Delivering a great presentation in medicine

In Education & Quality Improvement by Nadim Lalani7 Comments

It’s orientation week for our new residents in Saskatoon. As we pride ourselves on our presentation abilities at my institution, part of the transition to residency was a talk about creating a great presentation by my brilliant colleague Rob Woods. Read on to learn from his wisdom.

Why do you need to give a great presentation?

We’ve all gone to conference talks that make you want to sleep, only you can’t because you also feel like poking your eyes out. You can’t just get up and leave either, because the ushers made you sit in the middle of the row and the rows are so close together you’d be “excuse-me”-bumming your way out for like 5 minutes!!

Why would you inflict that one someone else??? It seems obvious, but generally the goal of a presentation is to try to teach someone to go out and do the right things in their clinical practice. However, for you to deliver a truly great presentation – a presentation that sticks – you are going to need to communicate effectively.

Why do talks fail?

We don’t know how to teach effectively – Traditionally, our medical educations have not done a good job of teaching us how to teach.

We do not know how to use presentation software effectively. Again, we are rarely taught how to effectively use various presentation software. Unfortunately, PowerPoint sets you up to fail because of its focus on bullet points and text. Personally, I prefer Prezi because it allows concepts to be tied together in a much more visual way. Remember that “A picture is worth a thousand words.”

Even when we know a bit about effective presentations we often try to do too much with our talks, resulting in presentations that go on too long, try to cram to much in, or have poor pacing.

Hopefully these pearls will help you to do it right.

1. Request the Details

Who is the Audience? How many people will attend? What is level of training of participants? Are there multiple specialties/levels? Will there be any ‘hawks’ in attendance who are likely to ask you specific or difficult questions?

What is the goal of the presentation? Who asked you to give the talk?  Do they have a list of objectives to be covered?  If not, think what you would want to know if you were to attend your own talk?  If there are people of different professional backgrounds, poll them to find out what they need to know.

When are you giving the talk? This will allow you to “reverse plan” your deadlines [lit search, creating presentation, editing and rehearsing etc]. Anticipate spending about 20-40 hours designing your talk.

Knowing answers to these vital questions will allow you to decide about the content and the depth of information and allow you to anticipate questions from the keen-eyed hawks.

2. Prepare the content

Okay, you’ve got your timeline, you know the audience, and you have objectives – ready to boot up your Powerpoint? NO! To prepare an exceptional slide deck you need to have all of your information readyIt is important to develop your content BEFORE because you need to know WHAT you are going to say before you can figure out HOW you plan to best convey that information.

The first thing to do is to determine exactly what you are going to cover and gather all of your information. Generally you’ll only get a 1-hour time-slot… this means that you’ll need to limit your content. Being concise means that you’ll need to pick 3-5 things/controversies/ practical questions. Giving a good talk entails way more than just regurgitating content in a confident fashion. One of the biggest faux-pas is to get an article from Uptodate or a textbook chapter and use the “cut’n’paste techinique.” More importantly … the content needs to be brokered. You do this using Restrained Preparation

Once you’ve done that, you can start to  create your handout.

Contrary to what most of us have experienced a handout is NOT a copy of your power point slides or a photocopied article.
-Rob Woods

A good handout is an organized outline of the content – the “Coles Notes” if you will. It can contain all of your references as well as additional background and serve as the audience’s “take-away” from your talk. Brent Thoma (CanadiEM Editor) advocates for posting a blog posts rather than handing out content as publishing this information online allows you to spread the information farther, gets you additional credit, and makes it easily accessible for those who attend your talk and others. Posting to CanadiEM adds the additional benefit of the “coached peer review” process1 where the CanadiEM copyeditors and staff reviewers will provide you with feedback to make your blog post (and presentation) even better! For more information on submitting to CanadiEM click here.

Good resources for Emergency Medicine content can be obtained via Pubmed, Academic EM, and the Evidence Based EM bookFOAMSearch.net2 and Altmetrics3 can provide you with some great #FOAMed resources (e.g. blogs and podcasts) summarizing the latest controversies in the field. If you’re still stuck … talk to colleagues and consultants about the common pitfalls, any controversies or any new developments around the topic. Vet these ideas with the person that asked you to give the talk.

3. Ready the Slides!

Now that you’ve requested the details and practiced restrained preparation it’s time to create the presentation and prepare the delivery. A couple of important influences went into creating the pearls below [and need to be acknowledged]:

Firstly: If you’re not listening to Rob Rogers – you should. Here’s a link to his FREE podcasts at iTeachEM [click here].

Secondly: Kessler  published a neat article “Qualitative Analysis of Effective Lecture Strategies4” – it is one of those articles that you wish you wrote!

Thirdly: Manuel Mah, one of the Master Teachers at the University of Calgary, once gave a presentation on Becoming an Insanely Great Presenter. Download it here.

Your presentation should be simple, memorable, visually attractive and interactive.  The slides are not the talk.  If someone were to listen to your talk without seeing your slides, it should still be easily understood.  The slides merely highlight your speaking
-Rob Woods

Ever heard of the Dual channel theory of information processing? Essentially – You have Eyes and You have Ears. When it comes to attending a talk you can’t listen to speaker AND read text  on the slides at the same time. LESS WORDS MORE PICS

If you want your audience to read, shut up.  If you want your audience to listen to you, put up a memorable picture and talk. R.W. 

Visual Aids aren’t just gimmicks. They engage the audience. They allow the learner to compartmentalize the content. They allow the learner to focus on what you’re saying. The result is that they reinforce the concepts  and allow for more effective learning.


