls forward and backward. Twist your body gently from side to side. Breathe in and sigh out. 4.   Warm up and strengthen your instrument . Do some lip trills. This is what you may have called “motor boat” when you were young or playing with young children. Use air to vibrate your lips. You can hum notes or hum a song you know (e.g., “Oh, Say Can You See” or “Happy Birthday”). If you have trouble doing this, gently push or pull the sides of your lips together. You can also try to do a few enunciation exercises as outlined later.

My mother was a professional broadcaster and theater actress. As a little girl, I would ride in the car with her and listen as she practiced elocution and breathing exercises on the way to the broadcast station or theater. She would literally be warming up her vocal instrument so that she would be ready to perform. Try a few of these exercises to help warm up and keep your vocal skills sharp:

Exercises to Improve Enunciation and Elocution Say these slowly at first and then increase your speed: • She sells seashells by the seashore. • How now brown cow. • Peter piper picked a peck of pickled peppers. • Red leather, yellow leather. • Unique New York. Unique New York. • Betty Botter bought a bit of butter. But the bit of butter Betty Botter bought was bitter. So, Betty Botter bought a better bit of butter.

Read one or two of the exercises daily for at least several days before your presentation. Try to increase your speed. Record yourself. If you memorize a few of these, you will be able to use them as part of your warm-up exercises before you give a presentation.

There are many other exercises to help you awaken and strengthen all of the muscles of the face, tongue, throat, and diaphragm that produce your voice. You can certainly find many of these exercises on YouTube and elsewhere. You can also consider scheduling an appointment with a speech therapist and see if you need any professional help. You can hire a voice or singing coach to help you improve your voice or join a community theater or chorus.

Daily Voice Exercises from Voice Training 1.   Yawn five times . Soft palate lifts, brings down the lower jaw, and opens and stretches your instrument from the lips to the throat to the diaphragm. Some problems with voice, including a “nasal” quality or even mumbling, can be due to our tongues not being engaged and our soft palates not being lifted. When the back of our throat is opened (like during a yawn), the voice can sound better. 2.   Lip trills. Awakens and strengthens the muscles around the lips. 3.   Tongue trills. Engage the tongue, say “butter”; then bend tip of tongue up to roof of mouth and vibrate while making a sound. This awakens and strengthens the tongue. 4.   Say “Ho-hummmmmm” then hum a song or a scale. With the lips closed and the jaw, mouth, and back of the throat wide as possible. This will open and soften the throat—as well as help you find your natural pitch. 5.   Stifle a laugh . Keep your lips firmly pressed together. This will activate your jaw, lips, and other face and throat muscles. 6.   Tongue circling in the front of upper and lower teeth . Both directions. Count 4 right, then 4 left, then 3-3, 2-2, and 1-1. This will help strengthen and improve the agility of the tongue for clearer enunciation. 7.   Say or sing a vowel for as long as you can . (A) “ah” (E) “eh” (I) “eye” (O) “oh” (U) “oo.” Use a full breath. Sing or say one vowel at a time. Open your mouth as wide as you can (look in the mirror) and deepen the back of your mouth and expand your diaphragm.

How can we improve the projection of our voice? When we give a presentation, it is very important that we project to an audience with a full and resonant tone. We need a full breath and the ability to control it to produce this sound. According to Jayne Latz, speech pathologist, our power source is our diaphragm and there are many exercises we can learn to strengthen and engage it. 3 , 4

Here are her exercises as well as some I do in singing workshops: Stand or sit up in your chair with your feet firmly planted. (Do not do anything that makes you dizzy or feel sick. If you do feel faint, stop right away.) Make sure you are comfortable. Breathe in and then count loudly as far as you can. “One, two, three, four. . . .” Try it again and see if you can increase the number each time. Make sure during the last few numbers you say that you are still using a strong and full voice. Again, breathe in and then count aloud. Keep adding on to the numbers if you can. Fill your back muscles with air. Count outloud on the outbreath to ten, then to fifteen, and then try to count to twenty loudly and clearly if you can. You can also make a “hissing” sound on the exhale or sing or say a vowel sound (“ah” or “eh”). Look at your watch and time it, and continue to try to make it longer each time. Again, if you feel dizzy or out of breath, stop immediately and sit down.

You can improve your voice by doing these types of exercises daily. After becoming familiar with these types of exercises, you may begin to feel your diaphragm as you take much fuller breaths. Our breath is what produces our voice. The fuller our breath is, and the more we learn to utilize and control it, the better our voices will be. Speaking coaches will work with the specific characteristics of your voice, improving in areas where you may need it the most, from your volume and resonance to enunciation and clarity. There are many tools and techniques that can improve the quality of your voice. But the bottom line is that the better your voice is, the better your presentation will be.

The best thing most speakers can do is optimize their ordinary speaking voice for public performance. Audiences will like you better for it—and you will feel both more natural and more relaxed as a result. —Tina Blake, Voice coach 5

Four Common Mistakes in Presentations

Common Mistakes in Presentations • Letting your nerves get the best of you • Reading every word of a script • Speaking too quickly • Not engaging the audience

After years of leading communication skills training workshops and programs, I have witnessed many different types of problems, but there are some common mistakes I see most people make. Fortunately, there are many relatively quick and easy solutions.

Letting Your Nerves Get the Best of You

There is no doubt that if you let your mind create a stressful environment, then a shower of negative thoughts and anxiety often carried by your stress hormones will cascade over you during the classic fight, flight, or flee response. Once that physiologic mayhem begins to happen, it is hard to give a calm, clear, and concise presentation. Trust me, even the best public speakers get nervous, but they stay in charge of their nerves and emotions by doing the following:

  Realize it is normal to be nervous . Expert speakers realize that being nervous is a normal response. In other words, if you are not nervous, something is wrong. But the level of nervousness and how you handle those nerves will determine your success.

  Channeling nervous energy . You can channel nervous energy into a good performance with tools such as positive thinking, remembering why you wanted to give this talk and how important the information is for the audience. Remember to use your breathing and visualization techniques. If you are in charge of your emotions, you will be in charge of your presentation.

  Think of activities you are good at. What are you really good at? Think of the professional activities (e.g., operating as a surgeon, speaking with patients or medical students, diagnosing illnesses, talking to employees) or personal hobbies or activities (e.g., golf, tennis, skiing, painting, playing a musical instrument, talking to your children). Now, think about the confidence of your speech and your body language when you are doing those activities. Try to emulate your body language and voice from those activities when you give your presentation. Remember how nervous you were when you were a medical student and you interviewed your first patient? Think of how comfortable and confident you are now when you interview patients and know that you can be the same way in your presentations.

  It is not about you . One way I have calmed down many medical students and residents and improved their presentations of patients’ histories and physical exams is to remind them why they are doing the presentation. Presentations on rounds or while handing over care to another doctor are done to ensure that the next doctor or other doctors can take great care of your patient. The presentation is about the patient and not about the student or resident giving the presentation. The same is true for you. Remember, your presentation, regardless of the topic, is about the information you are teaching and message you are imparting. It is about your ultimate goal and overall mission in doing the presentation; it is not about you.

  Visualization and imagery . I often tell people to imagine that the presentation is over and visualize it playing out in the best possible way. Ask yourself a few important positive questions. How did it go? How great was it? How did you want your presentation to go? How did you want your audience to think about you and remember your information? Now, go out and make your presentation that way, just as great as you imagined it.

No one ever complains about a speech being too short. —Ira Hayes, US Marine

There is another strategy called a “premortem” (hypothetical opposite of a postmortem) or “prospective hindsight” that business people often use before a project is launched. A project team imagines that a project or organization has failed and then works backward to determine what potentially could lead to the failure of the project or organization. You could certainly do this before giving your presentation. Think about all that you are worried about. Play out each scenario or even write them down. When you review them one by one, they will not look so bad, and you can think of ways to prevent your worst fears from coming true during your presentation.

According to an article in the Harvard Business Review written by Gary Klein, “unlike a typical critiquing session, in which project team members are asked what might go wrong, the pre-mortem operates on the assumption that the ‘patient’ has died, and so asks what did go wrong. . . . The pre-mortem analysis seeks to identify threats and weaknesses via the hypothetical presumption of near-future failure. But if that presumption is incorrect, then the analysis may be identifying threats/weaknesses that are not in fact real. 6

Here is a sample a pre-mortem you could do before your presentation:

Ask yourself why are you so nervous to give this presentation. Articulate your specific reasons and fears out loud or write them down. Many of your fears may seem ridiculous and somewhat irrational. But you can also begin to create an emergency toolbox if any of your fears begin to come true during the presentation.

  Are you afraid you are going to freeze and forget what to say? Bring your cheat sheet of bulleted points and engaging quotes or phrases and, yes, even a script if you must. Prepare and practice beforehand. Take a deep breath. Look out and find a friendly face and smile. Calm down. Go with the flow. Be kind and supportive of yourself before, during, and after the presentation.

  Are you worried your throat will get dry and you will lose your voice? Bring water and some throat lozenges and keep them handy. Taking periodic sips of water (not a caffeinated beverage) will keep you hydrated and, most important, will give you and your audience a nice break.

  Do you fear you will make a mistake or lose your train of thought? Remember you are human. You might make a mistake. It is okay. Often, your audience will not notice, and even if they do, just apologize and get back on track. Again, bring your specific notes to glance at. Prepare and practice beforehand. Learn to react on your feet. “I am sorry, I think I just misspoke or stated that the wrong way. This is what I meant to say.”

  Are you afraid your audience won’t like you or you will look like a fool in front of your peers? Most audiences want you to succeed, they want to hear and be rewarded with your great presentation. Don’t imagine them in any other way. Look out while you are speaking to get immediate feedback from their expressions (and comments or questions) and then adjust as needed.

  Are you worried you will speak too quickly or in a monotone voice or not be understandable or look too stern? Videotape yourself practicing the talk. Watch and listen to it, and you will immediately see what you need to fix. Do you need to slow down or smile more or take a few pauses at important points? You may be your worst critic, so you may want to ask a friend to look at the video with you. Once you see yourself, you will likely know how to sound and look better.

  Think you may faint? Remember to sit down immediately if you are feeling faint or ill in any way. Tell your audience or others on the panel if you think this very rare event might be occurring.

  What will you do if you are asked tough questions? You should always try to predict the questions and comments you might receive from your audience and write down the answers beforehand. Prepare a list of responses such as, “that is a very good question but it is outside of the scope of my talk” or, “that is an interesting and important comment, I am happy to talk to you afterward.” Or you can always repeat the question back to them. Ask them to clarify the question and give you more specifics. “That is a good question—why do you ask or what do you think the right answer is?” Answer the question the best you can or simply say, “I am not sure of the answer to that.” Many people who ask tough questions just want to be heard and are not attacking you or your work. Even if they are challenging you, it is always best not to react emotionally or become defensive. Remain calm, confident, logical, in charge, and credible. The audience knows you have just received a tough question and, many times, they are just watching to see how you handle yourself and whether you can give an answer. Remember that your audience is not your enemy—they are your students and they are there to learn from you. But you are also there to learn from them, and like any conversation, it is okay to have a good give and take session. Ask them questions. Learn from them and what they have to say. Maybe someone in the audience knows the answer to the tough question someone else asked—listen to the answer, congratulate them and move on. Create and keep a collegial and supportive environment during your presentation.

  Could the computer or audio/video equipment fail? Think about all the possibilities of how technical equipment might fail, assume that it will, and have a backup thumb drive or alternative source of power or microphone or other important backup equipment. Know who and how you can call for assistance and how you might finish your presentation even if the equipment fails.

  Might the audience boo you or throw tomatoes at you? Keep a hooded rain jacket handy.

While you should consider the possibility of some of your worst fears happening, generally they will never occur. After you have examined your worst fears about public speaking, begin to focus on the positive aspects of yourself and imagine your presentation being a success. Just like in sports or in theater, visualizing a positive performance while you are preparing your presentation and before you begin are key to an optimal performance.

It takes one hour of preparation for each minute of presentation time. —Wayne Burgraff, American philosopher

One major reason that we become so nervous speaking in front of an audience is our fear of being evaluated, assessed, and rejected. Trust me, people are already evaluating, assessing, and, yes, even rejecting you at times, and there is very little you can do about any of it. So, during your talk just be who you are every day. Just prepare and know what you want to say, then practice your presentation, smile, be calm and confident, and remember to imagine and rehearse giving a great talk beforehand.

Visualization versus Premortem

Personally, I like to imagine myself giving a great talk in the exact setting I will be speaking in. I like to close my eyes for a few minutes and actually watch a movie of my performance, similar to what athletes do before they compete. I may even try to visit the location or simulate it in my office. I may record myself with audio or video so that I can watch myself and see if I sound and look okay. The minute I hear and see my recording, I can see things I can improve on. Am I speaking clearly and with enthusiasm? Or am I speaking too slowly or sternly? Am I smiling? Am I pausing and using natural infections? Am I sounding hesitant or unknowing? Am I slowing down and using important pauses when I say something really important? Do I sound natural? Are there any words, names, or data that I am worried about stumbling over? I focus and rehearse and sometimes record these beforehand just to make sure I reduce the risk for error.

Athletes and actors use visualization all of the time. Writing more than two thousand years ago, the famous philosopher and scientist, Aristotle, described the process this way:

First, have a definite, clear, practical ideal; a goal, an objective. Second, have the necessary means to achieve your ends: wisdom, money, materials, and methods. Third, adjust all your means to that end. —Aristotle

Creating the mental image of how you want your presentation to go can help you achieve your desired outcome. If you can see it before you perform it, then you can lower the chances of your nervous energy getting the best of you before you speak—and improve your odds of giving a great talk. We must see it before we can believe it. Before we can believe in a goal, our brains and our bodies have to know what it is going to look and feel like.

Reading Every Word of a Script

There are very few people who can read a speech word for word and make it engaging and effective. Usually, it will sound flat, perfunctory, and unnatural. Most of the people who can read a scripted presentation and sound engaging are actors or professional broadcasters.

But instead of using a script, you should have an outline with prepared bulleted points, data, and conclusions. If you are using slides, this can always help you stay focused and organized. But you still want to include your own impromptu comments, personal stories, or maybe even some light humor. You want to have a conversation with your audience about your key points. If you have a conversation (and don’t read a script), you will use natural pauses, modulation, and inflections; you will speak in your normal voice. You will use natural body language and facial expressions. You want to interact and react with your audience. You will not be frozen in a monotone voice or appear like a “deer in the headlights” in front of your audience. The key is to sound like you are having a discussion with your audience. Each audience is different so each time you give your talk it should be slightly different.

If You Must Read a Script

If you must read a script, and sometimes you will, then you need a well-written (and well rehearsed) script in a conversational tone. Use shorter sentences. Write creative, engaging and memorable phrases. Think about cadence and word choice and even poetry or free verse. Mark up your script while rehearsing it. Find the areas where you need to slow down or to pause. Your words need to be powerful, unforgettable, and well-selected. Think about political speeches and remember there is a reason that speech writing is a professional career. When you have a well-written script, you will need plenty of practice to use your natural speaking voice and make your message indelible. Remember to look up and out to your audience as often as possible. You can use your finger or a pen to keep track of where you are so when you look back down you know where to begin again. Professional broadcasters and actors are very good at this because they literally make physical or mental notes about when to look up at the audience and when to pause. (And they rehearse!) It takes practice reading from your notes or a teleprompter to appear natural. If you are using a teleprompter, ask for help beforehand and try to rehearse with the device as many times as you can. If you must read a script, you will have to practice looking relaxed, acknowledging individual faces in your audience, and speaking with varied tone, pitch, and breathing to emphasize important points. You need to allow your audience to listen and enjoy your words. Making notes in the margins of your script to remember to smile, breathe, and make eye contact can be helpful and important. Underlining or highlighting statistics or important phrases can be critical.

Speaking Too Quickly

Many people speak too fast. Most people do not speak too slowly. Again, in reality, for most people it is almost impossible to speak too slowly. The biggest problem with reading or memorizing a script (or being nervous) is that you may tend to speak even more quickly. Reading a script (or memorizing a script) may make you speak too quickly, but even when not reading a script, many people will speak with too much speed. Unfortunately, if you do speak too fast, people will not be able to understand you. Imagine if you spoke a foreign language to your audience. They would not understand, much less remember a thing you said, right? If you speak too quickly, you might as well speak in a foreign language because your audience will not understand you.

By slowing down a speeded-up presentation and using passion and natural inflections and rhythms of your own voice (and making eye contact with your audience), you will be seen, heard, and remembered. Speaking in a flat monotone voice without any energy is not the same as speaking too slowly. In all my years of teaching communication skills, I have seen very few people speak too slowly.

Not Engaging Your Audience

One of the most common problems for many speakers is not smiling, making eye contact, or using natural facial expressions. You need to make eye contact with the audience as much as possible, and avoid a “deer in the headlights” appearance. Smile more and use natural expressions. If you are speaking about a very serious subject, and smiling would be inappropriate, you can soften your facial features and avoid looking stern or nervous by appearing earnest, solemn, calm and encouraging or using other emotional expressions suitable to your topic. Before you begin speaking, take a full breath and look out to your audience. Find at least one friendly face and connect with them. Throughout your presentation, continue to find another friendly face to connect with. If you do this, you will receive three major benefits: First, you will appear calm and confident. People will trust you and look right back in your eyes. Second, you will receive immediate feedback on how you are doing. If your audience is looking perplexed, you are not being clear or believable. If your audience is looking bored or distracted, you are not being conversational, enthusiastic, or engaging. Third, in looking up and out, you will pause, and your speed and delivery will be more natural.

