The art and science of presentation: electronic presentations.S Prasad, B Roy, M Smith
Department of Ophthalmology, Wirral Hospital, Merseyside, UK, Orthopaedic Surgeon, Leeds, UK, and Librarian, The Royal College of Surgeons of Edinburgh, UK.
Correspondence Address: Source of Support: None, Conflict of Interest: None PMID: 11298471
Source of Support: None, Conflict of Interest: None
Keywords: Audiovisual Aids, Clinical Medicine, standards,trends,Computer-Assisted Instruction, methods,Electronics, Great Britain, Human, Teaching, methods,
The need to make presentations is an essential part of life as a doctor. Whether it is for the purpose of teaching, presentation of research findings or the presentation of a case history at a ‘grand round’.
Presentations are most often made with the help of audio-visual aids. Traditionally these have been 35-mm slides on formal occasions and overhead transparencies in more informal settings. In recent times, on-screen shows using a computer and electronic data projector have gained increasing popularity. The once ubiquitous 35-mm slide projector with the associated tasks of carrying carousels, rearranging slides, and replacing damaged ones, seems to be headed for extinction. The goal of using these modern aids is to make your presentations more effective in getting your message across to your audience. Technology complements and enhances good presentation skills, but does not replace the essential skills of delivering your content and controlling the audience backed up by planning and practice. A good speaker with poor slides will be better received than a poor speaker using the latest technological wizardry.
This article provides guidelines about making effective on-screen electronic presentations. Some of the underlying principles of effective presentation technique and the use of digital aids for making presentations are both discussed.
Conventional media such as overhead transparencies or 35 mm slides have served us well and will continue to do so for some time. However, electronic on-screen shows permit the use of a range of features and design options beyond those available with the conventional media.
1. You can animate text and images, incorporate audio and video material, and hyperlink to Internet sites.
2. The time needed to create a presentation has been reduced from days to hours.
3. The results are far more memorable and captivating than a slide show.
4. The need to negotiate slide production with a third party is eliminated thus saving time and money.
5. This also allows you to update your slide show as frequently as you wish without charge.
6. Changes can be made to your presentation even at the last moment if required.
7. Presentations can be emailed to others and can be made available on the web.
Perhaps the only drawback in opting to present ‘on-screen’ is that one is more reliant on the equipment. Also, data projectors often don’t match the image quality of conventional slide projectors. Although this technology is advancing rapidly, many poor installations with inadequate viewing area, poor resolution and low screen brightness still exist. It is therefore essential to carefully check that the available equipment is adequate for the task, before choosing this method of presentation. It is also wise to make sure that a CD ROM drive, or Zip Drive is available if required.
Properly executed electronic presentations allow you to show complex and dynamic concepts more effectively than you could with ordinary slides. For example, a digital video clip of a patient coughing along with the accompanying intercostal retractions has an effect that is difficult to replicate with static text and images. Multimedia has moved off the cinema screen and has now arrived in conference-rooms and lecture-halls. Electronic presentations are becoming popular in part because of rising expectations. It is difficult to attend a medical conference without noticing who is using old, scratched, 35-mm slides and who is using modern electronic aids. Some people who give a lot of presentations say that freedom from jammed slides and the inevitable bulb burnout is reason enough to convert to an electronic format.
On occasion you may choose to deliberately avoid this high-tech route. Suppose you were presenting details of your work in an isolated rural community to a polished urban audience. You may choose to deliberately appear in rolled up shirt sleeves and cotton trousers and used hand written over head transparencies as your only audio-visual aids, maybe interspersed with a few photographs or sketches. This can be very effective in conveying a ‘down-to-earth’ atmosphere and work well for the confident presenter. A word of caution though, this sort of approach requires the presenter to have much greater presentation and audience control skills. However, this scenario is of the nature of the exception which proves the rule, in most settings you will do well to make the best use of available facilities and a good electronic on-screen show will be more effective than one made using more basic aids.
