Suggestions for Effective Presentations

  1. Length of didactic presentations: A study of the concentration  level of medical students during 50-minute didactic lectures showed that  concentration rose steadily for the first 15 minutes and then steadily  declines toward the end of the lecture. (Stuart, J. Lancet 1978; 2:514) For  this reason, many educational leaders are recommending that presentations be  no longer than 30-35 minutes.

  2. Use of interactivity: The didactic lecture continues to be used in  the delivery of most formal continuing medical education programs. This is  due, at least in part, to the fact that our lecturers grew up in this type  of system and are comfortable with design and delivery of a standard  lecture. The usual lecture format does allow for sharing of information and  allows the recipient to determine if his/her knowledge base in that subject  needs to be updated. Unfortunately, studies have shown that it is a very  inefficient method for education.

  A systematic review of 14 randomized controlled trials of a variety of CME  activities, both passive and interactive, found that the didactic lecture  alone was not effective in changing physician behavior or healthcare  outcomes. (Davis, D, et al. JAMA 1999; 9:867) A growing body of CME  literature indicates that interactive continuing education sessions that  include participatory activity can increase learning, effect change in  professional practice behavior, leading to an improvement in health care  outcomes. (Steinert, Y, et al. Medical Teacher 1999; 21:37)

  There are several teaching techniques that can enhance interactivity in  large group lecturing (excerpted from Silver, I and Rath, D. Best Practices:  Making the formal lecture more interactive. Intercom 2002; 15:6.)

 

    Rhetorical questions: These can be used at the beginning of    a lecture to grab the attention and interest of the audience. As an    example, one might start a lecture on treatment-resistant depression by    asking “How many of you have sat in your office with a chronically    depressed patient and felt almost as nihilistic about their prognosis as    the patient?” 

 

    Surveys: This technique is used to identify audience    characteristics, interests, beliefs or state of knowledge about a topic.    As an example, the speaker might ask “How many of you have treated    treatment-resistant depressed patients?” A follow-up might be “What    approaches have you used?” 

 

    Brainstorming: This process entails creating a list of answers by the audience to a    question posed by the teacher. For example, one might ask for a list of    all treatment approaches. The lecturer would then type a list generated by    the audience (using PowerPoint). After the list is completed, the teacher    can help the audience organize and prioritize the correct answers. 

 

    Quizzes: Using multiple choice or short answer questions can    help focus the audience on key learning points. A playful addition is to    make five color-coded cards attached at the bottom for each audience    member. Each one of the five colors represents one of the choices in a    standard multiple-choice question. Audiences are then asked to vote by    holding up the appropriate color signifying their choice. The audience is    able to see how their peers voted, and the presenter receives immediate    feedback on the level of knowledge. This method requires that the lecturer    not be color blind. A more sophisticated version of this can be achieved    with an audience response system. There are se eral commercial suppliers    available and this can be treated this as an appropriate expense in a    budget of a course. 

  Small group sessions:   Attendees in small group sessions can be paired off to discuss  questions/cases. The group is then asked to share their consensus.  Alternatively, 3-4 students are turned around to face 3-4 others and go  through the same process.

  Liberal use of clinical cases with various stopping  points for discussion of workup, diagnosis, and therapy.

  Written materials: Syllabus material these days often makes use of a  copy of the PowerPoint slides. The hard copy of the slides can periodically  be deliberately incomplete; this requires the attention and concentration of  the audience to fill in the blanks. The inclusion of recent references is  greatly appreciated by attendees.

  Question and answer period: Allow sufficient time for questions and  answers

  3. Other suggestions:

  Use of colors in PowerPoint: Dark cool colors (blues and greens) tend to  recede. Light warm colors (yellows, oranges, and whites) come forward. Thus,  cooler colors make better backgrounds while warmer colors are best for  lettering. Avoid the use of red.

  Consider ending 1 day with a roundtable/ open panel discussion; this can be  combined with a reception.

  A number of studies have shown that retention increases significantly with  repetition. Give thought to converting some or all of the presentations into  enduring materials (eg, CD-ROM, web -based products, printed materials)  which can be used for follow-up/review with participants and to expand the  reach of a program to larger national and international audiences.