Know Your Mission, Audience, Content, and Yourself

As I mentioned earlier, I developed a lesson to help people improve their public speaking presentations and other communication endeavors. I call it, “MACY” for mission, audience, content, and you. These are the four important aspects to think about before and during your presentation. Before you begin to plan and practice your presentation, try to answer these questions:

  M—Mission : What is my mission? Why am I speaking? What is the purpose of this talk? What is my ultimate goal? If I could accomplish one goal with this talk what would it be? State your mission in one sentence.

  A—Audience : Who are they? What do they need from me? What do they already know? (You may need to ask them directly.) What do the members of the audience want to know? What will they learn from my talk? How can I be most responsive to their needs?

  C—Content : Make sure it is organized and informative. Use words and phrases that make your message concise, relevant, and engaging. Tell a story if you can. Overall, make sure your talk has a beginning, a middle, and an end. Be prepared with specific points you want to make but also be prepared to improvise. Have a conversation with your audience about your important points. Do not read every word from a prepared lecture.

  Y—You : Be prepared, organized, and rested. Be calm, clear, and confident. Rehearse the entire talk at least twice in the week leading up to the talk. Know why you are the best person to give this talk on this day. And remember, it is not about you—it is about the information you are presenting.

I am convinced that most people have all the tools they need to be a great communicator. To help you improve, it usually requires identifying and tapping into your natural communication skills and then using them in an unnatural setting. It also requires identifying and eliminating obstacles or habits that may be getting in your way of giving a great presentation.

How can you identify and tap into your natural communication style and skills? Think about when you are with friends, trusted colleagues, or beloved family members. Stop and listen to yourself when you are talking to a friend or doing an activity that you are good at. Most likely you are clear and confident. You know you have something to say and something to do, and you go about doing just that in a natural way. Your body language and posture, as well as your facial expressions and your voice, tell everyone you know what you are doing. That character and persona is what you need to tap into to transfer these attributes to your presentation skills. But how do you translate being poised, eloquent, fluent, effective, persuasive, lucid, expressive, intelligible, comprehensible, and understandable into another setting—particularly at a podium in front of a large audience or in front of a video camera in a television studio?

First, we need to tap into the basics of what makes a good communicator. Again we can turn to Aristotle and the 3 critical elements of a great communicator he identified. Ethos is our character, credibility, reputation, trustworthiness, tone and style. Pathos is our emotional imaginative impact—the stories we tell to make a personal connection. Logos is the reasoning, arguments, facts, figures and case studies we use—the logic and the actual words we speak.

We do all of these naturally when we are engaging in an activity we are good at. Do you remember the first time you played the piano, examined a patient, performed surgery, or followed a recipe? My guess is that you were not as confident and capable as you are now doing those activities, right? How did you gain that confidence?

Yes, with knowledge, expertise and practice, but also focusing not on yourself but on the task at hand. You need to play the music on the piano keys, not think about yourself playing each note. You need to examine that patient and present your findings to your team and not focus on your words or pauses or posture. You need to swing that golf club or tennis racquet for a successful game and not think about how nervous you are trying to perfectly connect with the ball.

You need to focus on the task at hand. You need to play the concerto and win the point. You need to give a great presentation. The information you are presenting needs to be communicated. The audience wants to hear your message and learn from you. Communicate with confidence and by using your natural abilities and talents.

Observe Natural Communicators—including Yourself

Try to study people who are natural communicators. When you are listening to a live lecture or watching a TED talk or a news broadcaster on television, think about what qualities you appreciate in a speaker. What makes them effective at communicating? What is their body language? What are their facial expressions? How lively and interesting is their voice? How are they connecting with the audience or the camera? How do they make you feel as if they are talking directly to you? Do you think they are nervous? Trust me, they are, but they are letting their message be more important than their nerves.

Most important, you need to observe and study yourself. Again, what do you sound and look like when you are with your best friends or family? When you are talking to your children or sailing your boat or riding your bike? When you are engaging in familiar activities in familiar settings, what does your voice sound like? You can transfer this confidence, conversational speaking style, calmness, and clarity to your public speaking.

Imagine that Your Audience (or the Camera) Is Your Best Friend

Think of someone who makes you feel both calm and confident—someone who believes in you. Bring that person to mind and really see and hear them. They are looking and listening to you, and they want not only to hear what you have to say but also for you to do a good job. Whether this is your best friend, a trusted colleague, or a family member, imagine this person is in the audience (or in the camera) and then speak directly to him or her.

One Skill You Would Like to Improve

If you could improve one aspect of your presentation skills, what would it be? Most people usually know where they need to improve their communication capabilities.

Do you speak too quickly? Do you try to memorize and end up sounding like a machine speaking in a monotone voice? Are you too nervous to make eye contact with the audience? Are you so uptight that you do not blink or smile or use your natural facial expressions? Do you forget to take a big breath and calm yourself beforehand? Can you be calm and focused and just have a conversation so that you incorporate pauses and natural inflections in your speech? Can you improvise or react when you get a tough question or something goes wrong with the equipment? Write down your important points and answers to tough questions you may be asked before you begin.

Again, the most important tip I can give is to be yourself and have a conversation with your audience.

Avoid the Standard Format if You Can

Many medical talks, like published abstracts, academic writing, research articles, and patient notes (e.g., histories and physical exams) often follow a standard format. Most medical presentations use or misuse slide programs such as PowerPoint. But that doesn’t mean you have to—especially when speaking to a nonacademic audience. Even in an academic setting, think about ways to break the mold and be more effective and informative, and your audience will thank you.

How can you improve your clinical talk, academic research, or other important presentation to your peers?

Why should you avoid jargon even when speaking to your peers? In every profession, including medicine, we use jargon and acronyms assuming everyone in the audience understands us. The problem is that it is not always true. Often, using professional jargon, buzz words or acronyms becomes a bad habit and a crutch that limits the discussion instead of broadening it. Many times, you and your peers have either never known or have forgotten what the real meaning is. And even if that is not true, there is nothing that makes a talk flat and uninspiring as one that is riddled with idioms and professional vernacular. Challenge yourself, with your writing and your speaking, to avoid the use of jargon, abstruse professional terminology, and acronyms. Try to stop using words like “stakeholders” “big data” “population health management” and “innovative care strategies” and just use words to explain exactly what you are talking about. Pretend you are talking to someone outside of health care. Use plain English. If you must use acronyms (and medicine is filled with them), at least say the whole phrase or name—at least once say endoscopic retrograde cholangiopancratography instead of ERCP or lateral collateral ligament instead of LCL. You will not only broaden your audience (not everyone always knows the professional jargon you may use), but your audience will listen more closely and maybe even learn and or remember something they had forgotten.

Do you and your audience really know the meaning of all the acronyms you use? Even if you and they do, what is the harm in saying the full meaning once in your talk? Words are powerful and informative. Acronyms are slang crutches and shortcuts that can become outdated or misleading. They can clutter our presentations, preventing us from fully engaging our brains. I challenge you to avoid any use of acronyms the next time you give a presentation.

Slide Presentations: PowerPoint and Others

The vast majority of presentations today still utilize Microsoft PowerPoint, but there are certainly other slide presentation programs now available, including Google Slides, Prezi, Visme, Haiku Deck, Emaze, Keynote, Projeqt, Slidedog, Slidebean, and Zoho Show. Slide-building software programs are invaluable tools to help illustrate and illuminate your information. Unfortunately, many people make major errors in using the programs. First, most people use too many words on each slide. Many speakers fill each slide with text or even write out their entire talk on each slide. Then they proceed to read whole paragraphs and even sections of chapters or expect their audience to read large sections of text from each slide. This is not only inefficient but also boring and frustrating.

You want to use PowerPoint or another slide program to elucidate and augment your talk not as a crutch or a distraction. Illustrations, graphs, photographs, formulas, data points, life cycles, and other simple but efficacious graphics should bring your presentation to life. They should be simple and easily understood. You should use as little text as possible. You also should not overwhelm your audience with moving graphics or too many bells and whistles. You are giving a lecture, not putting on a circus of multimedia examples. Think of yourself as an audience member. You want to be informed and enlightened, not befuddled and bombarded with special effects.

The slides should speak for themselves. You should not have to “read” your slides to your audience. You can refer to them or let them illustrate what you are saying but do not read them outloud. You want to make eye contact as much as possible while talking to your audience. You are having a conversation with your audience and making important points. Slides should illustrate information clearly and memorably than your spoken words. Again, do not write out your talk on your slides to use as a crutch. Know your talk well from your rehearsals and then illustrate the important points with graphic slides.

[S]cientists look toward the projected slides a lot when they present. As a result, they fail to maintain eye contact with the audience, which is a very important part of a good presentation. In my study I found that, during a 20-minute presentation, speakers turn toward the projection an average of 3 times per minute. —Brigitte Hertz, PhD, Wageningen University, Netherlands 7

Best Practices for Slide Presentations • Write the outline of your talk before making any slides. • Limit the number of words on each slide. • Slides should augment your information (not distract). • Use graphs, illustrations, formulas, and pictures. • Important visual message on each slide should speak for itself. • Use 10 relevant slides for twenty-minute talk (or 20 slides for forty-minute talk). • Slides should communicate something you cannot say in words.

Informal Audiences: Patients and the Public

If you have the opportunity to speak to a group of patients or members of the public or others in a community or academic setting, by all means do it. Some physicians are more intimidated talking to a group of nonphysicians than they are speaking to peers, but they shouldn’t be.

Talking to a group of patients or members of the public is no different than talking to patients one to one or members of the public one to one. True, these are not medical colleagues, and you may need to speak in simpler terms and explain technical points or complex medical information, but you should be doing that regardless of your audience. With a nonmedical audience, you should think about talking to individual members of the audience, not a large group of faceless audience members. Think about talking to specific family members and friends who are do not work in medicine. You can still be informative and engaging even without using scientific, academic or professional words or jargon.

Fred Sullivan Jr. is a professional actor who teaches public speaking. He teaches his students to imagine they are throwing a ball to the audience when they are speaking, and the audience has to catch it and throw it back. This image illustrates the dialogue you have to have with your audience—you need to make sure they are hearing and understanding you. Take your cues from their facial expressions, ask them questions, and encourage their questions to make sure you are throwing the ball (your information and message) and they are catching it (understanding your message and responding to your information).

Tips for Excellent Presentations • Make eye contact with specific audience members. • Relax—be comfortable and confident. • Tell a story (beginning, middle, and end). • Use humor (but be appropriate and be cautious not to offend). • Ask the audience questions. • Poll your audience by asking for a “show of hands.” • Encourage the audience to ask you questions.

The most precious things in speech are the pauses. —Sir Ralph Richardson, actor

In 1986, I read The Man Who Mistook His Wife for a Hat by the brilliant Dr. Oliver Sacks. I learned that he was speaking at the Harvard Graduate School of Education that fall and I could not wait to attend. I arrived early and noticed Dr. Sacks in the hallway outside the classroom by himself. I approached him with my pen and my copy of his book in hand. But when he noticed me, he snapped at me with a menacing look. I don’t remember exactly what he said, but I quickly went into the classroom and took my seat near the front. Throughout his lecture, I noticed he was sweating profusely. Many of his slides (shown through an old carousel slide projector) were out of order. He seemed frustrated. Even though his lecture was not as smooth as I thought it could be, it was still interesting. But I was embarrassed and nervous myself about approaching him again. The minute Dr. Sacks finished, and once the applause and cordial exchanges ended, he came directly over to me and apologized. He explained how nervous he was about public speaking. He asked to sign my book. I still have the book and cherish his autograph to this day. But it was an early lesson that even some of the finest minds (and writers) among us are not always naturally great lecturers.

Of course, in the decades that followed, Dr. Sacks became a public figure and gave many interviews and talks and often appeared on television. He clearly became more comfortable speaking to groups, and perhaps he received some professional communications training along the way. But he certainly improved his skills and hopefully reduced his anxiety.

Don’t Be Afraid to Ask the Audience Questions

Peggy Noonan, author and political speech writer for President Ronald Reagan, spoke at Harvard Kennedy School in the late 1980s. I squeezed into the standing-room-only auditorium packed with students, faculty, and others. After being introduced, the accomplished and brilliant Noonan went up to the microphone and looked out over the audience. The room was silent. No one could wait to hear from the person who wrote some of the best political speeches of our time, including President Reagan’s “Boys of Pointe du Hoc” speech on the 40th anniversary of D-Day and his address to the nation after the Challenger explosion, and Vice President George H. W. Bush’s famous phrases “a kinder, gentler nation” and “a thousand points of light.”

She stood at the microphone, looked out over the audience, and said, “tell me what questions you have.” My heart sank, when I realized this phenomenal speech writer had not prepared her own speech for us. I was a little taken aback. But then Noonan proceeded to take an hour of questions from the audience and gave the most eloquent, thorough, and informative answers you can imagine. She gave the audience exactly what they had come for—a chance to ask their specific questions. There was a standing ovation from the audience at the end of her talk.

While I don’t recommend you doing what Noonan did for your presentations, I do think the take-home lesson is to try to give the audience what they want and need from you. Know your audience. Know what they already know and what they need from you. Keep looking directly at their faces during your talk to see how you are doing. Encourage comments and feedback. Leave time for questions either throughout the talk or at the end.

What is difficult about speaking to a group of nonpeers is that you may not know what they already know and what they hope to learn from you. Whether you are speaking to a group of patients at the community library or legislators at the state capitol, here are some tips that can help you “read” your audience:

  Ask the audience questions. Start out by asking a few questions that would help you understand their level of understanding. “Does anyone know the year AIDS was first described?” “Can anyone tell me what country has higher overall vaccination rates—Cuba or the United States?” Asking a question is a great way to begin your talk—and your conversation with your audience. Of course, you should also try to figure out what burning questions your audience hopes you will answer in your talk. Go ahead and ask them a few open-end questions before you start. You can answer their questions right then or better yet write them down and tell them you will make sure you address those questions in your talk. Some audience members will just want to make a comment and not have a specific question. You can always respond to comments and expand on them. “That is a very good point and here is some more information about that topic” or “I will talk more about that later in my talk” or simply “That is interesting” and then move on.

  Introductions . Ask for a few volunteers from the audience to introduce themselves and tell you what they are hoping to learn from your talk. If there is time, and it is a small audience, you can certainly have everyone introduce themselves.

  Encourage comments . Before you begin, tell your audience that you welcome questions and comments either throughout your talk or at the end. It will help you and your audience warm up and get to know each other if you take questions early on. After you begin your presentation, you can decide whether you want to be interrupted during your talk. I usually prefer to be interrupted throughout my talk because then my presentation becomes more of a conversation with the audience. But you can also tell your audience that you will leave enough time for questions, answers, and discussion at the end of your talk, which may help you keep from getting off point or running out of time. If you do this, then encourage your audience to write down any questions and make sure to ask them when you are finished with your talk.

But what if your audience is a camera? Here are some lessons about giving a presentation on a television broadcast or via a recorded video.

Video Skills: On-Camera Presentations

If you are speaking to a camera, first of all you need to do two things: (1) forget the camera is a camera, and (2) imagine the lens is your best friend. Again, imagine that someone who helps you feel calm and confident (a family member, colleague, or a friend) is literally sitting inside the lens. Talk to that person.

If you can actually imagine that your best friend, beloved family member, or trusted colleague is inside that lens, then you will lean into the camera and talk to them directly. Your body and your voice will be more natural. Of course, there is no one looking back at you giving you immediate feedback, as with a live audience, but imaging that someone you admire is listening to you will help you look into the lens and be a sincere, effectual and natural communicator. Your eyes should not be reading a script or darting around the room. You should be smiling and pausing and using your natural compelling and useful facial expressions. Everyone looks better when they smile, breathe, and let their body and their breath follow their thoughts and the mission of communicating important information.

Like an actor, if your mind can think of a person you trust and like (or even love) and who helps make you feel comfortable and confident, then your body, face, and voice will ease, and you will be on your way to using your own best style to communicate authentically.

If you are speaking to a camera, you need to make “natural” eye contact with the lens. This can be intimidating at first. But if you can imagine that the lens is the actual face of your best friend or trusted colleague, you will look and speak naturally. If you can imagine that a family member or friend is literally inside the lens, you won’t appear stone faced or have a “deer in the headlights” look. You don’t want to grimace, squint, or think about how much or how little you blink or if your smile is okay. You don’t want your eyes to look like they are reading a script or darting around the room and making you look shifty. If you can look straight into the camera and just truly imagine talking to the friendly person you have identified, then you will loosen up and appear less formal. You will be on your way to using your own best style to communicate authentically, even when speaking to a camera.

Writing for Video

When you write down the actual message and information you would like to say to the audience (through the camera), the information needs to be clear, concise, and conversational. Usually, you will want to state your name and your title first. Just like you would in person, introduce yourself and tell the audience the title of your talk. You should tell them what they are about to hear and why they should listen. Introduce yourself and grab their attention. You will want to tell a story to keep your audience engaged. Use short sentences. Use meaningful memorable phrases. Do not use jargon or professional buzzwords. Make sure you have written down five important points you want to make. Write down any statistics or data you need to cite, but present all of this information as a story and in a conversational style. Make the words sound as if you are talking to your best friend. Make it passionate and informative.

Name It and Give It a Title

You will also want to give your talk a brief, memorable, and descriptive title. After the audience hears a title, they are ready to grasp the details and explanation. When we give something a name or a title, we give it meaning so that we can make it tangible and memorable. We help our audience know what to expect with a title.