It is often said that electronic presentations are cheaper to create compared with using an expensive slide-making service. This is only true if you do not have to pay for all the needed equipment or can use computers that are bought for other uses. The versatile modern PC can serve to manage a patient appointment system in office hours and be used to design a presentation at other times. Nevertheless, always remember that computer systems can and do fail. For that all-important seminal presentation, it is still prudent to carry a set of 35-mm slides or overhead transparencies as a back up; there is nothing more impressive than the speaker who is unflapped by failing equipment and confidently continues in the face of such mishaps.
Major technological developments have converged to make electronic presentations popular. These include the development and widespread use of powerful standardised presentation software, availability of quality digital cameras and scanners, multimedia-capable laptop computers and affordable electronic projectors. Let us examine each of these briefly.
If you have created 35-mm slides on a computer, you’re already familiar with presentation software. The most popular package is Microsoft PowerPoint. PowerPoint’s Wizards, library of templates, and clipart allow you to create a reasonable presentation quickly. Pie charts, bar charts, animated text, sweeps, and other types of effects are easily implemented.
Competing products often offer all or most of the features available in PowerPoint. But the sheer popularity of PowerPoint means that it is the most likely software package to be available if you are going to use another computer to make the presentation. If you are going to make 35-mm slides, either as a backup, or for use on another occasion, PowerPoint is the most likely package to be accepted by the slide-making service. It is always important to check the version of software available at the venue. If you are using a different version to create your presentation (for example PowerPoint 2000 compared to PowerPoint 97, or The Mac version compared to the Windows version), always rehearse on the computer you are going to use at least once, allowing time to make adjustments, as your slides may look different on the other version of the software and you may need to make minor changes. If you are using your own laptop, then you have more control over the environment, and you can expect your presentation to look on screen just like you have designed it at home or in your office and of course you can use any software package you choose. All reference to software used for presentation is to PowerPoint in the rest of this article.
Digital cameras have come of age. Pocket-sized digital cameras and even video cameras now offer good quality, so you can keep one ready to capture images of that special patient. It has become increasingly essential to obtain written consent from the patient if you plan to use the images in publications or presentation, even if the patient cannot be identified from the image. Once you have a digital image, it’s simply a matter of inserting the image file or copying and pasting the image into your presentation software package. When buying a digital camera, the general rule is to buy one with the highest resolution possible within your budget. Resolution is usually stated in pixels; cameras with less than one million pixels produce pictures that are of low quality and those with less than three million pixels may prove to be often inadequate for your purpose. At the upper end of the range cameras with over three million pixels resolution produce output that is comparable to traditional film.
The same ‘as high as possible’ resolution rule applies when comparing scanners; here it is the optical resolution one is interested in. Brochures and salesmen may mention very high resolution, which on closer questioning turn out to be ‘interpolated’; this means that the software is increasing the resolution. The golden rule in all imaging is that the quality of the original source is paramount, thus the native optical resolution is more important than software enhanced interpolated resolution. Flatbed scanners are now de rigueur. Handheld scanners are only useful for scanning text and low quality small images. If you need to convert old 35-mm slides, always retype text, scanned text slides do not reproduce well. For pictures it is best to use a slide scanner, this uses very high resolutions compared to a flatbed scanner. The ‘slide-adaptor’ available on most flatbed scanners is generally not good for this task due to relatively lower resolution. If you do not have access to a slide scanner, it is best to get prints made from your original slides and then to scan the prints, this will gives a much better picture quality.
