Rule #1: Know the Type of Talk You Are Giving

You will give two types of talks through your career. The goals for each type are the same: impart knowledge, change practice, and improve patient care and outcomes. The structure of these talks is very different.

The Core Content Talk

This type involves an apparently simple transfer of knowledge from a textbook chapter to a slide set to the mind of your learner. Initially, this looks easy—just copy and paste from the online version of the textbook and make up a bunch of slides. If you do this, it will be almost immediately apparent to your listeners that you have cobbled together endless facts that they cannot possibly absorb. They would be better-off if you just photocopied the chapter and gave it to them to read during quiet time.

By definition, the core content talk must cover masses of material, much of which must be recognized or memorized. You can help your audience get a handle on the important material by dividing the essentials into bite-sized chunks.

For example, you are assigned the topic “Oral and Dental Emergencies.” Outline your talk on paper before you ever go near the computer. Decide on the text you are going to use and see how the material is organized. Divide the topic by anatomy, from exterior to interior: lips, teeth, gums, tongue, palate, uvula, tonsils/peritonsillar area, and posterior oropharynx. Talk about the important conditions affecting each of these structures and how to treat them, for example, lips—angular cheilitis (perlèche), herpes simplex (cold sores), lacerations and regional blocks, and vermilion border. Next, talk about the teeth—teething, caries, third molar pain, periapical abscess, pericoronitis, postextraction pain and dry socket, postextraction bleeding, and chipped, loose, avulsed, and missing teeth. When you have finished your outline, then and only then should you start making slides and looking for illustrations.

If you follow this technique, your talk will be organized so that your audience can take notes in an outline format. Their notes at the end of the talk should look a lot like the outline you used to develop the talk. Your outline also makes a natural handout—give it to your audience and let them fill in the blanks.

This type of talk supplements the written material, so your audience will benefit more by reading the assignment either before or after the presentation.

The Other Talks

There are many other reasons to give a presentation. You may want to present the results of your research, pass on a new message, disentangle frequently confused information, motivate a change in practice, communicate a vision, or share a new and striking concept. The important thing to remember is that you must deliver information that the audience cannot simply obtain by reading a journal paper, and you always want to point your audience to additional learning resources.

For a 60-min talk attended by 40 people, the cost is 40 person-hour times the hourly value of each person’s time plus the time spent traveling to hear the talk. If what you present could have been accomplished reading an article for 10 min at the breakfast table or in the subway, you have wasted a huge amount of peoples’ time.

The mark of a bad presenter is not necessarily withholding information, but giving too much without presorting and editing. This is not the time to become a human encyclopedia, inflicting fact after fact on a numbed group. Rather than saying more, you should say less. Concentrate on delivering three to five major points. Your audience welcomes distilled information and a road map for learning. Again, think of the best presenters you have heard. They anticipated the question you might ask and answered it without prompting. That is the mark of a great teacher.

Another advantage of putting across a limited number of major points is that it makes your job of developing the talk easier. Instead of a 45-min talk, you are now developing three, four, or five talks, interrelated, but each only 9–15 min long. It is a lot easier to write a 10-min talk than to develop a coherent 45-min talk.

Now that you have a 10-min block, write down the point you want to make in that segment. Only after you have the conclusion should you start developing that section. Your goal is to spend 9 min developing the argument that was started in the last 1 min, much like a lawyer.

Rule #2: Know Your Audience

Speaking to a group of residents and/or medical students presents its own unique challenge [2, 3]. It is really the “core content” talk that residents need as a base of knowledge to build on. As residents progress into their senior years, they may be more interested in the “other talks,” but these talks are pretty much useless if there is not a strong base of the core content.

When speaking to residents, remember that they will be overworked and stressed out. A group of residents have a shorter collective attention span than a national audience, so take this into consideration when planning a talk for them.

A national audience is coming to hear you voluntarily and has possibly paid a lot of money to hear you talk. On the other hand, a group of residents are probably required to be there and might rather be elsewhere. While the goal of a speaker is to cultivate an engaged audience, a group of residents are a captive audience. This could make the task of holding the audience’s attention even more daunting. Talks to residents may need to be shorter, or have extra breaks, or be less text heavy. It is very important that the topic is relevant and interesting to someone learning the craft of emergency medicine.

Most current residents and medical students are members of the “millennial generation,” born in the 1980s and growing up in a high-technology environment, so their educational needs and learning strategies are different from those of previous generations. They are more reliant on technology as a learning modality and they expect immediate answers to their questions. This generation prefers a team-oriented approach to academics and may require more positive feedback than older generations. Whether you like it or not, this is true. People considered outstanding teachers 20 years ago may now be regarded as boring, tiresome, or old hat.

What if you are invited to speak at another hospital across town, for a residency program, or in an unfamiliar setting? Do not assume you can give the same talk you give in front of a sympathetic crowd of people you work with daily. Find out who will be present—physicians, nurses, administrators, lay people. Are they all emergency physicians, or can you expect some trauma surgeons, family physicians, and hospitalists in the audience? What is the anticipated audience size? Why are they attending—required continuing medical education? Do people come primarily for the free lunch? Is it a mandatory talk to meet some hospital or state requirement? Does your host want you to make specific points? Can you expect disagreement from certain audience members? The more you know about your audience, the easier your job will be.

Make sure that your cutting-edge technology is compatible with what is available at the speaking venue. Know whether you will be restricted to using a laptop at the podium or will be able to wander freely and use a remote control.

Rule #3: Know Your Ending

Why is this topic next? The end of the talk is the earliest part of the talk you should develop. Many talks are mediocre because they sputter to a halt with no warning, leaving the audience with a dissatisfied, puzzled look. One of the most anticlimactic statements you can utter is “Well, I guess that’s all I have.” The end of the talk is your opportunity to sum up and emphasize the points you want people to take home. Recap your three to five main points, and tell people how to use them.