Be yourself. It is not about you. It is about the information. Breathe. Smile. Look the person (or the camera) directly in the eye. Watch others and see what works—but more important, watch yourself when you are talking to your friend or family member about something you are excited about. Slow down in important sections. Pause after an important point. Don’t speed up or throw away lines (your name, title, project). Sit up or stand. Be enthusiastic and passionate. Make them care about what you are saying.

Framing . Try to make sure that your head, shoulders, and upper torso fill two thirds of the video screen. Try to make sure there are no windows or mirrors or ceilings in the picture. Sometimes you will see a very nice interview done in front of a window—but usually the lighting is perfect, and there are trees, sunshine, and a pretty landscape seen through the window. This is difficult to make look professional and usually requires professional photographers and lighting specialists.

Lighting . Most video cameras, even those in our computer screens or phones, make automatic adjustments as needed for lighting. You usually do not have to worry about doing any special lighting yourself. Usually the best lighting is natural lighting from windows nearby (but the windows should not be seen in the frame). If you must use the lights in the room (or on the camera), make sure that when you take a sample video, your face is not too dark and the overall lighting of the room is pleasing and not distracting by being too bright or too dark.

Clean office and neat background . Make sure your office, desk, bookshelves, and room seen in the video are clean and neat. You do not want a distracted or cluttered background. You want the exam room, office, or desk area to appear organized and professional. It should not be obtrusive. You can first take a still frame shot of yourself as you will appear in the video and then look at it and make sure it looks as good as it can before you begin videotaping. Make sure there is not an overflowing trash can or several piles of paper or clutter nearby.

Your appearance. Dressing in professional business attire is usually recommended. You want to be comfortable but make sure that what you wear is conveying the image you want to project. You should wear whatever you would wear in person to speak to the audience for whom you are videotaping. Follow whatever is the professional norm in your environment. Remember that it is usually better to be slightly overdressed than underdressed. Your clothes and your appearance are your image.

Clothes for On-Camera Appearance • Professional business attire is usually best. • Wear something that fits and is comfortable while standing or sitting. • Avoid wearing black or very dark clothing. • Avoid all white (usually includes a doctor’s white coat); white doesn’t look good on camera. • Avoid busy, loud, or small prints. • Avoid large jewelry because it can cause noise. • Have a suit, shirt, or dress lapel or collar to clip a microphone on. • Do not wear hats or large earrings. • Wear dress shoes (assume your legs and feet will be seen). • For men, navy blue suits with light shirt and tie look best on camera. • Women can usually wear pastels or bright solid colors. • Bring a backup suit or dress in another color in case you need to change.

In preparation for your presentation, think about the following: Your words. Your voice. Your body language. Your authenticity. Remember to just try to have a conversation with your audience. Do not read your speech or use a teleprompter. Smile. Breathe. Focus. Educate and engage your audience and they will remember you and the information you taught them.

Tips to Improve Vocal Skills and Presentations • Do more presentations and public speaking (not fewer). • Watch and study the experts, TED talks, lectures, political speeches, and other presentations. • Practice and record yourself giving a talk (find others to join you). • Listen (or watch) your recording and see what you need to change. Do you need to speak slower or pick up the pace? Be more animated? Smile more? Be more relaxed? • Take an acting class or public speaking seminar. • Find a voice coach or public speaking teacher. • Consult a speech therapist. • Join a chorus (singing can improve breathing and voice quality).

Practice, Practice, Practice

Always practice. Do a run through with another person if possible. But at the very least, read it out loud at least once. Time yourself. Try to videotape yourself. This can be very helpful.

Advice for Video Presentations • Your head, shoulders, and upper torso should fill up two thirds of the video screen. You should be the largest object in the picture. • The background should not be distracting. It should be clean and professional. Take a still picture first with you in it just the way you will be sitting when you talk to the camera, before you start. Make sure you and your background look the way you want them to. • Make sure you are eye to eye with the lens. You do not want to be looking down at or up into the lens. • Do not sit in front of a window or a mirror when videotaping yourself. • Make sure a lamp, plant, or other object does not appear to be growing out of your head. Background objects should be to the side of you generally. • You should be well-lit and well-framed. • Have a conversation with the lens as if your best friend were sitting inside the camera. • Think about standing because it will give your voice and body more energy. • If you sit, sit up comfortably with good posture. • Do not look frozen or assume a “deer in the headlights” look. • Soften your features and smile more. • Be confident that you know the information you are presenting. • Don’t think it has to be perfect. Speak naturally. Just talk and have a conversation with the lens. Talk like you do in your everyday life. It is okay to have a few filler words and not speak in complete sentences. • Make it a great video presentation!

Advice for Live Presentations • Relax, lean into the microphone or podium, and first say hello and introduce yourself. • Make sure you have water nearby. • Remember to ask the audience questions about their background and their experiences, including whether they are comfortable with the room audio, visuals, lighting, and temperature. • Talk to the audience like it is an audience of close colleagues and friends. • Speak in your natural voice with inflections and enthusiasm. • Wear professional attire that you are comfortable wearing while sitting or standing—and that projects your desired image. • Make sure there is a place on your clothing to attach a microphone if necessary (suit jacket or collar lapel). • Do not read a script. Memorize or write down the important points you want to make and the flow of your talk, then just have a conversation about your topic. • Create a catchy and memorable title for your project. • Know your opening and closing lines and make them memorable. • Use pauses effectively before or after you state important points. • Uses pauses to look out at your audience. • Speak slowly and clearly but with good energy and passion. • Do not look frozen or fearful. • Soften your features and smile more. • Think about standing because it will give your voice and body more energy. • If you sit, sit up comfortably with good posture. • Have a great presentation!

Further Reading

Matt Abrahams , “A Big Data Approach to Public Speaking,” Stanford Business , April 4, 2016. Retrieved from: https://www.gsb.stanford.edu/insights/big-data-approach-public-speaking .

Dorie Clark , “A Checklist for More Persuasive Presentations,” Harvard Business Review, October 11, 2016. Retrieved from: https://hbr.org/2016/10/a-checklist-for-more-persuasive-presentations .

Peggy Noonan , On Speaking Well: How to Give a Speech with Style, Substance and Clarity (New York: Regan Books, 1999 ).

Google Scholar

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Steve Olenski , “Five Communications Skills that Make Good Leaders Great,” Forbes, March 29, 2016. Retrieved from: https://www.forbes.com/sites/steveolenski/2016/03/29/five-communication-skills-that-make-good-leaders-great/#48bbe0457ae9 .

Charles Osgood , Osgood on Speaking: How to Think on Your Feet without Falling on Your Face (New York: William Morrow, 1988 ).

William Safire , Lend Me Your Ears: Great Speeches in History, Updated and expanded edition (New York: W. W. Norton, 2004 ).

Rebecca Shambaugh , “To Sound Like a Leader, Think about What You Say and How and When You Say It,” Harvard Business Review, October 31, 2017. Retrieved from: https://hbr.org/2017/10/to-sound-like-a-leader-think-about-what-you-say-and-how-and-when-you-say-it .

Allison Shapira , “Breathing Is the Key to Persuasive Public Speaking,” Harvard Business Review, June 30, 2015. Retrieved from: https://hbr.org/2015/06/breathing-is-the-key-to-persuasive-public-speaking .

1.   A. Tunkel , “White Coat Address at Cooper Medical School of Rowan University,” September 14, 2018. Retrieved from: http://cmsru.rowan.edu/students/whitecoat/ .

2.   S. Louet , “Your Voice: Your Passport to Authority,” Science , January 27, 2012. Retrieved from: https://www.sciencemag.org/careers/2012/01/your-voice-your-passport-authority .

3.   J. Latz , Communicating Up the Corporate Ladder (Oceanside, CA: Indie Books International, 2016 ).

4.   J. Latz , “Be Clear, Concise and Confident with Corporate Speech Solutions,” YouTube , January 30, 2017. Retrieved from: https://www.youtube.com/watch?v=8rQiqC6q5gUJayneLatz ; https://www.corporatespeechsolutions.com .

5.   T. Blake . Retrieved from: http://www.tinablake.com/category/voice/ .

6.   G. Klein , “Performing a Project Premortem,” Harvard Business Review, September 2007. Retrieved from: https://hbr.org/2007/09/performing-a-project-premortem .

7.   Hertz, B. , Kerkhof, P. , and van Woerkum, C. “ PowerPoint Slides as Speaking Notes: The Influence of Speaking Anxiety on the Use of Text on Slides,”   Business and Professional Communication Quarterly,   2016 ;79(3):348–359, doi: 10.1177/2329490615620416. 10.1177/2329490615620416

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Presentation Skills Toolkit for Medical Students

New section.

The ability to design and deliver an effective presentation is an important skill for all learners to develop. The Undergraduate Medical Education Section of the Group on Educational Affairs developed this toolkit as a resource for medical students and health professions trainees as you learn to create and give effective presentations in the classroom, in the clinical setting, and at academic meetings and conferences. In this toolkit, you’ll find helpful resources on developing and delivering formal lectures and presentations, poster and oral abstract presentations, patient presentations, and leading small group sessions.

Please note: Availability of resources may change over time. To suggest edits or updates, email  [email protected] .

On this page:

Formal lectures and presentations, posters and abstracts, patient presentations.

• Leading Small Groups

Traditional academic presentations in medicine and the biomedical sciences are necessarily dense with complex content. Thus, slides tend to be wordy, and presenters may use their slides as cue cards for themselves rather than as tools to facilitate learning for their audience. With the necessary resources, medical students (and presenters at all levels) can better identify appropriate learning objectives and develop presentations that help learners meet those objectives. Organization of content, clarity of slide design, and professional delivery are all essential components to designing and giving effective formal presentations.

Achieving all of these elements can make creating and delivering a formal presentation challenging. The strategies and resources below can help you develop a successful formal presentation.

View long description of infographic .

Strategies for success

• Define the objectives of the presentation. Always define learning objectives for each of your lectures to make it clear what knowledge or skills the audience should acquire from your presentation. The best learning objectives define specific, measurable, or observable knowledge or skill gains. Furthermore, consider how to communicate the importance of the topic to your audience and how information should be arranged to best communicate your key points.
• Design an effective slide set. You should begin creating your slides only after defining your objectives and key points. The slides should support your talk but not be your talk. Keep slides simple. The audience should be able to review a slide and grasp key points quickly. Avoid lengthy text and distracting decorative fonts, clip art, graphs, and pictures. If additional wording or images are necessary, consider handouts or alternative methods of sharing this information. Lastly, design your slide deck to emphasize the key points, revisiting your outline as necessary, and summarize concepts at regular intervals throughout your presentation to strengthen knowledge gains.  
• Practice your performance. Effective public speaking starts with preparation and practice. Ensure there is enough time to create your lecture and a supporting slide deck. Know your lecture material and slides without prompts! Understand the audience and learning climate (the size and knowledge level of your audience) and be prepared for the venue (virtual, in-person, or both, lecture hall or classroom). Think about what effective audience engagement may look like and how to incorporate audience response systems, polling, etc., into the lecture.
• Create a positive learning environment. Anticipate questions and allocate sufficient time to answer them. Always repeat the questions being asked for the audience’s benefit and to ensure your understanding. Some questions may be challenging, so be prepared and answer honestly. It is acceptable not to know an answer.
• Demonstrate professionalism in presenting. Exhibit professionalism by being punctual and having appropriate time management. Remember that mistakes happen; be kind to yourself and remain calm and collected. Be enthusiastic: If you can enjoy the experience, so will your audience. Finally, be open to feedback following your presentation. 

Additional resources

Below is a collection of resources that further address the elements of creating and delivering a formal presentation. Each resource addresses a specific presentation skill or set of skills listed above and can be used to develop your understanding further. 

• Healthy Presentations: How to Craft Exceptional Lectures in Medicine, the Health Professions, and the Biomedical Sciences (requires purchase, book). This illustrated book is a practical guide for improving scientific presentations. It includes specific, practical guidance on crafting a talk, tips on incorporating interactive elements to facilitate active learning, and before-and-after examples of improved slide design. (Skills addressed: 1-3)
• American College of Physicians: Giving the Podium Presentation (freely available, website). This guide includes recommendations related to presentation delivery, including tips on what to wear, how to prepare, answering questions, and anticipating the unexpected. (Skills addressed: 3-5)
• The 4 Ps of Giving a Good Presentation (freely available, PDF). This simple guide on public speaking from the University of Hull covers such topics as positive thinking, preparing, practice, and performing. (Skills addressed: 3-5)
• Zoom Guides (freely available, website). This website from the University of California, San Francisco is one of many great resources created by universities for presenting on a virtual platform, specifically Zoom. (Skills addressed: 3-5)
• Writing Learning Objectives (freely available, PDF). This excellent resource from the AAMC defines Bloom’s Taxonomy and provides verbiage for creating learning objectives. (Skill addressed: 1)
• Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83 (freely available, article). This AMEE Guide explains and explores the more commonly used adult learning theories and how they can be used to enhance learning. It presents a model that combines many of the theories into a flow diagram that can be followed by those planning a presentation. (Skill addressed: 1)
• Assertion-Evidence Approach (freely available, website). This approach to slide design incorporates clear messaging and the strategic combination of text and images. (Skill addressed: 2)
• Multimedia Learning (requires purchase, book). This book outlines the learning theories that should guide all good slide design. It is an accessible resource that will help presenters of all levels create slide decks that best facilitate learning. (Skill addressed: 2)
• Collaborative Learning and Integrated Mentoring in the Biosciences (CLIMB) (freely available, website). This website from Northwestern University shares slide design tips for scientific presentations. Specific tips include simplifying messages and annotating images and tables to facilitate learning. (Skill addressed: 2)
• Clear and to the Point (freely available, online book). This book describes 8 psychological principles for constructing compelling PowerPoint presentations. (Skill addressed: 2)

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Presenting the results of the research projects, innovations, and other work you have invested in at regional and national meetings is a tremendous opportunity to advance heath care, gain exposure to thought leaders in your field, and put your evidence-based medicine and communication skills into practice in a different arena. Effective scientific presentations at meetings also provide a chance for you to interact with an engaged audience, receive valuable feedback, be exposed to others’ projects, and expand your professional network. Preparation and practice are integral to getting the most out of these experiences.  

The strategies and resources below will help you successfully present both posters and abstracts at scientific meetings. 

Strategies for success  

• Identify a poster’s/abstract’s purpose and key points . Determine the purpose of sharing your work (feedback vs. sharing a new methodology vs. disseminating a novel finding) and tailor the information in your poster or abstract to meet that objective. Identify one to three key points. Keep in mind the knowledge and expertise of the intended audience; the amount of detail that you need to provide at a general vs. specialized meeting may vary. 
• Design an effective poster . Design your poster to follow a logical flow and keep it uncluttered. The methods and data should support your conclusions without extraneous information; every chart or image should serve a purpose. Explicitly outline the key takeaways at the beginning or end.  
• Present in a conversational, informal style . Imagine you are explaining your project to a colleague. The purpose of your work and key points should guide your presentation, and your explanation of the methods and data should link to your conclusions. Be prepared to discuss the limitations of your project, outline directions for future research, and receive feedback from your audience. Treat feedback as an opportunity to improve your project prior to producing a manuscript.  

Additional resources  

These resources support the development of the skills mentioned above, guiding you through the steps of developing a poster that frames your research in a clear and concise manner. The videos provide examples that can serve as models of effective poster and abstract presentations. 

• How to design an outstanding poster (freely available, article). This article outlines key items for laying out an effective poster, structuring it with the audience in mind, practicing your presentation, and maximizing your work’s impact at meetings. (Skills addressed: 1-3) 
• Giving an Effective Poster Presentation (freely available, video). This video shows medical students in action presenting their work and shares strategies for presenting your poster in a conversational style, preparing for questions, and engaging viewers. (Skills addressed: 2,3) 
• Better Scientific Poster (freely available, toolkit). This toolkit includes strategies and templates for creating an effective and visually interesting scientific poster. Virtual and social media templates are also available. (Skill addressed: 2)

As with all presentations, it can be very helpful to practice with colleagues and/or mentors before the meeting. This will allow you to get feedback on your project, style, and poster design prior to sharing it with others outside of your institution. It can also help you prepare for the questions you may get from the audience.  

Patient presentation skills are valuable for medical students in the classroom and in the care of patients during clinical rotations. Patient presentations are an integral part of medical training because they combine communication skills with knowledge of disease manifestations and therapeutic strategies in a clinical scenario. They are used during active learning in both the preclinical and clinical phases of education and as students advance in training and interact with diverse patients.  

Below are strategies for delivering effective patient presentations. 

• Structure the presentation appropriately . The structure of your narrative is important; a concise, logical presentation of the relevant information will create the most impact. In the clinical setting, preferences for presentation length and style can vary between specialties and attendings, so understanding expectations is vital. 
• Synthesize information from the patient encounter . Synthesis of information is integral for effective and accurate delivery that highlights relevant points. Being able to select pertinent information and present it in an efficient manner takes organization and practice, but it is a skill that can be learned.  
• Deliver an accurate, engaging, and fluent oral presentation . In delivering a patient presentation, time is of the essence. The overall format for the presentation is like a written note but usually more concise. Succinctly convey the most essential patient information in a way that tells the patient’s story. Engage your listeners by delivering your presentation in an organized, clear, and professional manner with good eye contact. Presentations will go more smoothly with careful crafting and practice. 
• Adjust presentations to meet team, patient, and setting needs . Adaptability is often required in the clinical setting depending on attending preferences, patient needs, and location, making it imperative that you are mindful of your audience.  