Laptop computers are getting thinner, smaller, and more powerful than ever before. Besides being useful for a multitude of other things they make creating, editing, and showing electronic presentations a pleasure. A modern laptop is a must if you want to produce advanced presentations with the sound, animations, and video clips as this allows you to have total control of the medium avoiding software incompatibilities. If you’re shopping for a laptop and plan to use it for presentations, think of whom your audience is likely to be. If you are going to be presenting to small groups mainly (five to eight people), a laptop with a good large screen will allow you to do this without the need of a projector. For larger audiences, make sure there’s a video-out jack for driving an external monitor or an external projector. The laptop with the fastest processor and largest amount of memory (RAM) is best, but as a presentation engine the graphics capability is also important. As always get the best graphics capability you can afford (a good measure is the amount of ‘video RAM’ or VRAM). Remember, that the VRAM is very difficult and expensive to upgrade, whereas you can usually boost the memory (RAM) and increase performance easily by plugging in appropriate modules. Cordless remote control devices (mouse) are now available, and these often incorporate a laser pointer, which liberates you from having to stand next to the computer whilst presenting. An experienced speaker’s travel kit always includes a laser pointer; a critical item whose performance - unlike that supplied at the venue - can be guaranteed.
Electronic projectors have also become more powerful and more affordable while at the same time becoming smaller and more feature-laden. Advances in electronic-projector technology are the main reason electronic presentations have taken off as fast as they have. Electronic projectors are still expensive. However, if you’ve ever used one of the better projectors, you know that they’re worth the price. You need to be familiar with the projection system to be used - much more so than you would with conventional 35-mm slide projectors. Data projectors are manufactured to a variety of specifications and you need to ensure that they are adequate for the content of your show. For example, the screen resolution of VGA and SVGA projectors may not be sufficient for the viewer to resolve the fine detail present on, say, fundus images – you will need the resolutions offered by XGA or SXGA projectors. If in doubt, always rehearse on the available equipment so that you know what it will look like before you actually ‘go live’.
The commonest mistake made by the novice presenter using electronic wizardry is to get carried away with the available gimmicks and neglect the basic rules of presentation. Foremost, you need to know the content thoroughly. This will give you the confidence that can only come from knowing that you are more knowledgeable than your audience.
* Planning is paramount
* Know your audience
* Check the facilities
* Arrive in good time to prepare
* Rehearse, rehearse and rehearse!
The opening line is most important, you have to grab the attention of the audience. You will often have to start a presentation by thanking the hosts or chairman. Do not repeat what has already been said. If the chairman has just introduced you as Dr Singh from The Famous Medical College, do not begin by saying ‘I am Dr Singh from The Famous Medical College’! Having completed the formalities courteously but briefly, launch into your subject. A very useful three-point rule used to structure your presentation is; “tell them what you are going to tell them, tell them and tell them what you have told them”. This serves to emphasise your message. Be emphatic when concluding, we have all seen the politician who finishes a speech by saying, “It is a Win, Win, Win situation”. Have a short punchy finishing line; do not hesitate to repeat this!
Spend sometime planning before you hit the keyboard. You first need to choose or create a framework, or structure, for your presentation.
Start by defining salient issues such as:
* The purpose of your presentation
* The single most important idea you want to communicate
* The action or change in practice you want your audience to make
* The arguments can you are going to use to foster the desired action or change in practice
* The possible objections your audience might have to your arguments
* How can you best overcome their objections
It is useful to jot down your ideas about how you are going to address these issues on a sheet of paper and refer to it as you create the slides that make up your presentation.
Before composing your first slide, go to the Page Setup menu and check that it is set for On-screen show. This will ensure that your slides will appear in the slide show in the same layout (width-to-height ratio) as you design them. Then, choose the colours and layout most appropriate for your presentation. If you are using the AutoContent Wizard, select Presentation Style and select the output device you will use to deliver your presentation. PowerPoint chooses an appropriate combination of foreground and background colours. Click ‘Next’ and the AutoContent Wizard shows you where to add the presentation title, slide number, and date to each slide. This can add a professional touch to your slides, but remember that the AutoContent wizard is primarily aimed at creating business presentations and the ‘bells and whistles’ used for these often seem out of place in a medical context. The name of the game when it comes to slide layout is KISS (Keep It Simple Stupid!). Even when using straightforward colour schemes, PowerPoint offers a myriad of variations in hue, saturation, luminance, ‘fill’ and typographic style effects. One appealing option is to grade the slide background in intensity from dark (top) to light (bottom). You can also use an image as a background - perhaps a photo, an X-Ray or even institution logo. Make sure that you have manipulated it in a graphics package to reduce contrast and brightness so that the background is subtle and does not detract attention from the foreground contents.
