Put yourself in their shoes

Keep it simple, tell a story and know that every audience is different

Communicating clearly: preparing your talk
In his new book, Communicating Clearly about Science and Medicine, LionsDen chief executive John Clare outlines the techniques he has developed over 20 years. He has taught them to industry leaders, triallists, academics and scientists and during that time has built an international reputation.

In the first of four articles, exclusively for Communiqué, Clare reveals his own techniques for preparing your talk.

What makes a great presentation?
‘Just put the best possible words in the best possible order’, said the English poet Samuel Taylor Coleridge, and you’ll write poetry.

He didn’t have to deal with over busy PowerPoint slides and complex medical data and most of us don’t have such lofty ambition when we sit down to write a scientific presentation, but there’s nothing wrong with aiming high.

So how do you identify the best words and the best order? It depends what you want to say, who you’re talking to and what you want them to do when they’ve heard you.

I’m at ASCO in Chicago, where there will be about 250 presentations delivered. The scientific content of all of them will be first rate, but how many of them will be great presentations? What makes a great presentation, or even a good one?

The starting point is to understand that the presentation is not the clinical paper and vice versa. It is understandable that you are delighted if the New England Journal of Medicine has accepted your paper or that your abstract will be included in the main ASCO media briefing. Savour that moment. But then put it out of your mind when you sit down to write the presentation. It will be based on the data that appeared in the paper, but everything else about it is different:

The presentation will be shorter…you may have to summarise a two-year study and its results in just five minutes
The audience cannot turn back and re-read points that are unclear or complex
They cannot take in the minutiae of complicated graphs, charts and slides, which need time to study
Their attention may be wandering, so you have to grab it and keep it.

I have three guiding principles that will enable you to overcome these problems and set you on the way to producing a great presentation.

Principle one: Einstein’s dictum
I start with the advice attributed to Albert Einstein:

Make things as simple as possible…but no simpler

When I was writing Communicating Clearly about Science and Medicine I couldn’t find the primary source for these exact words. However, he was well known as an advocate of appropriate simplicity, as illustrated by his advice: ‘Any intelligent fool can make things bigger, more complex and more violent. It takes a touch of genius…and a lot of courage…to move in the opposite direction.’ I stress here that I am not advocating ‘dumbing down’ or over-simplification. Scientific communication is challenging. The subject matter is complex and doesn’t always lend itself to a picture storybook approach (though it is worth looking at some books and websites aimed at teenagers for great examples of how to communicate simply). This is where the second part of the advice comes in, ‘…but no simpler’. Aim for appropriate simplicity. Keep it simple but don’t lose the scientific essence. The physicist Brian Cox is a great example of how to put this into practice. His subject matter is hugely complex, but he simplifies it to the right level and engages our attention. You should aim to do the same.

Principle two: tell a story
Yesterday I saw a great presentation about tyrosine kinase inhibition as a treatment for lung cancer. It was memorable because the presenter did far more than talk through the slides: he told a story. I will talk about techniques for delivering your talk in a later article. Here I want to introduce the second preparation technique:

A great presentation combines the accuracy of peer-reviewed science with the narrative skills of journalism

As with Einstein’s dictum, both elements of the advice are equally important. Scientific and statistical accuracy are paramount, and you can’t play fast and loose with the facts. However that does not mean you have to be dull. When I ask medics and scientists what drew them to their chosen profession, they often mention a great teacher or inspirational lecturer. They often relate an incident that drew them into the scientific world. They are telling stories. If I ask you to tell me what you remember from the bible you are likely to mention the Good Samaritan, Lazarus raising from the dead or the water being turned into wine. They are all stories, in biblical terms known as parables.

I once saw an Israeli professor of paediatrics explain the difficulty of conveying the concept of risk to parents by telling his audience that one mother took her children across the Gaza Strip to his clinic, but wouldn’t let him give them the MMR jab because she said it was dangerous. It’s a great story, memorable, and made the point.

Principle three: put yourself in their shoes
Most of the 2,500 presentations being delivered at ASCO this week will be new due to the need for novelty as a requirement for getting on the programme. However, I wonder how many of them will become the ‘standard talk’ for these presenters, to be dusted down and trotted out around the world irrespective of the audience? The vast majority, I imagine. In many instances this will be a mistake because every audience is different. They have different levels of knowledge, understanding, interest, commitment, scepticism, worry, time and financial constraints.

I regularly see well-respected scientists deliver their standard talk on their specialist topic without any thought for the specific needs of different audiences. This is wrong, and in my view disrespectful to the audience. I recently sat in a presentation about the biology of protease inhibition where the presenter lost the audience in the detail within two minutes of a 30-minute talk, which would have been more accurately aimed at post-doctoral researchers rather than HIV physicians.

When I talk about this in my presentations, I illustrate it with a slide showing photographs of many different types of shoes: high heels, pumps, workmen’s boots, trainers, shiny city shoes, canvas shoes, flip flops, soccer boots and others. I also use a photo of Prince Charming trying to fit the wrong size shoe onto Cinderella. The point is well made: there is no ‘one style and size fits all’ for scientific presentations.

PowerPoint: the good and the bad
When I work with presenters who are planning a talk, I ask them to put aside the slides, and tell me the story verbally without any illustrations. I ask them to imagine they have made a presentation at a news conference and that I am a journalist who has arrived late and asks for a brief summary of their presentation. We then work together to work out how the story should flow on a flipchart. It needs a beginning, a middle and an end. We use some well-known techniques such as ‘tell them what you’re going to say… say it… tell them what you said’. The point is to get them away from the habit of ‘talking through the slides’.

PowerPoint is a very good programme for illustrating your talk… no more, no less. It should not be a crutch, an aide-memoire or a script. Having the slides drive your presentation is the equivalent of the tail wagging the dog. It’s not a pretty sight.

Despite its overuse, abuse and misuse, PowerPoint can be very helpful in preparing your talk: you can use it to produce a storyboard that will give your talk a good narrative flow.

Here’s how: in ‘normal’ view the panel on the left usually displays miniatures of the slides. At the top of this column select the ‘outline’ tab. This will show you the text on the slides. To prepare a storyboard, start by filling in the slide titles, which should be the key topics in your talk. Once you have decided the titles, select the best way of illustrating each topic, one topic per slide. In this way you can build up your storyboard quickly and effectively. Then you are using PowerPoint as it was intended. You, your audience and your story will all benefit.