Most of us are not Flash or Adobe experts, but there’s this INTERNET thingy that has loads of FREE Content. Use videos to show the “happy wheezer” child with bronchiolitis. There are multiple galleries full of images published with Creative Commons copyrights which are free to use (especially for non-commercial educational content). If something IS copyrighted – ask to use it – most people are okay with educational use.

If unclear – there is a generally accepted rule that 1) as long as you’re not profiting from the use 2) as long as the source is acknowledged – you are fair dealing‘ in your use of media from the ‘net.’ [read more] -Andy Neill

When laying down the content. Adhere to the Law of Repeated Exposure:

Tell’em what you are going to tell’em. Tell’em. Then tell’em what you told’em.

Okay … you’ve got the talk ready. How do you deliver?

4. Delivering the Content

Malcom Gladwell in his Book Outliers – says that future success takes 10,000 hours. You probably don’t have 10, 000 hours to practice your talk [if you do  – get a life] BUT … the more you practise the better you get.

Amateurs practice until they get it right.  Professionals practice until they don’t get it wrong

Also, it is not enough to practice in your head.  You need to speak out loud, preferably to another person.  Pick a brutally honest family member – teaching something to a non-medical person will ensure that you can explain it to anyone.

Be prepared to be your own tech support (or find someone who can help you). This means that you need to show up early and work out any projector/audio issues well before the start of the talk. Some MAC STUFF WON’T WORK ON A PC! [big surprise]. Do a test-run so that you’re not standing in front of the room trying to get your presentation to work when you should be giving it.

If you’re using your own laptop … Bring your own laptop adapter.

It often helps to have every file (pic video, article) in a folder for that presentation.  Drag the entire folder from your USB to the desktop.  This ensures all files will actually appear in your presentation software.

Make sure there’s appropriate lighting. “Mood lighting” will anesthetize your audience.

Dress better than your audience  – at least 10% better than your audience (or 80% better for exclusively Emergency Physicians).

Do not make any apologies! – The audience expects you to be the expert. Making excuses 1) undermines your credibility and 2) sets the expectation of a weak presentation.

Use non-verbal communication to be more engaging.  Face the audience, get away from the podium (stand on the audiences’ left side of the screen – people read from left to right, so if you stand on their right it makes them feel uncomfortable), make eye contact, and speak to the audience like they are one person.

Ditch the Frickin’ Laserbeam! Using that little shaky red laser is not necessary (you can highlight aspects of your slides within presentation software), requires you to turn your back to your audience, is difficult for some to see (especially in large auditoriums), and can not be seen by anyone videoconferencing in to the presentation.

Speak up and make silence your friend. Speak in a voice slightly louder than your usual voice and use hand gestures and facial expression to emphasize what you are saying.  Don’t be afraid of silence. If you ask a question and do not get an immediate response, stand in front of a small group and make eye contact. They will speak up!

It’s a natural tendency to insert  “um” and “er” into you speech … this reduces the effectiveness of your talk. Silence is better. Pause often. Sip water. Work on removing those verbal ticks from your vocabulary.

Always have the Last Word – Some people who ask questions just want to hear their own voice. If this is the last thing people hear, it reduces the effectiveness of your talk. Don’t let others have the last word. Give the audience an opportunity for questions BEFORE you present your summary slide.

For further reading, here’s a neat blog post by my colleague  Michelle Lin on being a good speaker [link] Follow her on Twitter @M_Lin

5. Reflect and Revise:

Remember that no-one becomes a good speaker overnight. It takes trial and error along with a lot of hard work. Be sure to read your evaluations as they provide direction for improvement. If they are universally positive, find a speaker that you respect who will be attending your next talk and ask them to provide you with more critical feedback. If you do find some things to change, reflect on them and make note of what you’d like to change for the next time that you give that talk (if you do a good job you’ll likely be asked to present it again down the line). In the future, offer to give the same talk at a future date with a different audience. You can occasionally rescue an organizer with a strong “canned talk” that you have in your back pocket.  If you have reflected and made some changes, the 2.0 version of you/your talk will be infinitely better than the 1.0 version.

Okay got it? Any Questions? … NO?


courtesy Dr. Rob Woods

Note: This post was originally published on the ERMentor blog on July 12th, 2012. It was copyedited by Rob Carey(@_RobCarey) and Anali Maneshi (@a_maneshi) and revised by Brent Thoma (@Brent_Thoma) before being reposted on CanadiEM on July 21st, 2016.


Sidalak D, Purdy E, Luckett-Gatopoulos S, Murray H, Thoma B, Chan T. Coached Peer Review: Developing the Next Generation of Authors. Acad Med. May 2016.
Raine T, Thoma B, Chan T, Lin M. A custom search engine for emergency medicine and critical care. Emerg Med Australas. 2015;27(4):363-365.
Trueger N, Thoma B, Hsu C, Sullivan D, Peters L, Lin M. The Altmetric Score: A New Measure for Article-Level Dissemination and Impact. Ann Emerg Med. 2015;66(5):549-553.
Kessler C, Dharmapuri S, Marcolini E. Qualitative analysis of effective lecture strategies in emergency medicine. Ann Emerg Med. 2011;58(5):482-9.e7.
Nadim is an emergency physician at the South Health Campus in Calgary, Alberta. He is passionate about online learning and recently made a transition into human performance coaching. He is currently working on introducing the coaching model into medical education.