Case based teaching is an effective method of teaching as it provides a setting for problem solving in a realistic context.

Whether you are preparing for an RMO case presentation or a clinical teaching session with students or interns, effective presentation skills will help you connect with your audience and get your message across.

Presentation skills consist of 3 main components or sets of skills:

Storytelling skills – creating the narrative to get your message across

Visual design skills – selection of media to support the story plus the look & feel of the presentation (colour, font, imagery and white space)

Public speaking skills – delivering the story – execution, stage presence, passion, voice, body language, eye contact.

Each component requires

Planning
Practice
Critique

So, before you turn on your computer and open up PowerPoint you need to plan an outline of your patient case/s and the media that you are going to use to illustrate their story and your examination, investigation findings and management.

In the planning phase use:

A whiteboard
post-it notes
or a large piece of paper.

You are planning:

Step 1 – the patient story
Step 2 - your supporting media/images
Step 3 – your delivery

Using the post-it notes will assist in developing the ideas to create your story, step by step. You should be able to see your story as a series of steps. This provides a framework or structure to work with.

Who is your audience?
What do they know about the topic?
What is their level or prior knowledge in this field?
What do you want them to do as a result of your talk?
What actionable outcome do you want them to walk away with?

If you are a RMO/registrar/consultant presenting to interns or students who have just commenced or about to commence work as a doctor and won't have vast clinical experience or be familiar with a diversity of patient cases. So you need to consider how much experience they have around your topic and pitch your talk at their level. What can you impart that will help them in their every day work practice, what advice can you give them to improve their communication and interaction with patients? To help them with their management plans and treatment options.

So where do you want your learners to be at the end of presentation? What actionable outcome/s do you want them to walk away with?

This will help you generate your 3 key take home messages.

Let’s look at the story. In a presentation, why do you think it is important to create a story rather than just imparting the facts and data?

A story has more meaning then a list of bullet points, and if it has an actionable message – your learners will remember

Stories provide an emotional link to illustrate your message

Telling stories creates a simulation of reality. It provides the setting to problem solve and analyse of a realistic patient encounter.

Research shows our brains are not hard-wired to understand logic or retain facts for very long, but are wired to understand and retain stories

The case presentation is not a data dump of information and facts – you need to convey a message in order to have an actionable outcome – you want them to leave the presentation with “this will really help me”.

What is the overarching idea that will hook the audience – capture their attention – confirm relevance for their participation at your talk.

Using an emotional hook/connection will create more buy in for your story..why is it important that they know this – what is the value and how will this help them in the clinical setting.

Provide context in each step of the story, invite them to analyse the problem.

Ask questions around the problem - and how they would manage this situation?

Give examples of your own thought processes and how you synthesise the problem - this will provide them with insight into the clinical reasoning processes of an 'expert' clinician.

To connect with the audience – tell them what was going through your mind at the time, how were you feeling?

In your introduction involve the audience as the doctor reviewing the patient to provide context:

“ you are the junior doctor in ED, its early morning and you have just started your shift when a call comes through from QAS en-route with a patient and signs of a stroke… You are asked to meet the patient in the resus bay.. What is your plan, what are you thinking..”

This drops your learners right into the scene that you were presented with – it provides them with a visual picture of the beginning of your story. You can then ask for their opinion, this involves them in the decision making for this case, it gets them to ‘think’ about what is going on..rather than you just telling them what happened.

Throughout the case you don’t have to provide slides full of lists, detailed diagrams or reference excerpts

Having no text on the screen forces the audience to listen and not read ahead in an attempt to figure out the diagnosis from their own perspective rather than that of the presenter.

Note: Bullet point slides with reams of text are a barrier to communication – busy slides reduce the ability to remember what was the point of the slide. While they are reading the slide they are not listening to you.

Dont copy and past a table from excel or a journal article and then add a red box around the relevant words - your audience cannot see the words - if they are important to your talk - cut the words from the document and place the sentence in the middle of the slide so that they can 'see' what you are referring to.

Depending on the allocated time for your talk, whether it's a 20 minute case presentation or a 1 hour lecture you won't be able to cover everything in your topic. Again think about the level of your learners, they don't have your experience or expertise, so you will need to keep it simple enough for them to understand.

Your learners won't remember everything from your talk, so plan it around 3 take home messages.

Present one idea at a time – don’t reveal everything at once. If you need to list a number of key points present them one at a time.

Don’t be scared that you may have too many slides – it’s much better to talk briefly about one slide then try and cram 12 pieces of information (and multiple images) on the one slide.

Remember one relevant image per slide.

As soon as the audience see a slide with bullet points, they will read the list and if you are reading it out as well, they will finish before you do.

Once a list is read it will be forgotten. The list actually stops the audience from listening to you.

The bullet points or text aren't your script - your visuals/graphs/quotes and other media will provide the trigger to discuss the ideas for each slide.

Consistency of colour, font, theme, proper use of white space.

Avoid the powerpoint template themes – they add extra clutter and take up the valuable real estate space of your slide.

A white background works better than a dark background in smaller lecture rooms.

Otherwise a dark (black background) with white text for larger rooms.

Align the elements on your slide to create meaning, relationships and focal points.

See the principles presented by Garr Reynolds:
http://www.presentationzen.com/

Use one image per slide
High quality images or take your own photos (make sure you have patient consent)
Obtain the originals of radiology, x-rays and blood tests but remember patient confidentiality - ensure you de-identify all patient details

Colour is effective way to generate focus – a bar graph using colour for the points you want to explore

Representing data

Data should be easily interpreted, clear and memorable.

Don’t simply provide data, construct an appropriate table – use colour to highlight your findings.

Don’t insert whole data table on your slide, or copy and paste from excel. Your audience won't be able to see, let alone decipher what is presented in the table.

Your job is to analyse the data beforehand, and then present this in your talk. If you have raw data that is important provide a handout that they can take away with them.

“Sorry I missed your talk – can you please email me your slides” - WRONG!!! If your slides can be interrupted without you – then this is not a presentation – it is a document!

Your slides need you to be there otherwise they won’t make any sense.

Seth Godin:
“Communication is about getting others to adopt your point of view, to help them understand why you’re excited. If all you want to do is create a presentation of facts and figures, then cancel the presentation and send participants a report.”

“Create a written document. A leave-behind. The document is the proof that helps the intellectuals in your audience accept the idea that you’ve sold them emotionally.”

“Don’t hand out print-outs of your slides. They don’t work without you there.”

Practice your talk
record the audio
record the video

practice in front of the mirror or in the room you are presenting - this will also give you the opportunity to test the equipment.

Practice in front of friends - ask for specific feedback

Good body language - gestures help fluency and articulation.

Use your voice, tone and pitch to emphasise elements of your story

Use silence or a long pause after an important statement

Be authentic – Show your passion

Tell the audience how you feel, tell them why this is so important to you, why it interests you, why it excites you – your honesty and passion are valued by the audience.



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Case based teaching is effective in that it provides context to problem solve around 'real world' patient scenarios. It requires planning around the patient story.

To be effective use a narrative style to tell the patient story and provide context. Your supporting media (visuals, graphs , quotes ) help illustrate the case.

Practice your talk and use body language and voice to help get your message across.

For more information see ffolliet.com:

- Case based teaching: http://ffolliet.com/2017/01/17/case-based-teaching/#comment-591

- Data slides: http://ffolliet.com/2017/02/19/data-slide-2/