The resources below provide samples of different types of patient presentations and practical guides for structuring and delivering them. They include tips and tricks for framing a case discussion to deliver a compelling story. Resources that help with adjusting patient presentations based on the setting, such as bedside and outpatient presentations, are also included. 

• A Guide to Case Presentations (freely available, document). This practical guide from the Ohio State University discusses basic principles of presentations, differences between written and oral communication of patient information, organization, and common pitfalls to avoid. (Skills addressed: 1-3) 
• Verbal Case Presentations: A Practical Guide for Medical Students (freely available, PDFs). This resource from the Augusta University/University of Georgia Medical Partnership provides a practical guide to crafting effective case presentations with an explanation of the goals of each section and additional tips for framing the oral discussion. It also provides a full sample initial history and physical examination presentation. (Skills addressed: 1-4) 
• Patient Presentations in Emergency Medicine (freely available, video). This training video for medical students from the Society for Academic Emergency Medicine demonstrates how to tell a compelling story when presenting a patient’s case. The brief video offers handy dos and don'ts that will help medical students understand how best to communicate in the emergency department efficiently and effectively. These skills can also be applied to patient presentations in other specialties. (Skills addressed: 1-4) 

Additional information and support on effectively constructing and delivering a case presentation can be found through various affinity support and mentorship groups, such as the Student National Medical Association (SNMA), Latino Medical Student Association (LMSA), and Building the Next Generation of Academic Physicians (BNGAP). 

Leading Small Groups

For physicians, working within and leading small groups is an everyday practice. Undergraduate medical education often includes small group communication as well, in the form of problem-based learning groups, journal clubs, and study groups. Having the skills to form, maintain, and help small groups thrive is an important tool for medical students.   

Below are strategies to provide effective small group leadership. 

• Outline goals/outcomes . Delineating the goals of a meeting ensures that everyone understands the outcome of the gathering and can help keep conversations on track. Listing goals in the agenda will help all participants understand what is to be accomplished. 
• Establish ground rules . Establishing explicit procedural and behavioral expectations serves to solidify the framework in which the conversation will take place. These include items such as attendance and how people are recognized as well as the way group members should treat each other.   
• Create an inclusive environment . In addition to setting expectations, group leaders can take steps to help all participants feel that their perspectives are valuable. Setting up the room so that everyone sits around a table can facilitate conversations. Having individuals introduce themselves can let the group understand everyone’s background and expertise. In addition, running discussions in a “round-robin style” (when possible) may help every person have an opportunity to express themselves. 
• Keep discussions constructive, positive, and on task . As meetings evolve, it can be easy for conversations to drift. Reminding the group of goals and frequently summarizing the discussion in the context of the planned outcomes can help redirect meetings when needed. 
• Manage virtual meetings . Online meetings present their own challenges. Adequate preparation is key, particularly working through technological considerations in advance. Explicitly discussing goals and ground rules is even more important in the virtual environment. Group leaders should be more patient with members’ response times and be especially diligent that all participants have an opportunity to be heard.   

The resources listed below outline additional helpful points, expanding on the skills described above and providing additional perspectives on managing small group meetings of different types. 

• Communication in the Real World: Small Group Communication (freely available, online module). This chapter includes an overview of managing small groups, including understanding the types and characteristics, group development, and interpersonal dynamics. (Skills addressed: 3,4) 
• Conversational Leadership (freely available, online book chapter). This short online resource provides guidance for determining group size and seating to best facilitate participation by all group members. (Skill addressed: 4) 
• Tips on Facilitating Effective Group Discussion (freely available, PDF). This resource from Brown University provides tips for effective group facilitation, creating an environment conducive for discussions, keeping conversations positive, and managing common problems. Also included is a valuable list of references for further exploration. (Skills addressed: 1-4) 
• Facilitating Effective Discussions: Self-Checklist (freely available, online checklist). This checklist from Brown University provides an easy-to-use, practical framework for preparing for, performing, and reflecting on small group facilitation. (Skills addressed: 1-4) 
• Sample Guidelines for Classroom Discussion Agreements (freely available, PDF). These guidelines from Brown University give useful tips for managing classroom discussions, including when disagreements occur among group participants. (Skill addressed: 2) 
• Fostering and assessing equitable classroom participation (freely available, online article). This online resource from Brown University includes methods to maximize group members’ participation in discussions and to communicate expectations. Also included is a valuable list of references for further exploration. (Skill addressed: 3) 
• Facilitating small group learning in the health professions (freely available, online article). The aim of this paper published in BMC Medical Education is to provide students involved in peer/near peer teaching with an overview of practical approaches and tips to improve learner engagement when facilitating small groups. It includes a discussion of the roles of facilitators, strategies for fostering interactions among the group, and methods for resolving common problems. (Skills addressed: 1-4) 
• Facilitating a Virtual Meeting (freely available, PDF). This infographic from the University of Nebraska Medical Center includes key points to consider when facilitating an online meeting, including technical considerations, preparation, and follow-up. (Skill addressed: 5) 
• Most universities have a communication department with faculty who specialize in small group communication. You may also find that these individuals are a valuable resource. 

This toolkit was created by a working group of the Undergraduate Medical Education (UME) Section of the Group on Educational Affairs (GEA). 

Working Group Members

• Geoffrey Talmon, MD, University of Nebraska Medical Center
• Jason Kemnitz, EdD, University of South Dakota Sanford School of Medicine 
• Lisa Coplit, MD, Frank H. Netter School of Medicine at Quinnipiac University 
• Rikki Ovitsh, MD, SUNY Downstate College of Medicine
• Susan Nofziger, MD, Northeast Ohio Medical University  
• Amy Moore, MEd, Cleveland Clinic Lerner College of Medicine 
• Melissa Cellini, MD, New York Medical College 
• Richard Haspel, MD, Harvard Medical School 
• Christine Phillips, MD, Boston University School of Medicine 
• Arvind Suresh, Geisel School of Medicine at Dartmouth 
• Emily Green, PhD, MA, Warren Alpert Medical School of Brown University 
• Holly Meyer, PhD, MS, Uniformed Services University of the Health Sciences 
• Karina Clemmons, EdD, University of Arkansas for Medical Sciences
• Shane Puckett, EdD, University of South Florida 
• Angela Hairrell, PhD, Burnett School of Medicine at Texas Christian University 
• Arkene Levy Johnston, PhD, Kiran C. Patel College of Allopathic Medicine
• Sarah Collins, PhD, UT Southwestern Medical Center 
• Patrick Fadden, MD, Virginia Commonwealth University School of Medicine 
• Lia Bruner, MD, Augusta University - University of Georgia Medical Partnership 
• Jasna Vuk, MD, PhD, University of Arkansas for Medical Sciences 
• Pearl Sutter, University of Connecticut School of Medicine 
• Kelly Park, Baylor University Medical Center

Become a Member

Mastering Presentation Skills: An Essential Skill for Physician Leaders

Farzana Hoque, MD, MRCP (UK), FACP, FRCP

Nov 2, 2023

Volume 10, Issue 6, Pages 30-32

https://doi.org/ 10.55834 / plj.3732703608

By mastering public speaking skills, physician leaders can convey information more effectively, make a positive impact on healthcare delivery, enhance patient care, and contribute to the advancement of the medical field.

Warren Buffet described public speaking as “an asset that will last you 50 or 60 years. And it’s a liability — if you don’t like doing it or are uncomfortable doing it — that will also last you 50 or 60 years, and it’s a necessary skill.”

Merely possessing knowledge is not enough; a skilled and influential physician leader must be able to communicate proficiently.

Mastering public speaking skills empowers physicians to convey medical information, educate others, progress in their professional journey, and advocate for their patients. By honing these skills, physicians can make a positive impact on healthcare delivery, enhance patient care, and contribute to the advancement of the medical field.

Presentation skills enable physician leaders to educate and inspire diverse learners, including medical students, residents, and colleagues. As they ascend in leadership positions, there is more demand for them to communicate with a wider range of individuals, such as sponsors, legislators, staff, board members, and media representatives. Public speaking often serves as the pathway toward promotion and increased influence.

ACTIONABLE STRATEGIES

Regardless of whether you practice in an academic or community setting, public speaking empowers you to build your regional, national, and international presence and reputation. What follows are six practical and actionable strategies that you can implement immediately to craft an engaging and influential presentation that captures the attention of your audience.

1. Prioritize Your Audience

Prioritize your audience over yourself. Presentations often aim to inspire, motivate, or persuade the audience to act or embrace new ideas. By focusing on the audience’s needs, you put them in a position of importance and empower them to make informed decisions or take appropriate actions.

Instead of immediately jumping into creating PowerPoint slides, start by writing down the key messages you want to convey to your audience. Categorize that information into three groups: “Need to know,” “Want to know,” and “Nice to know.”

Remember that people attend your presentation with the expectation of gaining valuable information. Whether it’s sharing knowledge, showcasing innovative ideas, or providing practical solutions, your presentations are your opportunity to offer value to the audience. Shift your attention to their needs, aspirations, and interests.

By placing the audience at the center of your presentation, you can engage and resonate with them, ultimately leaving a lasting impact. By presenting information compellingly and persuasively, you, as the presenter, empower the audience to make positive changes in their thinking or behavior.

2. Start at the Beginning and End

Prioritize the organization and structure of the beginning and end of your presentation before diving into the content of the main body. To illustrate this point, think about sitting down to watch a new drama series on television. If the initial scenes don’t grab your attention, you’re less likely to continue watching the series. The reason for this is simple: without a powerful and engaging beginning, you quickly lose interest and become easily distracted.

Just like takeoff and landing are crucial parts of a flight, setting the stage with a captivating opening and leaving a lasting impression with a memorable closing are vital aspects of delivering a successful talk. This principle is supported by the psychological phenomenon known as the “serial position effect,” which suggests that people tend to remember the beginning and end of a series more vividly than the middle portions.

By crafting a captivating introduction that grabs your audience’s attention from the start and a memorable conclusion that pulls the content together to leave a lasting impact, you will compose a compelling presentation that resonates with your audience long after the talk has ended.

3. Show Your Enthusiasm!

Think back to one of your favorite presenters and try to recall their entire talk, from the beginning to the end. It’s unlikely that you remember every detail of that speech; however, you probably do remember how that speaker made you feel. As the wise Maya Angelou once said, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

Establishing a dialogue creates an emotional bond with your audience. Our emotions, driven by our mirror neurons, are highly contagious, and it is crucial to use that connection to hold the audience’s attention.

Showcasing enthusiasm and passion for your subject matter engages the audience; if you are not genuinely excited about your work, it is unlikely that your audience will be either. This emotional resonance will not only captivate their attention, but also leave an impression, making your talk impactful.

Begin with a confident and engaging opening that immediately grabs the audience’s attention. Maintain an upright posture, establish eye contact with the audience, and use expressive gestures to convey your enthusiasm. Move around the stage or use the available space to engage with different sections of the audience. Use visual aids such as slides, videos, or props to enhance your presentation. Well-designed and visually appealing materials can effectively capture and retain the audience’s attention.

Remember, the audience is genuinely interested in your topic and your expertise, which is why they chose to dedicate their valuable time to attending your talk. Take pride in their trust and express your gratitude for having been given this opportunity. Embrace this moment that not only educates, but also inspires your audience.

4. Avoid Uptalk

When delivering a presentation or lecture, be mindful of your speech patterns and avoid using “uptalk.” Uptalk means ending a sentence with a rising intonation, which implies a question. Research indicates that about 85% of individuals in the United States perceive uptalk as a sign of insecurity; therefore, it is crucial to professional credibility to eliminate this speech pattern.

Instead, end your sentences with a straight or downward intonation to sound confident, credible, and compelling. To identify instances of uptalk in your speech, consider recording yourself and playing back for analysis. Take note of specific instances in which you engage in uptalk and focus on correcting those patterns. Trusted friends, colleagues, or even a speech coach can help identify areas where you use uptalk and provide valuable suggestions for improvement. By becoming aware of your speech patterns, you can develop a more assertive and confident speaking style.

5. Transform Your Nervousness to Confidence

Have you ever felt your heart pounding before giving a talk? You certainly are not alone in that regard. Mark Twain once said, “There are two types of speakers: those who are nervous and those who are liars.”

The close connection between our body and our mind is fascinating. Our confidence is reflected in our body language and, conversely, our body language and posture can influence our confidence and inner thoughts. Harvard University conducted a research study that unveiled the impact of assuming open, space-occupying postures, such as the “Wonder Woman pose,” for just two minutes. It was discovered that such poses can generate a sense of power within us. Conversely, when we slouch and make ourselves small, we tend to feel powerless.

It’s important to note that even experienced speakers may feel nervous before a presentation. However, you can use scientifically proven power poses to boost your confidence, improve your appearance, and enhance your delivery. By adopting these poses before your presentation, you can positively influence your mindset and effectively connect with your audience.

Practice redirecting your nervousness into excitement. Remember that audiences seek engaging, thought-provoking, educational, and enjoyable speakers. If the idea of speaking to a sea of unfamiliar faces makes you nervous, consider engaging in conversations with a few audience members before you deliver your speech. The very same anxious energy that elicits stage fright can actually serve to your benefit.

Remind yourself of the significance of the moment, and that’s precisely why your body is gearing up for it. Embrace this feeling, harness its power, and convert it into a wellspring of exhilaration, liveliness, and eagerness.

6. Incorporate Data with Stories

In the field of medicine, data play a crucial role in informing our decisions; therefore, it is vital to incorporate cutting-edge evidence to enhance the credibility of our content. Relying solely on data during presentations may not be sufficient, however. Complement data with stories and personal experiences to engage the audience. Humans have an innate affinity for stories and are more likely to remember them than specific numbers or figures.

During a recent presentation at the American Association for Physician Leadership annual conference, I made sure to include both data and personal experiences. The impact was remarkable; the audience responded with enthusiasm, leaning forward and becoming fully engaged when I shared my personal stories and real-life examples. By incorporating success stories, personal challenges, and patient experiences, presenters can effectively emphasize their message. Combining data with personal experiences better resonates with the audience and leads to better reviews.

Presenting is both an art and a skill. Like learning to swim, it requires practice and actual experience; relying solely on theoretical knowledge is not enough. Malcolm Gladwell’s concept of the 10,000-hour rule, which suggests that mastery in any field typically requires about 10,000 hours of deliberate practice, also applies to presentation skills.

As we master presentation skills, we build our reputation and establish a strong professional brand.

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Presentation Skills for Clinicians: Making Your Next Presentation Go Better than Your Last

WHY IS PRESENTING IMPORTANT FOR HEALTHCARE PROFESSIONALS?

Why is it crucial for you to present yourself and your material well? Well, the point is our careers depend heavily on the way we present ourselves and our material. If you do this well, doors swing open. If you don't, they usually find somebody else. So, this could be a career-maker or a career breaker. 

Now, how did I get involved in this? Well, a number of years ago, I was elected to be our speaker at high school graduation. And it didn't go very well. And I couldn't quite figure out why. I thought it must have been the microphone or whatever. But I went off to college, Rice University. While at Rice University, I listened to one of the greatest speakers I've ever heard, and that was Muhammad Ali, who spoke in front of the campus and commanded the audience. He almost didn't graduate high school. I figured if he could do this well, I could get better. 

I read books, I took courses, and it's from what I learned the hard way, I want to share with you some of the tips and tools that we've learned. One of the things that we have done is a workshop where we videotape learner colleagues, and we go together and group critique what goes well and what could be improved. And I've been doing this for about 20 years now. 

So, let's go through some of the important lessons. The goal today is I want your buy-in that this is important and teach you a few things. But I really want to motivate you to think about put in your presentations together a little differently than you've done in the past. And I'll try to demonstrate some of these skills as best I can to you today. 

16 TIPS AND TOOLS FOR GIVING A BETTER PRESENTATION

• BODY LANGUAGE

Body language is very important. You've probably seen TED talks in the past. Ted speakers speak with what we call open body language . What does that mean? It means nothing between you and your audience so they don't stand behind lecterns and hold on to the lectern. They don't have their hands clasped or arms folded. They're out in front, full-body hand gestures going, and it creates a real impression with the audience, and it makes everything go better. 

• ALWAYS INCLUDE YOUR EMAIL IN THE PRESENTATION

So, a couple of basics. If you're speaking formally, always include an email address on a slide, on a whiteboard, or on a handout. You might ask, what does this tell your audience? It says you're approachable. If they have questions or want to contact you, they can.  

Now, one of the questions I often get from people is, “Oh, won't you get a lot of spam doing that?” I get spam, but it's never, never abused in a professional audience. I might get an invitation to speak in Hawaii. I might get a referral, I might get some constructive critiquing. But rarely do you get anything. It just makes you look good. 

• WRITE YOUR OWN INTRODUCTION

Again, if it's a formal presentation, write your own introduction. In the Bible, it might say the meek shall inherit the earth. Not when you're wanting to write your own introduction, you need to give yourself credibility on the topic to which you are speaking. And this is important – only you know the credibility you have. And if you send a 40-page curriculum vitae to somebody, nobody reads it, and they might pull out things that you don't feel are important. 

• THE NAME BADGE

And then what have I learned about the name badge? Well, first of all, when you are presenting formally, lose the badge because if you have a badge on your body, it looks stupid, it flops around, and anything on your person that is distracting will detract from your presentation. 