General rules for the design and layout of slides are similar to those used for 35-mm slides and are discussed in another article in this series. Limit each slide to a single idea; use this idea as the slide title. Replace the “Click to add text” placeholder with the ideas and arguments that best support the premise of the slide title. When using bulleted lists, use keywords rather than full sentences. This encourages you to restate the ideas in your own words during your presentation, rather than reading to your audience. Remember: your goal in creating visuals is to provide a framework for your presentation, not replace yourself.
Endless text is boring. Whenever possible, translate words into visuals. Visuals such as charts, graphs, and tables are more effective at communicating comparisons, hierarchy, relationships, and sequence. To insert a chart, click the Insert menu, and then click Chart. To display the Drawing toolbar and access its numerous AutoShapes, right-click the menu bar in PowerPoint and select Drawing from the list of Toolbars. Exercise restraint when adding clipart to your slides. It is best to avoid standard clipart, which is often overused, use your own images wherever possible. Emphasize visuals that support, rather than decorate, or distract from, your ideas. When scanning images for insertion into PowerPoint, specify a resolution sufficient only to fill the space available on a slide. Scanning at a higher resolution only makes for harder-to-manipulate images and increase the overall size of the presentation.
A slide with animation reveals to the audience only that content which the presenter wishes to be viewed at any particular moment. One of the problems with presenting an unanimated slide consisting of, say, bulleted text is that the audience may be inadvertently reading one bullet point whilst the speaker is elaborating upon a completely different point. Animating the slide such that each bullet point appears at the command of the presenter eliminates this problem producing what is known as a progressive slide.
PowerPoint offers many different and elaborate animation effects. Generally it is best to confine yourself to a simple Appear, Dissolve or Fly From Left. You can be more adventurous in your choice of animation for graphics (Zoom Out is particularly good for revealing clinical photographs, but use this sparingly). Whatever effects you choose, make sure you maintain consistency within your presentation. If, say, a series of slides each includes a micrograph, then if you opt to animate their appearance, use the same effect on each slide. Be careful, there is a fine line between using animations to good effect and to being perceived by your audience as too much of a showman or show-woman.
Many sound effects come included with PowerPoint. It is best to avoid these as they can quickly become irritating. They can be effective as a means of attracting the audience’s attention to perhaps one crucial point in the show, to emphasise humorous content, or to signal the beginning or end of the presentation. You may of course incorporate your own sound files: a patient describing their symptoms perhaps, or a ‘sound bite’ recorded from the radio or downloaded from the Internet.
Including a movie (video clip) on a slide is one of the most sophisticated PowerPoint options at your disposal. To draw attention to the start of the movie, and to signal its end, consider using a transition. Consider the software environment before using movies. Movies included on slides compiled using the PC version of PowerPoint will be incompatible with the Macintosh version and vice versa. The second warning is that unlike other PowerPoint objects such as static images, PowerPoint does not incorporate the movie into the saved presentation file but locates it during the show from a storage device, typically the local hard disk.
Problems can arise if you transfer the presentation to another computer, as PowerPoint will initially attempt to locate the movie files from the computer from which they originated. This problem can be overcome by careful naming of the storage devices and folders on the respective computers or by using your own laptop for the presentation, thus avoiding the need to transfer it between computers. Always carefully edit the movie clip you want to use to fit in with the presentation and timing. The standard way of inserting a movie in your presentation is to use the ‘Movies and Sounds’ on the ‘Insert’ Menu, however if you want to have the ability to replay or skip parts of your video, use the Insert/Object/Create from File command. This ensures that PowerPoint uses the native application to play the movie (such as Windows Media Player or QuickTime) and provides the controls required to manipulate the video on the slide.
Slide transitions are the short graphic interludes between slides. With conventional slide projection, the transition is normally just a brief flash of light as one slide replaces another. PowerPoint offers a variety of dynamic transitions.