But if you are going to use the badge, put it on the upper right of your lapel. Why? Because when we meet and greet and shake hands, or bump fists, or hit elbows, it's on the upper right side and people can glance and see your name without looking over your torso embarrassingly to try to remember what your name was. 

• POWERPOINT – WHAT NOT TO DO

In medical presentations, lots of PowerPoints are still used, and it can be your friend, but it can often be your enemy. A college professor surveyed a thousand students and asked, “What do you all find most annoying sitting through PowerPoint presentations?” And they could answer more than once, but let me just share a few of the things they found most annoying, 

No. 1 was the speaker reading verbatim, word by word, your slides. Next, having tiny point type in the slides. Well, if you have 17 lines on a slide, you have to have tiny lettering to be seen. So, if you've heard of the rule of five or six, that's something to think about – no more than five or six lines per slide and no more than five or six words per slide. And watch out for hard-to-see colors, flying techs, and complex charts. 

Let's get to the meat of this talk and talk about how you best connect with an audience and the number one tip, know who's in your audience and meet their needs. 

• KNOW WHO'S YOUR AUDIENCE AND WHAT THEY WANT & NEED

What do they want to know? What do they need to know? Not, what do you want to talk about? If you can do that, your evaluations will go sky-high. And that's hard for some people to connect with. But it also takes a lot of baggage off of your shoulders. You don't have to talk about everything about a topic, you don't have to cover from front end to back end. You just have to think about what's this audience wants to know or needs to know. 

And you will meet their needs because they are tuned in to an FM radio station whenever you and I speak called WIIFM – What's in it for me? If you answer that question early, you've hooked them. They want to hear more. We'll talk a little about hooks further on. 

• ORGANIZATION AND HOOKS

The other important point is the organization of your presentation. An audience will give us somewhere between 5 and 30 seconds before they make a judgment of us and our material, and if you don't hook them, out come the iPhones and they’re reading their email. So, in that opening statement, you need to hook the audience. You can do that with a story, medical stories are cases, or the word imagine. And I'll give you an example. 

So, let's say that you're the chief resident is giving a discussion with the residents about diarrhea. And he starts out by saying, “Good morning. Today, we're going to speak about diarrhea. Diarrhea was first described by Dr. Dye and Dr. Rhea in 1898,” and in the audience is going, “Oh, lord, get me out of this. Now, this is going to be terrible.” 

But what if the same chief resident started with something like this? “Good morning. You pick up the chart of your first patient. She's a 39-year-old woman who's complaining of three weeks of watery diarrhea. Your heart sinks. You think, ‘What do I need to ask historically? Is there anything on the exam I need to pay attention to? What about testing? Do I need to do testing or order stool studies, or could I empirically treat her and see if she gets better?’ Great questions we’ll answer all these in this presentation. So if she's your first patient, you'll be ready.” 

That's a hook, starting with a case. Now, they feel they need to know or want to know more about diarrhea, when before, they weren't interested in a bunch of facts. 

• LESS INFORMATION IS MORE

Speaking of facts, it has been shown that after a typical gland rounds presentation, when the learners walk out of the room, and they're asked to recite any facts they recall from the presentation, the average number is zero to three. Zero to three! Why in the world would we give presentations if they don't remember everything we say? 

Unfortunately, if your goal is 25 facts in 25 minutes, you'll fail every time, but you can do a lot with a presentation. You can get the learners interested in your topic, so they learn more and want to read more about it. You can get funding for your research. You can get a promotion. You can change somebody's career. You can teach a procedure. But if your goal is 25 facts in 25 minutes, you'll fail every time. 

• STRONG FINISH

“Oh, we're done today,” is not a strong closing, nor is a picture of your family, the new baby, or a sunset. If people are going to remember anything out of your presentation. It's usually the last five percent. So I like to teach, say, these two words: In Summary . People awaken. If they've got a pencil, they'll start writing down whatever you say next. If you say, “And if you only remember three things from today,” that's probably what they'll remember. 

• GOOD DELIVERY AND SPEEDood Delivery and Speech

Concentrate on the delivery – face your audience, not your screen or your slides. Avoid monotone. You don't know what you sound like unless you've listened to your presentation, and your voice. 

Pace is important too. Many speakers talk very fast because after all, they only gave me 15 minutes to go through all this material, and I've got about 40 minutes of material but if I talk really fast, I can get through most of it. And I don't know about you, but I get a little nervous in front of an audience, so the faster I speak, the quicker I sit down. 

What's the trouble at that pace? It’s hard to listen and hard to understand, so you lose a sentence or two, and again, out come the iPhones and your into your email. 

And the most important speech technique you can master is pausing. To a speaker to pause seems eternal – to the audience, it's a short break. And for those of us that have filler, sounds like, “um, ah, so, uh, you know, etc.” knowing that you make those sounds and learning to replace them with a pause instead is the key here.  

• MAKE YOUR PRESENTATION A PERFORMANCE

Now, this is a hard thing sometimes for medical presenters, but you need to make your presentation a performance. Now, when I say performance, you don't have to tell jokes or sing and dance, but you have to connect with your audience. And the easiest way to connect right off the bat is to remember to smile. The audience wants you to succeed. They want you to feel that they can approach you after the presentation, ask you a question. 

Yet many of us are actually kind of frowning and looking off-putting because we're trying to think about that 23rd fact that nobody cares about anyway. If you cannot show enthusiasm for your own topic, how is your audience going to care? 

• HAND GESTURES

Hand gestures are important. We talked about open postures, so they're not together and grabbing, but along with open posture, you can have purposeful gestures. Do you know they're making pacemakers now at the size of a postage stamp? They can be tucked right under the clavicle. Can't even be seen anymore. Stories are better than facts, but a fact tied to a story will be remembered. And in medicine, our stories are wonderful. We have patient cases stories. We have lots of cases, and we can illustrate a teaching point that will probably be remembered because it's part of a story. 

• YOU WON'T LOOK NERVOUS, EVEN IF YOU FEEL NERVOUS

One of the biggest fears of people is public speaking, and I've heard from so many learners that they feel petrified and nervous if they have to speak in front of a large group. In fact, tongue in cheek, I heard once from a friend that there was an article published that showed, at a funeral, 80 percent of the congregation would feel more comfortable in the casket than delivering the eulogy. But public speaking can be a little frightening. 

The beauty is most anxiety doesn't show. In our videotaped workshops, we always videotape colleagues and then we ask them, were you nervous during this? “Oh, yes, very nervous.” Then we ask the group of other learners, “Did he or she look nervous?” “Absolutely not.” Most audiences will rate the speaker looking cool and calm, even though the speaker feels uncomfortable. The biggest fear of the speaker is looking nervous, biggest fear of the audience is being bored. 

• DRINK WATER

Sometimes, your voice can get a little dry. I think the parasympathetic can kick in. So, it's OK to have a little water to sip on while you're speaking. You probably don't want to slam down a big drink of diet cola before you speak. Not just the caffeine, but the bubbles could come up at the wrong time and embarrass you. So sipping on a little water is fine. 

• MAKE EYE CONTACT WITH AT LEAST ONE PERSON

Eye contact. If you're starting out, and you're a little nervous, make eye contact with somebody who is nodding and affirming, and that gives you a little more confidence. And then you can move around the room and make eye contact with others. 

I'm asking a lot about humor. If humor is part of your personality, like you can probably tell it's part of mine, it's OK to use it, but don't feel forced. And if you use humor, the safest humor to use is self-deprecating humor. I spoke poorly at my high school graduation. I'm sharing with you what I learned the hard way. That's a lot more acceptable than putting the humor on somebody else. 

We've covered a lot of ground. But in summary, if you only remember a few facts from this presentation: meet the needs of the audience, organize the presentation, start with a hook, limited facts, a strong summary, make it a performance, smile, hand gestures, purposeful gestures.  

And finally, your presentation skills are extremely important. And let me prove this to you. Think of a person that you have heard present in the last year or two that if he or she were presenting again, you'd make an effort to attend, get a face in your mind. I'll give you a moment now to yourself answer this question. How many facts do you remember the last time he or she spoke?  

I usually know the answer, but you remember the person. They were either friendly, approachable, very knowledgeable, funny, an expert in their field. All the stuff on slides isn't remembered, but you remember them for a long time as a great speaker.  And colleagues, I want you to be that person that is remembered for a long time as a great speaker. So, I hope these tips have been valuable to you. And I appreciate you reading.

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Doctor Marketing Skills: 12 Tips for Effective Presentations

“I’m only responsible for what I say, not for what you understand.”

This cheeky advice plays OK as a just-for-fun Twitter message. But it’s obviously a joke. In the real world of healthcare communications and doctor marketing skills, this punch line is upside down. In fact, understanding is the goal in many public speaking situations for doctors such as:

• One-to-one physician-patient conversations,
• Staff or colleague training,
• Community health presentations,
• Civic club luncheons, or even
• Addressing a few hundred colleagues at an international medical conference.

Although I’m a Bruce Willis fan, Ralph Elliott is one of the top authorities in making effective presentations. (Sorry, Bruce.) Dr. Elliott is a marketing expert, Vice Provost and Professor of Economics Emeritus at Clemson, and the founder and executive director of the Effective Seminar Marketing Institute .

Recently I had the pleasure of speaking at a Clemson University Internet marketing conference in Chicago where Ralph was the chairperson. With his permission, we’ve adapted one of his presentations—about how to make an effective presentation—for this skill-building article.

12 Tips for Effective Presentations

With full credit to Ralph Elliott, here are a dozen useful ideas to make any doctor marketing presentation more effective.

1. Get into the subject as quickly, boldly, dramatically, challengingly and excitingly as possible . Start off with a bang, and deliver something that sets their minds immediately thinking of the many ways in which they are going to apply what you are about to tell them.

2. Tell them why your presentation is important to them, (within the first two minutes.)  This creates a heightened level of interest and awareness (i.e., I’m going to give you eight specific techniques for….) It’s “what’s in it for them.”

3. Be specific. Be concrete. Use numbers. Use examples. Make these understandable and tangible. Issue any disclaimers up front. Let them know what you are not going to do, and tell them what liberties you are going to take with numbers and references.

4. Use a rapid fire pace. Don’t belabor, linger or dwell. See how many helpful ideas you can give them in the time you are allotted.

5. Stick to the time schedule as precisely as possible. Dry run your material at least twice, including once the day before the program.

6. Be relevant to your audience. Chose examples or information that connects with this specific group, and tell them why you have selected them. If you use a list (of techniques, advantages, etc.), begin by saying “I will be giving you 18 quick ideas of how to….” Then count them as you present each one so the audience knows where you are in the list.

7. Look for audience participation and questions throughout. Encourage questions and involvement early. (But keep your answers brief.) An involved audience is engaged and closer to you. Both the speaker and audience will be more comfortable.

8. No commercials please. Your best commercial is to deliver a relevant, timely session. (Your name, title and other particulars are in the program.) Stick with the topic that the audience came to hear.

9. Do not underestimate your audience. They are often skewed toward the high end of sophistication.

10. Support the program and other speakers. Be positive about the event in general…the exhibits, social events, quality of attendees, etc.

11. Develop a relevant handout. Some events require it, and attendees always appreciate a well-considered support piece. It will augment your session and be a reminder of your effectiveness long after the meeting.

12. And of course, the ultimate advice…have fun, be bold, love your audience and they’ll love you. Pour out your heart and soul in every technique or secret you know for helping this audience. In the long run, they end up helping you.

Applying these tips will draw your audience into your material and help them understand how the benefits of your presentation are useful to them. A presentation is only successful and effective when you can be responsible for a clear understanding.

Stewart Gandolf, MBA

Marketing a healthcare organization can be challenging - even painful if you don't approach it with the right knowledge, tools, and guidance. By reading about mistakes and lessons others have learned the hard way, you can boost your marketing effectiveness and take a shortcut to success. Discover how to avoid these "Seven Deadly Sins". Plus, join over 30,000 of your fellow healthcare providers with a free subscription to our Insight Newsletter.

How to Give an Excellent Medical Presentation

• By Sulaiman Ahmad
• July 22, 2019
• Medical Student , Pre-med
• Self-improvement

In medicine, we are constantly learning from each other. Professors stand in front of lecture halls to teach the fundamental knowledge needed to pass board exams and to treat our patients. Outside of the classroom, medical students, researchers, and physicians attend conferences to communicate ideas and update their colleagues with oral and poster presentations. In the clinic, students and resident physicians relay pertinent patient information to the physician in charge. Eventually, you will find yourself in front of an audience listening to your talk or an attending grading your clinical presentation. First, I will discuss what it takes to make an excellent presentation.  I will then finish this topic by providing guidelines for perfecting different types of presentations.

Critical Elements of an Excellent Presentation

 do some research.

Your audience will consider you an expert on the information you deliver. It is your job to achieve the expected level of comprehension of the topic. After choosing a topic, gather enough background information from diverse but appropriate sources (e.g., journals articles, relevant chapters in textbooks, personal discussion with subject matter experts, online videos).  Your research should provide you with a thorough understanding of the topic and a list of the important facts supporting your take-home message . Any gaps in your knowledge will become evident during your presentation. The goal is to develop confidence in your understanding of the topic and ability to share what you know.

Know Your Audience

Before putting your presentation together, take a moment to assess the baseline understanding of your expected audience . Ultimately your audience should walk away having learned something new. Try to figure out their collective interest, reasons for attending, and prior experience with the topic. Knowing your audience will allow you to focus on information that will keep them engaged and interested. For example, premed students have a different understanding of medical topics than medical students.  A presentation on the same subject should be different for both groups. If your listeners have different levels of expertise, take a moment to explain the fundamental concept, then build up the language and complexity to allow everyone to benefit from the information shared. Your audience is the reason why you are presenting.

Tell a Story

The human brain is wired to remember stories , especially if presented logically. A presentation is about the information shared, but it should also include the presenters’ passion, excitement, and personal style. All topics can be formatted to include characters, a description of the setting, plot, conflict, and a resolution. The story should allow the audience to take a journey with you. The hardest part is identifying the start and endpoint of your story and which details are needed. Make every word count by checking if it adds value to your narrative. Consider using metaphors, real examples, and descriptions that give life to your words .

Practicing your presentation is a vital step in developing an excellent presentation. You can memorize a script. However, memorization can reduce your connection with the audience. But in certain situations, scripts are quick and effective means of communicating important facts. Another approach is drafting bullet points of the main ideas and practicing the natural flow of information . This method allows your personality to shine on stage. To become comfortable speaking, start by practicing on your own . You can also record yourself with a cellphone or tablet and review the recording to evaluate your performance. Next, find a small group to present in front of and ask for their honest assessment . Eventually, your presentation will feel natural, and your stage presence will aid in communicating your main idea.

Q&A Session

Usually, your presentation does not end until after a question and answer session. Most presentations should include approximately five minutes in the end for the audience to ask questions . This part of the presentation allows you to clarify or further explain any part of your presentation. A question can also lead to expanding your presentation beyond what you originally planned to discuss . It is important for you to understand what is being asked and address the specific question directly. And if you do not have an answer, it is okay to admit that you do not know . Questions will force you to be creative and truly test your knowledge of the topic.

Different Types of Presentations

Presentations have many different forms, each with different goals; thus, each form requires a unique approach. In medicine, professors and clinician often provide students with lecture objectives and PowerPoint presentations that guide the students in their hour-long lecture. Conferences are a researcher’s platform to share their lab’s progress and conclusions. The last presentation I will go into is the clinical presentation a student typically performs for the physician in charge.

The main purpose of the lecture is to educate the attendees. We all have had great professors captivate our attention and other experiences that were a complete waste of time. But what makes some lectures better than others? The lecturer’s knowledge on the topic becomes obvious, and their stage presence confirms how comfortable they are with the topic.  If you are tasked with lecturing on a topic or a series, ensure that you have a solid understanding and address your learning objectives in the time allotted . The main concepts should be repeated multiple times throughout the lecture, followed by examples . Your PowerPoint slides should be limited to only main points and images that support your talking points. After difficult concepts are covered, ask questions to gauge your audience’s understanding . It is better to reemphasize a concept before building up to more complex learning objectives.

Research Presentation

Attending a conference is exciting, especially if you are representing your lab with an oral presentation.  It is an opportunity to share your research story, from the point of identifying a question to the process of reaching a conclusion. Realize your audience will include Primary Investigators, post-docs, and Ph.D. students that are also experts in the field . Attempt to grab the audience’s attention from the beginning by providing them with a reason to care. Then continue to explain how your study relates to the published work . After building up the background, address how you arrived at your research question. The most exciting part of your presentation should be explaining your conclusions and the path you took to get there. Finish up strong by discussing the implications of your findings and how they will have an impact in the field . The natural flow of information will come with practice and a deep understanding of your research topic. Presenting as a student usually leads to networking with professors and clinicians that can help you progress in your career.

Patient Presentation

Medical students learn how to take a patient’s history and perform a physical exam, but it is more challenging to reason through your clinical findings and subsequently present to an attending . Your clinical presentation style will change depending on the environment, medical department, and supervising physician . Upon joining a medical team, discuss the expectations and preference with each physician . It may be a good idea to draft a script that can get you started on organizing your patient presentation. The success of your presentation is correlated to your knowledge of the basic sciences and ability to critically assess the patient’s history and physical exam; the more you learn and read, the easier decision making and producing a plan becomes. Another important element is practicing your presentation style until it comes out naturally . Take the time to listen to your peers and experienced colleagues; learn from their mistakes and strengths . After concluding your presentation, ask for feedback and practice implementing the suggestions. You will be the eyes and ears for the physicians in charge, perfecting your patient presentation will help get the care the patients need while making everyone’s job a little easier.

Final remarks

There are some basic steps to achieving an excellent presentation: know the topic well, understand who you’re presenting to, develop a memorable story, and practice until it comes out naturally. A career in medicine is very versatile; you can be at the forefront of the next generation of physicians sharing your experiences or updating the science community with your research conclusions. At the minimum, you will be presenting the patient in the clinic. Thus, presenting is a skill every physician must master.

Sulaiman Ahmad

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Effective Presentations: Optimize the Learning Experience With Evidence-Based Multimedia Principles [Incl. Seminar]

TABLE OF CONTENTS

What is an effective presentation.

Professional education requires presentations, from a small discussion or a short video to speaking to a lecture hall with an audience of hundreds.  In fact, presentations are at the core of the educational process. With the effort to view all our educational efforts through an evidence-based lens, the construction of an effective presentation needs to undergo the same scrutiny. Whether a presenter intends to share plans, teach educational information, give updates on project progress, or convey the results of research, the extent to which the audience understands and remembers the presentation relies not only on the quality of the content but also the manner in which that content is presented. While the medium of the presentation may range from written content to graphics, videos, live presentations, or any combination of these and more, each of these mediums can be enhanced and made more effective by the use of evidence-based practices for presenting. Regardless of the medium, effective presentations have the same key features: they are appealing, engaging, informative, and concise. Effective presentations gain attention and captivate the audience, but most importantly, they convey information and ideas memorably.

With the integration of technology and online learning, educators have more opportunities than ever to present rich content that enhances and supports student learning. However, these opportunities can be intimidating to educators striving to engage students, as it can be daunting to create visually appealing and informative materials. Additionally, many educators feel pressured by the continued myth of learning styles: the widespread misconception that learning materials should match students’ visual, auditory, or kinesthetic “styles” to optimize learning (1). Despite being featured in many articles and discussions, there is no compelling evidence that matching educational content to learner’s style preferences increases educational outcomes. However, using multiple modes of delivery such as visuals, audio, and active learning has been shown to benefit all learners. In other words, no matter their stated preference, all learners benefit from a variety of media. Using evidence-based principles for multimedia content such as the principles found in Richard Mayer’s multimedia learning as well as the principles of graphic design and universal design supports learning and increases educational outcomes.

Why effective presentations work

What makes a presentation effective? Is an appealing and engaging presentation also an effective one? Research from cognitive science provides a foundation for understanding how verbal and pictorial information are processed by the learner’s mind during a presentation.

Mayer’s cognitive theory of multimedia learning

Based in cognitive science research, Mayer’s evidence-based approach to multimedia and cognition has greatly influenced both instructional design and the learning sciences. Mayer’s cognitive theory of multimedia learning comprises three learning principles: the dual channel principle, the limited capacity principle, and the active processing principle. Mayer’s cognitive theory of multimedia learning lays the theoretical foundation that underlies the practical applications to boost cognitive processes (2).

The dual channel principle proposes that learners process verbal and pictorial information via two separate channels (see figure below). Within each channel, learners can process limited amounts of information simultaneously due to limits in working memory, a phenomenon known as the limited capacity principle . In addition to these principles describing learning via the verbal and pictorial channels, the active processing principle proposes deeper learning occurs when learners are actively engaged in cognitive processing, such as attending to relevant information, creating mental schema to organize the material cognitively, and then relating to prior knowledge (3). These three principles work in tandem to describe the learning process that occurs when an audience of learners experiences a multimedia presentation.

Cognitive Load Theory, Adapted from Mayer (3) . Depicting how verbal and visual information is processed in dual channels through sensory, working, and long-term memory to create meaningful learning.

As learners listen to a lecture or watch a video, words and images are detected in the sensory memory and held for a very brief period of time. As the learners attend to relevant information, they are selecting words and images , which allows the selected information to move into the working memory where it may be held for a short period of time. However, working memory is limited to about 30 seconds and can only hold a few bits of information at a time. Organizing the words and images creates a coherent cognitive representation (schema) of these bits of information in the working memory. After the words and images are selected and then organized into schema, integrating these bits of information with prior knowledge from long term memory creates meaningful learning.

Cognitive Capacity . Three types of processing combine to determine cognitive capacity. To improve essential processing and generative processing, extraneous processing should be limited as much as possible .

No matter how important the content may be, the capacity of learners to retain ideas from a single presentation is limited. The amount of information a learner can process as they select, organize, and integrate the ideas in a presentation relates to the cognitive load, which includes Essential, Extraneous, and Generative cognitive processing. Essential cognitive processing is required for the learner to create a cognitive representation of necessary and relevant information. This is the desired part of processing but should be managed to not overload the cognitive process. Extraneous processing refers to cognitive processing that does not contribute to learning and is often caused by poor design. Extraneous processing should be eliminated whenever possible to free up cognitive resources. Generative cognitive processing gives meaning to the material and creates deep learning. Learners must be motivated to engage and understand the information for this type of processing to occur.

Foundations in neuroscience

What we know about cognition and learning has been supported and informed by research in neuroscience (4). Neuroscience advances have also allowed us to gain deeper understanding into cognitive science principles, including those on multimedia learning. Researchers have been increasingly tracking learner eye movements to study learners’ attention and interest as a method of validating the impact of multimedia principles, and the results have supported the benefits of proper multimedia design on learner performance (5). Another avenue of research with great potential includes functional MRI (fMRI) readings or electroencephalography (EEG) (6). It has long been established that verbal and pictorial data is processed in different parts of the brain. More recently however, by examining changes in blood flow in different regions of the brain, researchers in Sweden were able to demonstrate that increased extraneous load could impact the effectiveness of learning, in line with the dual channel principle (7).

Evidence for effective presentations

Mayer’s multimedia principles.

Mayer’s Multimedia Principles.

Mayer’s multimedia principles are a set of evidence-based guidelines for producing multimedia based on facilitating essential processing, reducing extraneous processing, and promoting generative processing (8). Mayer’s list of principles often includes fifteen principles, some of which have changed over time, and in a study conducted with medical students, the following nine principles were found to be particularly effective (3). The first three of these principles are used to reduce extraneous processing.

Principles for reducing extraneous processing:

• Coherence principle: eliminate extraneous material 
• Signaling principle: highlight essential material 
• Spatial contiguity principle: place printed words near corresponding graphics

To illustrate these principles, we will use a lesson about the kidneys. The instructor wants to make diagrams of the anatomy to use during discussion. The coherence principle says to only include the information necessary to the lesson. Graphics such as clip art, information that does not relate to anatomy, or unnecessary music reduces cognitive capacity. The signaling principle says to highlight essential material; this might include putting important content in bold or larger font. Or, if the kidney is shown in situ , the rest of the anatomy may be shown in grayscale or a much lighter color to de-emphasize it. The spatial contiguity principle says to place printed words, such as the labels, near the graphics.

Reduce extraneous processing .  Do : keep labels next to diagrams, use only essential material, highlight essential material such as titles.  Don’t: separate labels from diagrams, include extra facts, or have excessive text on a slide, especially with no indication of what is most important.

Principles for managing essential processing:

• Pre-training principle: provide pre-training in names and characteristics of key concepts
• Segmenting principle: break lessons into learner-controlled segments 
• Modality principle: present words in spoken form

The next three principles are used to manage essential processing. If the kidney lesson moves into diseased states or diagnostics, the pre-training principle says that learners should be given information on any unfamiliar terminology before the lesson begins. To satisfy the segmenting principle , the learner should be able to control each piece of the lesson. For example, a “next” button may allow them to progress from pre-training to anatomy to diseased states and then diagnostics. The modality principle says that words should be spoken when possible. Voice-over can be used and text can be limited to essential material such as key definitions or lists.

Manage essential processing.   Do: Present terms and key concepts first, break lessons into user-controlled segments, and present words in spoken form.  Don’t: Give long blocks of text for students to read without priming students for key concepts.

Principles for fostering generative processing: 

• Multimedia principle: present words and pictures rather than words alone 
• Personalization principle: present words in conversational or polite style 
• Voice principle: use a human voice rather than a machine voice

Mayer’s work also includes principles to increase generative processing. The multimedia principle is a direct result of the dual channel principle and limited capacity principle. Words and pictures together stimulate both channels and allow the memory to process more information than words alone. To adhere to the personalization principle to promote deeper learning, a case study is better presented as a story than a page of diagnostics and patient demographics. Finally, the voice principle says that a human voice is more desirable, so it is better to use the instructor’s voice when doing voice-overs rather than auto-generated readers.

Foster generative processing. Do: Present words and pictures, present words in conversational style, and use a human voice.  Don’t: Present text only, present words as a list of facts or overly technical language, or use a computer-generated voice.

Additional multimedia principles: 

• Temporal contiguity principle: present words and pictures simultaneously rather than successively
• Redundancy principle: for a fast paced lesson, people learn better from graphics and narration rather than graphics, narration, and text 
• Image principle: people do not learn better if a static image of the instructor is added to the presentation

Additional principles include the temporal contiguity principle , which states that words and pictures should be shown simultaneously rather than successively. This also includes narration and images or animation. For example, if an animation demonstrates normal cell division, the narration should be given during the animation, not after. The redundancy principle states that people do not necessarily learn better if text is added to graphics and narration. The duplication of information creates extraneous processing as learners try to process print and spoken text. The image principle states that learners do not learn better if a static image of the instructor is added to a presentation. For example, if students are watching an animation with normal cell division, they do not learn better if an image of their instructor is placed next to the animation.

Additional principles for fostering generative processing: 

• Embodiment principle: onscreen instructors should display high embodiment not low
• Immersion principle: 3D virtual reality is not necessarily better than 2D presentations 
• Generative activity principle: use generative learning activities during learning

In the newest edition of Mayer’s Multimedia Learning (8), three additional principles have been added. The embodiment principle states that onscreen instructors should display high embodiment rather than low embodiment, meaning they should use natural gestures, look at the camera as if making eye contact, and if drawing, show the image being drawn. If demonstrating something like a surgical procedure, a first-person perspective should be used so the learner sees the perspective of the person performing. Low embodiment would include standing still, lack of eye contact, and using a third-person perspective. The immersion principle states that 3D immersive virtual reality is not necessarily more effective than 2D presentations, such as on a computer screen. This is thought to be caused by the cognitive load on the learning involved in using 3D immersive technology but more studies are needed. Lastly, the generative activity principle states that learners should use generative learning activities while learning such as summarizing, mapping, drawing, imagining, self-testing, self-explaining, teaching, and enacting. These activities help learners cognitively select and organize new material and then integrate with prior knowledge.

Other Design Principles

Mayer’s design principles are functional but do not address aesthetics per se . Anyone can master the basic graphic design principles as discussed by Reynolds (9) to captivate and engage an audience. 

• Create graphics that are designed for the back of the room. Whatever the venue, the person in the back needs to be able to see and gather information from the graphics. Ensure font size is appropriate, image size and clarity is sufficient, and that font type and spacing allow words to be seen clearly from a distance. For online materials, this principle may mean designing for the person who will be viewing on the smallest screen (such as a phone) rather than assuming viewers will use a large monitor (10).
• Limit the types of fonts. Too many fonts or fonts that don’t coordinate well can make graphics seem jarring and unpleasant. Some programs will suggest font families that are appealing, and a safe guideline is to limit to two or three fonts maximum per graphic. 
• Use contrasting colors. Colors that are too similar or using type on top of images that lack contrast can make type difficult to read. Color family suggestions can be found online or in software such as Powerpoint.

Graphic design principles.  Do: Use coordinating fonts and color schemes with contrasting colors.  Don’t: use multiple fonts, excessive colors, and/or non-contrasting colors that may be difficult to distinguish.

In addition to singular graphics or presentations, online course presentation makes a difference in how learners perceive and utilize a course. When designing online learning experiences, consider using guidelines such as Quality Matters to assess the functionality. Quality Matters rubrics look at key components that have been proven to facilitate learning by making navigation and presentation of course elements explicit. Key components include providing information on how to get started, including learning objectives, allowing learners to track their progress, and using learning activities and technology tools that support active learning. Navigation among course components should facilitate access to materials.

In addition to all of these principles, accessibility must be considered in all forms of presentation. In education, designing for accessibility can be guided by universal design principles . Some schools may even require all courses and materials to be fully accessible. Providing accessible options has been shown to benefit all learners, not just those with a documented need for accommodations (11). Some basic accommodations that should be offered in any class include offering media in multiple modes. For example, videos should have the option of captioning and/or access to a transcript, and photos and graphics should have captions that describe the image. Many learning management systems and software programs now have options to check for accessibility. Additionally, most schools can provide assistance in assessing and developing accessible materials.

Practical Applications for Presentations in Health Professions Education

Implementation in the classroom.

When planning how to present materials in the classroom, first consider the most effective form of presentation for the given information. It may be a Powerpoint, a video, a graphic, or a handout. Consider using a variety of media appropriate for the intended outcomes. Creating high quality materials may seem daunting, but quality content can be reused, shared, and has been shown to enhance student learning.

Powerpoint has been much maligned for overuse and abuse, but well-designed presentations can be remarkably effective (12). When designing in Powerpoint, limit the amount of text per slide. One rule to remember is the 5/5/5 rule: Use no more than 5 lines of text with 5 words each or 5 text-heavy slides in a row and try to avoid bullets (13). Graphics are preferable to text or tables when representing data, but graphs and labels should be kept as simple as possible using 2D graphics and simplified labels that are easy for viewers to see (14). When presenting, refrain from reading from the slides. Slides should highlight important concepts and provide visual aids, not present everything. In addition, keep Powerpoint and video presentations short; most listeners will lose attention in 6–10 minutes (15,16). Whenever possible, engage the audience by interspersing active learning elements. Between sections or topics, transition slides can be used to indicate pauses for activity or reflection or to cue students to changes in topic (14).

When planning a presentation, consider presenting some of the information online before class for students to review. This flipped classroom technique allows for more class to be spent using active learning and facilitates the presentation of multiple forms of media and accessible options. 

Implementation online

Videos often become an integral part of the online learning experience. To facilitate learning, consider the following tips for your own video production (17,18): 

• Align the video with learning objectives and course outcomes. Focus on pertinent instructional points to reduce extraneous processing and thereby reduce cognitive load. 
• Limit the length of videos and use interactive elements to promote active learning. To help maintain student engagement and deepen learning, include interactive elements such as discussions, quizzes or embedded questions to maintain student attention. 
• Limit extraneous information, graphics, and sounds that do not pertain to the learning goals (19). Busy backgrounds, music, or animations that don’t contribute to understanding concepts unnecessarily add to a learner’s cognitive load.
• When using existing videos, ensure the source is reliable and the video is high quality. Video production can take time, so using professional videos can be beneficial if they come from credible sources that target the learning objectives with up-to-date and accurate information.

Additionally, Schooley et al. (18) have proposed a 25-item quality checklist that can help educators create and curate high-quality videos. Many of the items in the checklist have been discussed here such as length, captioning, using relevant graphics, and self-assessment opportunities, but also included are other points an educator should consider, such as the offering learners the ability to download files and adjust playback speed as well as providing them with recommendations for further reading.

For a course in any modality, creating and curating content online can save time and facilitate student learning. As you consider what material to create and use for your courses, assess existing material using the guidelines above to determine if it could be made more beneficial to learners. Does it follow Mayer’s principles? Does it follow graphic design principles and universal design principles? Consider using a Quality Matters rubric to check the course design for best practices.

Recommendations

Educator’s perspective.

• Use Mayer’s multimedia design principles to revise existing presentations and review new creations for simple changes that can make a big difference (12).
• When delivering a presentation, start by discussing an unusual case, presenting an interesting story or an unexpected statistic, or explain how the topic impacts the listeners. This personalization will help gain their attention from the start (13).
• When designing your own materials and graphics, “less is more” is often a good guideline: limit the amount of information on slides, limit the types of fonts, and limit the excessive use of colors (9,12).
• Videos should be limited to 5–6 minutes when possible and avoid exceeding 10 minutes. Break up longer videos and intersperse interactive elements to keep students engaged (15–17).
• When using technology and online delivery, universal design and accessibility considerations can be complicated. See if your school has an expert that can review your materials to ensure all students will benefit.

Student perspective

• When creating presentations, reports, and charts, follow Mayer’s multimedia design principles to ensure your audience gets the most from your presentation.
• Avoid copy/pasting but rather try and present concepts in an original way in order to augment your understanding of the material.
• When looking at materials online, look for options such as captioning, transcripts, or audio buttons for accessing additional media output.
• If a presentation is lengthy, pause and insert your own activities to help yourself stay focused. Taking notes, pausing for reflection, and self-quizzing can help deepen your learning and keep your mind from wandering.
• If a variety of media aren’t offered, consider finding your own to supplement your learning. Credible sources with learning objectives that align with your course can augment your learning experience.

(Please select all that apply) 

1. When creating a graphic about the current status of heart disease in the US, which of the following would align with best practices?

a. Gaining the audience’s attention with a picture of your dog.

b. Using 3 colors that coordinate well on a contrasting background.

c. A 2D graph with simple labels rather than a table of data.

d. An image on the left with labels listed separately on the right.

e. An image next to a paragraph of text that you will read for the audience.

2. Which of the following are true about educational videos?

a. They need to be created by professionals to be high-quality.

b. They should be less than 10 minutes.

c. There should be an option for closed captioning or a written transcript.

d. Longer videos may be used but should be broken up with active learning elements.

e. Videos don’t need to align to objectives as long as they’re well-made.