Generally, these are probably not necessary or appreciated. Exceptions to this observation are the opening and closing of a presentation and perhaps when you are showing a series of slides with very subtle differences between them, to make the slide change noticeable. If you are going to use transitions then as a rule use only one type of transition per slide show or slide category.
Hyperlinks can be used to navigate to Internet sites whose contents you wish to be viewed during your presentation. When running the slide show, you activate the hyperlink, typically by using the arrow pointer (mouse) and PowerPoint will automatically open your web browser and connect to the address you have specified. For example, if you were giving a lecture about a literature search using PubMed (Medline), you could design a PowerPoint presentation such that it included a slide containing the hyperlink (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi). Clicking on this leads to the appearance of the PubMed home page in a new window from where a search can be demonstrated. It is not a good idea to make your presentation over reliant on any one particular hyperlink; if it cannot be accessed for any reason (for example an error connecting to the website), you may be left in an embarrassing position. A fall back option is to insert a picture of a screen shot of the home page of the site you hope to open, with a couple of bullet points on what the site’s features are.
Be sure to check that you will have Internet access when making your presentation, if you plan to hyperlink to the Web. Hyperlinks can also be used to access other PowerPoint presentations you may want to refer to within your main presentation or indeed to other applications and documents.
When presenting the show you will be advancing at your own pace by a means of a mouse click or key press. At some point you may wish to halt the show and blank the screen (to focus the audiences attention on what you are saying) and you can do this by selecting from the menu option revealed by clicking the icon which appears at the bottom left of the screen (NB you need to move the mouse in order for the icon to appear). Here you will also find the Pen Tool (whose colour you can select to contrast against the colour scheme of the slide), which you can use to highlight specific information on a slide. Remember that at the end or any time, for questions, you can touch the keyboard “b” key to give a blank black screen, and “w” key to give you a blank white screen. This is neater that showing a ‘windows’ screen and focuses the audience’s attention on you rather than the screen.
You will also need to check that the storage media on which your presentation resides is compatible with the projection installation. The best way around this problem is to use a laptop computer; otherwise if there is a PC permanently installed, transfer the presentation file using a floppy or more likely a zip disc (Macintosh users should be especially alert to compatibility issues with these devices). Presentation files may also be compressed (zip file) on to floppy disks and then expanded on to the hard drive of the in situ PC. PowerPoint offers a ‘Pack and Go’ option which greatly facilitates the task of transferring presentations from one computer to another, using multiple floppy disks or other media. It is a good idea to print off the short instructions on unpacking, and keeping them with the packed presentation
‘Take-aways’ are always appreciated. Consider the form most appropriate: a simple ‘skeleton’ in which a list of relevant headings and sub-headings are set out, ‘slide miniatures’ (readily produced in PowerPoint), or full-blown notes. Give thought to whether it is appropriate to give the handout out before or after the presentation. Consider whether you want to share your on-screen show with a wider audience. This is easily done by posting your presentation on a web page, perhaps your own, or your institution’s (The ‘Save as HTML’ command in PowerPoint 97 and 2000 makes this easy). That way others can view your presentation at their leisure. Your material may end up, for better or worse, being included in someone else’s presentation! Consider including on the last slide in your show the web address at which your presentation can be viewed by those inclined to do so.
Timing is everything!
Never include more slides than you have time to show. If you include too many slides and don’t pay attention to how much time you should spend on each one, you’ll rush towards the end or—worse—omit slides. Either alternative greatly diminishes your credibility. Never run over the time allotted. Your presentation should always be shorter than the time you have available, allowing time to respond to audience questions.
Rehearse, Rehearse, Rehearse
Rehearsing is a key to successful presentations. Rehearse your presentation by speaking out loud (preferably in an empty room or in front of a sympathetic audience). Rehearsing helps you identify and eliminate awkward word combinations. Rehearsing out loud also shows you how much time is needed to deliver your presentation.