3. Which of the following would be examples of Mayer’s multimedia principles?

a. Using a human voice rather than a machine voice.

b. Using formal language instead of conversational language.

c. Playing soothing music in the background of a video.

d. Providing new words and definitions before the presentation begins.

e. Putting important words in bold for emphasis.

4. Which of these would follow best practices for online content?

a. Creating a module where all the material is on one page for easy access.

b. Adding buttons for next, back, and table of contents options for students to navigate.

c. Breaking material into 7-minute videos with practice questions between them.

d. Adding fun clip art and cool images to the pages even if it doesn’t directly relate to the content.

e. Having text only because images are distracting.

Answers: (1) b,c. (2) b,c,d. (3) a,d,e. (4) b,c.

Online Seminar

This online seminar and its accompanying article will focus on the topic of Effective Presentations, which have a set of key qualities: they are appealing, engaging, informative, and concise. Effective presentations gain attention and captivate the audience, but most importantly, they convey information and ideas memorably and efficiently. Using evidence-based principles in educational multimedia can ensure the development of high-quality learning experiences. Our host, Dr. Peter Horneffer will be sharing with us some key multimedia concepts that can help facilitate the development and implementation of effective multimedia into the educational process.

Watch the seminar recording:

Would you like to learn more? Explore the Pulse Seminar Library.

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Meredith Ratliff is a doctoral student in Instructional Design and Technology at the University of Central Florida. Her research interests include evidence-based medical education, branching scenarios, and faculty development. She has received her B.S. and M.A.T. in Mathematics at the University of Florida and her MA in Instructional Design and Technology from UCF. She has been an Associate Faculty member in the mathematics department at Valencia College in Kissimmee, Florida for the past nine years. As part of the Learning Science team at Lecturio, she serves as an educational consultant helping to design and develop materials for medical educators.

Satria Nur Sya’ban is a doctor from Indonesia who graduated from Universitas Airlangga. While a student, he served as the president of CIMSA, a national medical student NGO, working on a diverse range of issues that included medical education and curriculum advocacy by medical students. Before graduating, he took two gap years to serve as a Regional Director, and subsequently as Vice-President, of the International Federation of Medical Students’ Associations (IFMSA)*, working on and developing various initiatives to better empower medical student organizations to make a change at the national level. At Lecturio, he serves as a Medical Education Consultant, supporting Lecturio in developing and maintaining partnerships with student organizations and universities in Asia, as well as providing counsel on how Lecturio can fit in existing teaching models and benefit students’ learning experience.

*IFMSA has been one of the leading global health organizations worldwide since 1951, representing over 1.3 million medical students as members spanning over 123 countries.

Adonis is a doctor from Lebanon who graduated from the University of Balamand. He was a research fellow at the Department of Emergency Medicine at the American University of Beirut Medical Center and has worked with the World Health Organization Regional Office of the Eastern Mediterranean. During his studies, Adonis served as the president of the Lebanese Medical Students’ International Committee (LeMSIC), a national medical student organization in Lebanon, and moved on to serve as the Regional Director of the Eastern Mediterranean Region of the IFMSA*. Among his roles as Regional Director, he focused on medical education advocacy, oversaw collaborations with external partners, and undertook several medical education projects and initiatives around the region. As a Medical Education Consultant at Lecturio, he advises the Lecturio team on how the platform can fit in existing teaching models and benefit students’ learning experience, develops and maintains partnerships with student organizations and universities in the MENA region, and conducts research on learning science and evidence-based strategies.

Sarah Haidar is an educator and educational specialist from Lebanon who has graduated with a BA in English Linguistics and a Secondary Teaching Diploma (T.D.) from  Haigazian University in Beirut, Lebanon. She has received her M.Ed. in Teaching English as a Second Language (TESOL)  from the Lebanese International University. She has been teaching ESL classrooms at the Deutsche Internationale Schule for four years. As part of the administrative team at the All American Institute of Medical Sciences (AAIMS), she is working on the design and implementation of a set of academic and administrative reforms that can help both faculty and students in their professional and academic endeavors. She has joined Lecturio to support the Learning Science team in the writing and communication based tasks that might be needed to announce and market their services and events that are targeted at medical educators. She is also supporting the Learning Science team with her perspective on educational and pedagogical topics that will inform the general audience of educators.

Sara Keeth is a Ph.D. and certified PMP (Project Management Professional) who graduated from the University of Texas at Dallas. As an educator, she has worked as a Teaching Fellow at  the University of Texas at Dallas, as a full-time professor at Richland College (now Dallas College’s Richland Campus), and has also taught at Austin College. Dr. Keeth has also worked as a consultant for Parker University’s Research Center and has a decade of experience as an operations manager for an advertising agency. As Senior Learning Science and Research Project Manager at Lecturio, she manages the Learning Science department’s activities, shares her education expertise and best practices for medical educators, and develops evidence-based content for both students and faculty.

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6 Powerful Ways to Start a Presentation to Doctors

The beginning of your talk will set the tone for your allotted time

Whatever you do during the first 30-60 seconds should succeed in captivating the audience securely enough for them to turn all of their attention to you for the duration of your presentation. Loosen them up, fascinate them, or make them curious from the very beginning.

Consider using one of the six presentation openers listed below if you would like to try something new.

Sustainable Finance Strategies for Healthcare Businesses

Boosting hospital efficiency with the right emr systems, requirements to get in partial hospitalization programs, 5 best practices for quality & accuracy in clinical labs, 10 proven strategies to level up your health business, 1. start with a personal story.

Open up to your audience by illustrating how the subject at hand is personally important to you. When you start off with a personal tale of medicine, illness, cure, or perhaps gain and loss, you are inviting everyone present to identify with you. Suddenly you all become a part of the presentation. Rather than having to agree or disagree with the cold facts that you produce, they will actually be able to feel what you are saying once you make yourself seem more personable.

A colleague of mine was giving a similar presentation to another group of doctors just last month. He told me that the number one point the doctors were concerned about was xxxx.

2. Start with a story of a patient

Make your presentation entirely relevant by taking it directly to the case of a patient your medical device had treated. Deliver your story in a clear and intriguing way that lets doctors know that it is to be trusted and is not anecdotal. Before you present, make sure you establish the specific facts of the story so that you have a mental guideline to follow throughout your fluid talk. With your patient story you will start off by creating relevance and accountability for yourself and your message.

A doctor I met in the past told me of a patient who refused xxxxx equipment on the grounds that it was too uncomfortable. 

3. Start with a statistic

Give doctors a reason to listen to the rest of your presentation. Rather than asking them to blindly trust you before you get to the proof of your facts, start off with that proof. Deliver a relevant statistic that illuminates the importance of your entire presentation. The data you offer will provide a black and white, irrefutable example of why the topic of your discussion matters to your listeners. Using a statistic also illustrates that you are knowledgeable in the area, giving just one more reason why what you are discussing is worth hearing.

Did you know that the xxxx industry has been growing at a rate of xx% per year?

4. Start with a video

Movies of your medical device or how your technology works are guaranteed to draw attention as long as they are good and well structured. Videos are extremely useful when your medical device is too small to present to a group of doctors, is used inside the patient’s body, or is not mobile and is too large to bring into the room. Another type of video you can use is a video testimonial of a colleague they know and respect.

5. Start with a silence

What can be more powerful than a silence when you are expecting a speech? That period of waiting can be intense as the listeners wait for what is coming next. When you are ready to begin your presentation, try surprising listeners by providing them with a single sentence, and then a moment of complete silence. Maintain complete composure during the pause so that the doctors do not fear that you have forgotten what you were saying, or perhaps that you are angry or waiting for anything in particular. If you wish, say a few more words only to be followed by yet another silent period. In less than a minute you will have taken complete ownership of the room as all attention has turned to you, waiting for what you have to say next.

6. Start with humor

Laughter is a fun way to draw people’s focus. If you are confident that you will make your listeners laugh, using humor is a strong way of opening a presentation to doctors. The first step however is knowing your audience. You must know what the doctors in front of you will find funny or amusing before you bust out your best joke-telling skills. Then make sure your joke is relevant to your topic as well. A joke is meant to loosen the audience and make them feel comfortable and open to what you are about to say. However, if you botch the joke, you will be in for a rough recovery over the next few minutes.

This product will save patients money, allowing them to finally follow your recommendation to cut down on stress.

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Public Speaking – A Necessary Skill Set in Healthcare

As a healthcare professional, public speaking is a vital form of communication used at ceremonies, demonstrations, informative presentations, and other events to engage and educate audiences.

How to speak effectively

Public speaking requires the speaker to first think about the audience. You must think, “Who is this audience? What are they looking to learn? What do they have to gain by attending this event? What events led them to attend this event?” You can then tailor the presentation to meet the expectations of the audience in a way that is most beneficial and interesting to them – the most important aspect of effective public speaking.

Once you understand your audience, you should fine tune the delivery of the speech by rehearsing the talking points and presentation. Speak using an outline, rather than writing out your speech word-for-word – you’re going for a relaxed, extemporaneous delivery in which you make eye contact with the audience, rather than reading a canned speech from the podium.

Rehearsal will help you reduce nervousness and exhibit confidence, provide concise and valuable information, and utilize proper grammar and pronunciation. Also, rehearsal is the only way to know if your presentation is the appropriate length for the time allotted – this is less important if you’re the only speaker of the day, but it’s critical if you’re presenting a workshop as part of a full day of programming.

Often, using a PowerPoint can help the audience absorb what you’re saying. Charts and graphs can be a great way to convey quantitative information, but make sure you point out what you want the audience to understand. While you should certainly refer to your PowerPoint, don’t read it as part of the presentation, as that’s tedious for your audience – instead, limit the words on each slide. Don’t forget to include blank slides in your presentation when you don’t have something meaningful to project, as this will direct the audience’s focus back to you, the speaker.

Effective speakers don’t focus on themselves during a presentation – therefore, listening to the opinions, ideas, and questions the audience may have will enhance the audience’s experience and create a more effective presentation. So it’s important to consider the question-and-answer session after the speech. What are you likely to be asked? How can you prepare for those questions? If you get a question you’re not expecting and don’t know the answer, say so – and be prepared to direct the person questioning to where they might find out.

The consequences of not connecting with your audience

When you fail to connect with your audience, the effectiveness of your speech is reduced. This lack of connection leads to audience disengagement, ineffective delivery of the information itself, and could hurt your reputation as a speaker.

Most presentations in the healthcare system are designed to educate others on new medical discoveries, techniques, or skills that can be used to save lives. In short, the information is important – therefore, it’s important that you work to be as effective as you can as a speaker.

Most common public speaking mishaps

No speech will ever be completely perfect, but following the techniques of effective public speaking will help all public speakers to avoid the most common public speaking mishaps.

The following items are some of the most common public speaking mistakes:

• Lack of audience connection
• Lack of preparation and rehearsal
• Reading from slides or over-dependence on visuals
• Lack of emotion or use of monotone voice
• Lack of eye contact
• Content focus too advanced or too simple for the audience
• Not ending on a strong note
• Use of jargon or incorrect grammar

Our annual student anesthesia seminar is a great place to enhance your public speaking skills

Every spring, we hold our annual student anesthesia seminar to help current CRNAs earn continuing education credits by observing and learning from the presentations of others in their field. SRNAs have the opportunity to enhance their public speaking skills by providing an informative speech on their current research.

For more information on our annual seminars visit www.aanesthetists.com/education .

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Improving your communication skills

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• Peer review
• Matt Green , medical publishing director, BPP Learning Media, London ,
• Teresa Parrott , consultant psychiatrist, Pluscarden Clinic, Dr Gray’s Hospital, Morayshire, Scotland, UK ,
• Graham Crook , retired consultant general medical physician and chest physician, Spain
• mattgreen{at}bpp.com

The authors of the book Effective Communication Skills for Doctors , Teresa Parrott and Graham Crook , explore, together with Matt Green of the BPP University College’s School of Health, the art of clear communication in medicine and the steps that doctors can take to improve their communication with patients, family, and colleagues

A large and compelling evidence base in communication science shows that communication is vitally important to doctors and patients. However, this research also shows that changes are needed in the attitudes and skills that underlie the way doctors communicate. For this reason, training in communication skills has become an increasingly prominent part of undergraduate and postgraduate medical training.

It has been found that the communication skills of medical students who have not had this training actually get worse as they progress through medical school. So, whether you are a specialty trainee, foundation doctor, or medical student, it is never too soon to start fine tuning your skills. Doing this will give you a head start in enhancing your personal development and in progressing your professional career.

What is effective communication all about?

In these times of austerity measures and efficiency drives, we’re getting good at making the most of what we have—we are all mindful of delivering efficient services with scarce resources. However, we are not so good at making the most of what we are. In terms of communication, this means being able to give people the information they need in a clear and concise manner and with the right attitude. Good communication leads to more satisfying interaction with colleagues, helps you to manage your time better, and makes you a more effective team member and leader.

Learning to communicate effectively means making the most of every opportunity to interact with others: to be positive and encouraging to your team, to show empathy and concern to your patients, and to be able to deal with demands and difficult emotions. Having an understanding of what type of communicator you are and being able to identify the ways in which better communication can lead to better outcomes will help you to maximise your personal effectiveness in many different situations, giving you the advantage in interviews, assessments, and in the day to day workplace.

When do you need to start thinking about your communication skills?

At no stage in our careers should we stop developing and learning about communication. Research has shown that poor communication can contribute to burnout among consultants, dissatisfaction among patients, lack of compliance, and medicolegal problems. Improved communication skills could have a positive effect on all these.

Curriculum changes at medical school have led to a much earlier focus on the teaching and assessment of communication skills. Throughout your medical career, your interactions with others will be observed and measured through exams, supervision, workplace based assessments, and appraisals. In the foundation years you will be expected to develop generic communication skills as outlined in Good Medical Practice . In your e-portfolio you will reflect on your own performance. At specialty training interviews you will be asked to describe examples of when you have failed to communicate appropriately. At interview, your leadership skills, initiative, empathy, and team playing will be tested—how you motivate others, negotiate, and deal with conflict.

How does patient feedback influence your practice? How do you manage stress? These are questions about communication skills. Knowing some of the theories and research in the field will help you to become more confident in discussing the underlying issues. In this way, improving your communication skills raises the profile of other areas of your portfolio.

At all stages of your medical training there is an expectation that you can identify your weaknesses and discuss plans for improvement. The Medical Leadership Competency Framework, introduced in 2008, encourages self awareness—that is, knowing your own strengths and weaknesses. It entails realising the effect of your behaviour on others and the influence of your own emotions and prejudices on your judgments and behaviour. The aim of increasing self awareness is to be able to manage the impact of your emotions in your day to day practice—and to improve your relationships overall.

Top tips for effective communication

Use clear language: Avoid jargon and tailor your language to your patients’ understanding and information needs.

Be conscious of your non-verbal communication: It is important to maintain eye contact—reading notes or looking at the computer screen may convey negative messages.

Negotiate an agenda: Ask patients what they need from the consultation, and explain what can be covered. Few doctors explain the purpose of the consultation or the time available, and less than one quarter negotiate over treatment.

Establish a dialogue: Determine whether your patient agrees with the diagnosis and management plan. Patients who disagree with the diagnosis probably won’t adhere to the treatment.

Be flexible in your consultation style: Tailor your approach to the individual patient. A more directive style may be appropriate for patients who want less involvement in decision making. A supportive style—listening attentively and asking questions about psychosocial issues—helps facilitate the disclosure of sensitive information.

Provide the information that patients want: Doctors tend to talk too much about drug treatment, whereas patients want to know about causes and the likely diagnosis and prognosis. They want more openness about side effects and advice on how to relieve pain and emotional distress and what they can do for themselves. Providing this information helps their symptoms, reduces distress, improves physiological status, reduces hospital stay and use of analgesia, and improves quality of life.

Reflect on the outcomes of your interactions with others: Why do some doctors work well and others not so well? Communication difficulties are one of the main reasons that patients complain about doctors. The most common criticism is not about the doctors’ competence but that they have failed to listen or to offer sufficient explanation.

Apologise when mistakes occur: Apologising and expressing regret at the suffering experienced by a patient is not an admission of liability. Ineffective communication is the single largest factor behind litigation by patients. Good communication, including effective apology, can avert or help end conflict, especially litigation. It never does any harm to apologise—for yourself or on behalf of colleagues.

Empathise and listen: Your relationship with the patient is vitally important. It facilitates therapeutic space in which patients can express their concerns and receive support and advice. Empathy is the ability to understand what another person is experiencing and to communicate that understanding to the person. As the patient begins to relate his or her story, it is necessary to silence our own internal talk, including the diagnostic reasoning process, which can interfere with our ability to listen.

Mindful practice: This is your ability to observe not only the patient but your own performance during the consultation. Mindful doctors can easily be identified by patients and colleagues—they are present, attentive, curious, and unhindered by preconception.

Establish rapport: Recognition and explicit acknowledgment of the emotional content in your patient’s story is particularly important in establishing rapport. Doctors often respond to emotional cues by offering premature reassurance, explaining away distress as normal, attending to physical aspects only, switching the topic, or “jollying” patients along.

Final thoughts

Communication is important in all aspects of your training, and learning more about communication skills will help you perform better in exams, assessments, interviews, and appraisals—as well as in your day to day practice. Maximising your effectiveness in communication not only enhances your personal performance in many different spheres but also improves your relationships with patients and facilitates career progression.

Background references

Balint M. The doctor, his patient and the illness. Churchill Livingstone, 1957.

Charon R. Narrative medicine: a model for empathy, reflection, profession and trust. JAMA 2001;286:1897-902.

DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care 2004;42:200-9.

Disiker R, Michiellute A. An analysis of empathy in medical students before and following clinical experience. J Med Educ 1981;56:1004-10.

Fallowfield LJ, Hall A, Maguire P, Baum M, A’Hern, RP. Psychological effects of being offered choice of surgery for breast cancer. BMJ 1994;309:448.

Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R. Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 2002;359:9307.

Frenkel DN, Liebman CB. Words that heal. Ann Intern Med 2004;140:482-3.

Haidet P, Paterniti DA. “Building” a history rather than “taking” one: a perspective on information sharing during the medical interview. Arch Intern Med 2003;163:1134-40.

Kaplan SK, Greenfield S, Gandek B, Rogers WH, Ware JE. Characteristics of physicians with participatory decision-making styles. Ann Intern Med 1996;124:497-504.

Kaplan SH, Greenfield S, Ware JE Jr. Impact of the doctor-patient relationship on the outcomes of chronic disease. In: Stewart M, Roter D (eds). Communicating with Medical Patients. Sage Publications, 1989:228-45.

Kindelan K, Kent G. Concordance between patients’ information preferences and general practitioners’ perceptions. Psychol Health 1987;1:399-409.

Kinnersely P, Edwards A, Hood K, Ryan R, Prout H, Cadbury N, et al. Interventions before consultations to help patients address their information needs by encouraging question asking: systematic review. BMJ 2008;337:a485.

Maguire P, Fairbairn S, Fletcher C. Consultation skills of young doctors: benefits of undergraduate feedback training in interviewing. In: Stewart M, Roter D (eds). Communicating with medical patients. Sage Publications, 1989:124-37.

Maguire P, Pitceathly C. Key communication skills and how to acquire them. BMJ 2002;325:697-700.

Matthews DA, Suchman AL, Branch WT Jr. Making “connexions”: enhancing the therapeutic potential of patient-clinician relationships. Ann Internal Med 1993;118:973-7.

Meryn S. Improving doctor patient communication. BMJ 1998;316:1922.

NHS Institute for Innovation and Improvement, Academy of Medical Royal Colleges. Medical leadership competency framework. 2008. www.institute.nhs.uk/assessment_tool/general/medical_leadership_competency_framework_-_homepage.html .

Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP. Improving physicians interviewing skills and reducing patients’ emotional distress: a randomized clinical trial. Arch Intern Med 1995;155:1877-84.

Royal College of Physicians. Improving communication between doctors and patients. RCP, 1997.

Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ 1995;152:1423-33.

Stewart M, Brown JB, Boon H, Galajda J, Meredith L, Sangster M. Evidence on patient-doctor communication. Cancer Prev Control 1999;3:25-30.

Tomm K. Interventive interviewing: part III. Intending to ask lineal, circular, strategic, or reflexive questions? Fam Proc 1988;27:1-15.

Wissow LS, Roter DL, Wilson MEH. Pediatrician interview style and mothers’ disclosure of psychosocial issues. Pediatrics 1994;93:289-95.

Zoppi K, Epstein RM. Is communication a skill? Communication behaviors and being in relation. Family Med 2002;34:319-24.

Competing interests: TP and GC’s book Effective Communication Skills for Doctors is published by BPP Learning Media, whose medical publishing director is Matt Green ( mattgreen{at}bpp.com ).

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6 presentation skills and how to improve them

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What are presentation skills?

The importance of presentation skills, 6 presentation skills examples, how to improve presentation skills.

Tips for dealing with presentation anxiety

Learn how to captivate an audience with ease

Capturing an audience’s attention takes practice. 

Over time, great presenters learn how to organize their speeches and captivate an audience from start to finish. They spark curiosity, know how to read a room , and understand what their audience needs to walk away feeling like they learned something valuable.

Regardless of your profession, you most likely use presentation skills on a monthly or even weekly basis. Maybe you lead brainstorming sessions or host client calls. 

Developing effective presentation skills makes it easier to contribute ideas with confidence and show others you’re someone to trust. Although speaking in front of a crowd sometimes brings nerves and anxiety , it also sparks new opportunities.

Presentation skills are the qualities and abilities you need to communicate ideas effectively and deliver a compelling speech. They influence how you structure a presentation and how an audience receives it. Understanding body language , creating impactful visual aids, and projecting your voice all fall under this umbrella.

A great presentation depends on more than what you say. It’s about how you say it. Storytelling , stage presence, and voice projection all shape how well you express your ideas and connect with the audience. These skills do take practice, but they’re worth developing — especially if public speaking makes you nervous. 

Engaging a crowd isn’t easy. You may feel anxious to step in front of an audience and have all eyes and ears on you.

But feeling that anxiety doesn’t mean your ideas aren’t worth sharing. Whether you’re giving an inspiring speech or delivering a monthly recap at work, your audience is there to listen to you. Harness that nervous energy and turn it into progress.

Strong presentation skills make it easier to convey your thoughts to audiences of all sizes. They can help you tell a compelling story, convince people of a pitch , or teach a group something entirely new to them. And when it comes to the workplace, the strength of your presentation skills could play a part in getting a promotion or contributing to a new initiative.

To fully understand the impact these skills have on creating a successful presentation, it’s helpful to look at each one individually. Here are six valuable skills you can develop:

1. Active listening

Active listening is an excellent communication skill for any professional to hone. When you have strong active listening skills, you can listen to others effectively and observe their nonverbal cues . This helps you assess whether or not your audience members are engaged in and understand what you’re sharing. 

Great public speakers use active listening to assess the audience’s reactions and adjust their speech if they find it lacks impact. Signs like slouching, negative facial expressions, and roaming eye contact are all signs to watch out for when giving a presentation.

2. Body language

If you’re researching presentation skills, chances are you’ve already watched a few notable speeches like TED Talks or industry seminars. And one thing you probably noticed is that speakers can capture attention with their body language. 

A mixture of eye contact, hand gestures , and purposeful pacing makes a presentation more interesting and engaging. If you stand in one spot and don’t move your body, the audience might zone out.

3. Stage presence

A great stage presence looks different for everyone. A comedian might aim for more movement and excitement, and a conference speaker might focus their energy on the content of their speech. Although neither is better than the other, both understand their strengths and their audience’s needs. 

Developing a stage presence involves finding your own unique communication style . Lean into your strengths, whether that’s adding an injection of humor or asking questions to make it interactive . To give a great presentation, you might even incorporate relevant props or presentation slides.

4. Storytelling

According to Forbes, audiences typically pay attention for about 10 minutes before tuning out . But you can lengthen their attention span by offering a presentation that interests them for longer. Include a narrative they’ll want to listen to, and tell a story as you go along. 

Shaping your content to follow a clear narrative can spark your audience’s curiosity and entice them to pay careful attention. You can use anecdotes from your personal or professional life that take your audience along through relevant moments. If you’re pitching a product, you can start with a problem and lead your audience through the stages of how your product provides a solution.

5. Voice projection

Although this skill may be obvious, you need your audience to hear what you’re saying. This can be challenging if you’re naturally soft-spoken and struggle to project your voice.

Remember to straighten your posture and take deep breaths before speaking, which will help you speak louder and fill the room. If you’re talking into a microphone or participating in a virtual meeting, you can use your regular conversational voice, but you still want to sound confident and self-assured with a strong tone.

If you’re unsure whether everyone can hear you, you can always ask the audience at the beginning of your speech and wait for confirmation. That way, they won’t have to potentially interrupt you later.

Ensuring everyone can hear you also includes your speed and annunciation. It’s easy to speak quickly when nervous, but try to slow down and pronounce every word. Mumbling can make your presentation difficult to understand and pay attention to.

6. Verbal communication 

Although verbal communication involves your projection and tone, it also covers the language and pacing you use to get your point across. This includes where you choose to place pauses in your speech or the tone you use to emphasize important ideas.

If you’re giving a presentation on collaboration in the workplace , you might start your speech by saying, “There’s something every workplace needs to succeed: teamwork.” By placing emphasis on the word “ teamwork ,” you give your audience a hint on what ideas will follow.

To further connect with your audience through diction, pay careful attention to who you’re speaking to. The way you talk to your colleagues might be different from how you speak to a group of superiors, even if you’re discussing the same subject. You might use more humor and a conversational tone for the former and more serious, formal diction for the latter.

Everyone has strengths and weaknesses when it comes to presenting. Maybe you’re confident in your use of body language, but your voice projection needs work. Maybe you’re a great storyteller in small group settings, but need to work on your stage presence in front of larger crowds. 

The first step to improving presentation skills is pinpointing your gaps and determining which qualities to build upon first. Here are four tips for enhancing your presentation skills:

1. Build self-confidence

Confident people know how to speak with authority and share their ideas. Although feeling good about your presentation skills is easier said than done, building confidence is key to helping your audience believe in what you’re saying. Try practicing positive self-talk and continuously researching your topic's ins and outs.

If you don’t feel confident on the inside, fake it until you make it. Stand up straight, project your voice, and try your best to appear engaged and excited. Chances are, the audience doesn’t know you’re unsure of your skills — and they don’t need to.

Another tip is to lean into your slideshow, if you’re using one. Create something colorful and interesting so the audience’s eyes fall there instead of on you. And when you feel proud of your slideshow, you’ll be more eager to share it with others, bringing more energy to your presentation.

2. Watch other presentations

Developing the soft skills necessary for a good presentation can be challenging without seeing them in action. Watch as many as possible to become more familiar with public speaking skills and what makes a great presentation. You could attend events with keynote speakers or view past speeches on similar topics online.

Take a close look at how those presenters use verbal communication and body language to engage their audiences. Grab a notebook and jot down what you enjoyed and your main takeaways. Try to recall the techniques they used to emphasize their main points, whether they used pauses effectively, had interesting visual aids, or told a fascinating story.

3. Get in front of a crowd

You don’t need a large auditorium to practice public speaking. There are dozens of other ways to feel confident and develop good presentation skills.

If you’re a natural comedian, consider joining a small stand-up comedy club. If you’re an avid writer, participate in a public poetry reading. Even music and acting can help you feel more comfortable in front of a crowd.

If you’d rather keep it professional, you can still work on your presentation skills in the office. Challenge yourself to participate at least once in every team meeting, or plan and present a project to become more comfortable vocalizing your ideas. You could also speak to your manager about opportunities that flex your public speaking abilities.

4. Overcome fear

Many people experience feelings of fear before presenting in front of an audience, whether those feelings appear as a few butterflies or more severe anxiety. Try grounding yourself to shift your focus to the present moment. If you’re stuck dwelling on previous experiences that didn’t go well, use those mistakes as learning experiences and focus on what you can improve to do better in the future.

Tips for dealing with presentation anxiety 

It’s normal to feel nervous when sharing your ideas. In fact, according to a report from the Journal of Graduate Medical Education, public speaking anxiety is prevalent in 15–30% of the general population .

Even though having a fear of public speaking is common, it doesn’t make it easier. You might feel overwhelmed, become stiff, and forget what you were going to say. But although the moment might scare you, there are ways to overcome the fear and put mind over matter.

Use these tactics to reduce your stress when you have to make a presentation:

1. Practice breathing techniques

If you experience anxiety often, you’re probably familiar with breathing techniques for stress relief . Incorporating these exercises into your daily routine can help you stop worrying and regulate anxious feelings. 

Before a big presentation, take a moment alone to practice breathing techniques, ground yourself, and reduce tension. It’s also a good idea to take breaths throughout the presentation to speak slower and calm yourself down .

2. Get organized

The more organized you are, the more prepared you’ll feel. Carefully outline all of the critical information you want to use in your presentation, including your main talking points and visual aids, so you don’t forget anything. Use bullet points and visuals on each slide to remind you of what you want to talk about, and create handheld notes to help you stay on track.

3. Embrace moments of silence

It’s okay to lose your train of thought. It happens to even the most experienced public speakers once in a while. If your mind goes blank, don’t panic. Take a moment to breathe, gather your thoughts, and refer to your notes to see where you left off. You can drink some water or make a quick joke to ease the silence or regain your footing. And it’s okay to say, “Give me a moment while I find my notes.” Chances are, people understand the position you’re in.

4. Practice makes progress

Before presenting, rehearse in front of friends and family members you trust. This gives you the chance to work out any weak spots in your speech and become comfortable communicating out loud. If you want to go the extra mile, ask your makeshift audience to ask a surprise question. This tests your on-the-spot thinking and will prove that you can keep cool when things come up.

Whether you’re new to public speaking or are a seasoned presenter, you’re bound to make a few slip-ups. It happens to everyone. The most important thing is that you try your best, brush things off, and work on improving your skills to do better in your next presentation.

Although your job may require a different level of public speaking than your favorite TED Talk , developing presentation skills is handy in any profession. You can use presentation skills in a wide range of tasks in the workplace, whether you’re sharing your ideas with colleagues, expressing concerns to higher-ups, or pitching strategies to potential clients.

Remember to use active listening to read the room and engage your audience with an interesting narrative. Don’t forget to step outside your comfort zone once in a while and put your skills to practice in front of a crowd. After facing your fears, you’ll feel confident enough to put presentation skills on your resume.

If you’re trying to build your skills and become a better employee overall, try a communications coach with BetterUp. 

Elevate your communication skills

Unlock the power of clear and persuasive communication. Our coaches can guide you to build strong relationships and succeed in both personal and professional life.

Elizabeth Perry, ACC

Elizabeth Perry is a Coach Community Manager at BetterUp. She uses strategic engagement strategies to cultivate a learning community across a global network of Coaches through in-person and virtual experiences, technology-enabled platforms, and strategic coaching industry partnerships. With over 3 years of coaching experience and a certification in transformative leadership and life coaching from Sofia University, Elizabeth leverages transpersonal psychology expertise to help coaches and clients gain awareness of their behavioral and thought patterns, discover their purpose and passions, and elevate their potential. She is a lifelong student of psychology, personal growth, and human potential as well as an ICF-certified ACC transpersonal life and leadership Coach.

The 11 tips that will improve your public speaking skills

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Let us introduce you to a new way of presenting healthcare centers. Did you think that we were going to use blue? Tut-tut! This time, the palette revolves around cream (the color of the backgrounds) and other pastel tones. As you explain in detail (or in brief) your healthcare services,...

Surgical Case Report

Download the "Surgical Case Report" presentation for PowerPoint or Google Slides. A clinical case is more than just a set of symptoms and a diagnosis. It is a unique story of a patient, their experiences, and their journey towards healing. Each case is an opportunity for healthcare professionals to exercise...

Hand Drawn Style Healthcare Center

If you need to present a healthcare center, the overall aesthetic you might be looking for is something peaceful and pretty. Something that makes your center look approachable and safe. In that case, we have the perfect template for you! These slides will make your presentation super calm and attractive:...

Download the "Eclampsia" presentation for PowerPoint or Google Slides. Taking care of yourself and of those around you is key! By learning about various illnesses and how they are spread, people can get a better understanding of them and make informed decisions about eating, exercise, and seeking medical attention. This...

National Library of Medicine

How many books about medicine can there be? And medical centers? We can't give you an exact number, but what we can offer you is a template for Google Slides and PowerPoint to present your medical center. In a simple, but direct style, you can talk about your center, where...

Pastel Palette Doctor Theme

Presentations on health and medical topics can be challenging to create, but this Google Slides & PowerPoint template is here to rescue you! This multi-purpose layout is designed with blue pastel tones, providing a professional and calm environment to showcase your medical expertise to colleagues, students, or patients. The template...

Psychopathology Case Report

Download the "Psychopathology Case Report" presentation for PowerPoint or Google Slides. A clinical case is more than just a set of symptoms and a diagnosis. It is a unique story of a patient, their experiences, and their journey towards healing. Each case is an opportunity for healthcare professionals to exercise...

Clinical Case 06-2023

Slidesgo is back with a new free medical template, perfect for a presentation about a clinical case. The design is very appealing, so these slides are a nice tool to provide a lot of useful information for doctors and researchers.

Clinical Case 04-2023

When trying to prevent diseases, information is key, and if it’s reliable, all the better. With this new free medical template, you can show the results of a clinical case, including the symptoms, the patient monitoring, the treatment and all the important data. Its design will help you grab your...

Simple Circles & Rhombus Medical Center

Download the "Simple Circles & Rhombus Medical Center" presentation for PowerPoint or Google Slides. Hospitals, private clinics, specific wards, you know where to go when in need of medical attention. Perhaps there’s a clinic specialized in treating certain issues, or a hospital in your area that is well-known for its...

Alcoholism Treatment Drugs Breakthrough

Drug addictions are a difficult condition to treat, but thanks to the investigations and studies conducted by health professionals, new breakthroughs are appearing to help people who suffer them. Speak about it with this visual design for breakthrough news and share the treatment you have discovered with the medical community!...

Patients and Nurses Medical Theme

As the backbone of every healthcare system, nurses play an integral role in providing top-notch patient care. Whether it's administering medication, monitoring vital signs, or simply holding a hand, these dedicated professionals are the ones keeping our loved ones safe and comfortable during their time of need. But let's not...

Genetic Diseases: Hemophilia

Download the "Genetic Diseases: Hemophilia" presentation for PowerPoint or Google Slides. Taking care of yourself and of those around you is key! By learning about various illnesses and how they are spread, people can get a better understanding of them and make informed decisions about eating, exercise, and seeking medical...

Clinical Case 01-2023

Present your clinical case to the medical community with this dynamic and engaging presentation by Slidesgo. Who said science can’t be creative and fun?

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