- Email: [email protected]
Working with slides and transparencies for presentations
ELSEVIER
Tips for Teaching
WORKING WITH TRANSPARENCIES
SLIDES AND FOR PRESENTATIONS
Mark H. Gelula, Ph.D. Department of Medical Education, University of Illinois at Chicago College of Medicine, Chicago, Illinois
CielulaMH. Working with slides and transparencies. Surg Neurol 1996;47:308-12.
This article provides ideasthat support visual aids. Good visuals will enhance and complement any presentation. Yet, as much as good visuals can strengthen a presentation, so too may ineffective visuals undermine it. “Visuals belong to your audience. They exist to synthesize your main points and to give your listeners a road map of where you are going [l].” Careful attention in planning the visual complement to an oral presentation will assure one’s audience is able to absorb a greater part of the intended message. . . and use it. KEY
WORDS
Undergraduatemedical education, graduatemedical education, instruction, visual aids, slide making. Ten percent is all you get -Audrey Thompson [l]
INFORMATIONOVERLOAD How many lectures have you witnessed in your lifetime? One hundred? Five hundred? A thousand? Among physicians, next to journal reading the lecture is the most desired continuing education format. This is not surprising. A sea of new information covering pharmacologic research, new surgical approaches, multicenter trials, new treatment approaches, and thousands of case study examples engulf physicians daily. A resident graduating today finds his/her fund of knowledge in need of significant updating within 2 years of completing the boards. As recently as 1982, John Naisbitt, author of Meg&rends, forecast that scientific and technical information could be expected to increase at rates that would reach 40%/year. Physicians are at the receiving end of an information processing cycle stemming from the publication of from 6000-7000 Address reprint requests to: Mark H. Gelula, Ph.D., Department of Medical Education (M/C 591). University of Illinois at Chicago College of Medicine, 808 S. Wood St., Chicago, IL 60612-7309. Received May 1, 1996. 0090-3019/97/$17.00 PII SOO90-3019(96)00343-6
scientific articles per day [2]! Clearly lectures are selected as a continuing education method of choice for their efficiency.
TENPERCENTISALL YOUGET The presenter is faced with a “half-full glass;” while efficiency may be a strength, a considerable deficit is that lectures have been found to be an ineffective means of learning. Educational psychologists have found that there is a rapid decline in retention following presentations by even the best presenters. Statistics indicate that 80% of what is taught is almost immediately lost by participants. Of the remaining 20%, 80% of that is forgotten within 3-5 days-unless used immediately. What is the impact of such statistics for you as a physician-presenter? Let’s say you have been invited to give a presentation regarding identification of viable candidates for surgical approaches to Parkinsonism. Your audience is a highly qualified group of primary care physicians. After careful thought you have limited yourself to 20 important points-perhaps the most important points you can identify. There are many interesting points, but they are extraneous to this presentation. Sound familiar? You may not know it but you are in a crucible. The likelihood that 99% of this competent audience will remember more than one single point is extremely remote. This is not due to the audience. Nor is it a function of your presentation skills, or the content. It is a manifestation of the learning process of adult human beings, given a lecture format. There is an upside. Let’s say that you have the potential to be extremely successful. You have followed all of the rules for preparing and presenting a lecture [3,4]. Let us presume that you can teach this group of physicians in such a way that they will 655 Avenue
0 1997 by Elsevier Science Inc. of the Americas, New York, NY 10010
Working with Slides
remember IO%-that they will take away two important points. What presentation will make that difference?
A VISUALAPPROACH Good slides and other audiovisual techniques provide variety to a presentation. Variety provokes interest, offers specificity, and allows participants to utilize more than one learning process (e.g., aural, visual). Finally, slides or other audiovisual techniques engender a reason for enhanced motivation by audience members-they can be entertaining. Slides and overhead transparencies are useful presentation tools and are ubiquitous among physician presenters. Of the thousands of lectures and presentations observed during my medical education career, I have seen fewer than 10 lectures where 35mm slides, overhead transparencies, or some other form of audiovisual aid was not used. In review courses and other continuing medical education events, 35mm slides are the most common form of presentation aid. Disturbingly, few slides are well made. Fewer still are used appropriately. How many times have you attended a presentation where several slides were copies of a table from a journal article-making them emphatically unreadable to anyone but the presenter? Warning!! If you choose to stop reading here, you should at least read the following three points: Design every slide you create for the people in the back row. If you can read your slide when you hold it at arm’s length, the back row audience will be able to read it when projected. Don’t use extraneous slides. Present only the ideas that you plan to discuss [5].
MAKINGSLIDESSUPPORT YOURTALK Slides must be visually pleasing. Without an inviting visual display a presentation might as well have no slides. The structure and composition of a slide can be effectively used to direct the audience’s attention to your fundamental points. Only a few years ago slide making was an art. There was little evidence of visual technique among all but a few of the most prominent presenters. I recall seeing slide after slide of white lettering on blue backgrounds at a review course I ran in the 1980s. Suddenly there appeared colorful lettering with one doctor’s presentation slides. Afterward I
Surg Neurol 1997;47:308-12
309
asked him how he had accomplished this. It appeared to be an obviously expensive production. “Oh, easy,” he said. “I take food coloring and delicately paint over the white letters to make the emphasis that I want.” This doctor was an artist in slide making. Luckily today such effort is unnecessary. There are a variety of available computer software programs that allow us to make slides easily, quickly, and with appropriate structure and composition. However, like all computer related procedures, these programs require human judgment to be most effectively used. SLIDE Because that are the slide
ATTRIBUTES slides should highlight important points reinforced with the verbal presentation, must have certain attributes:
1. The format should be simple present no more than seven items on a slide (e.g., lines, bullet points) if an algorithm is used, limit the number of blocks to no more than nine use sans serif (e.g., Helvetica) or serif (e.g., Times) typefaces. Fancy script or “Old English” style lettering are extremely difficult to read create your own tables and charts and place them in horizontal format do not copy tables and charts from journal articles; they will not project well keep the focus narrow using small bits of information -. Color adds visual power
make the slide colorful. All of the slide programs noted in the appendix provide colorful templates with appropriate lettering to background color relationship dark blue or black backgrounds work best with white followed by yellow; yellow/gold, orange, green and sometimes red lettering keep the number of colors to a few use no more than two highlight colors on a single slide. Too many color variations can be distracting and begin to “look more like a piece of abstract art” [6] be consistent during your entire presentation, using the same colors, symbols, and typefaces. Arredondo [6] notes that “consistency reinforces meaning.” employ graphs and photographs liberally. Re-
3 10
Surg Neurol 1997;47:308-12
Line Chart
Bar Chart StudyE - Patients with No Hx
l
90 60 70 60 50 40 30 20 10 0
. StudyW - Patient with intermittant Hx
. StudyN - Patients with previous trauma
All
Fe Mat me 88
0
Chart example 1.
member, words
H
it is true that a picture
3. Focus meaning
tells a thousand
l
l
l
l l l
using progressive
progressive disclosure means sequentially build information by adding a growing list over several slides progressive disclosure increases progressive disclosure increases progressive disclosure increases
5. Select graphs according l
l
l
1996
Chart example 2.
time;
bullet charts are most commonly used to highlight information (Figures 3 and 4). Bullet charts are the basic presentation format used to convey information
l
the point of your slide should be immediately clear l focus on only the key information l highlight important words and phrases with large bold lettering or underline l stay with a single color for all text lettering 0 create titles in large 44 point size l easy reading from any part of the room demands that headings, key words, and picture captions have a font like Helvetica or Times and have a point size of 32 l graph labels display well with saris serif fonts at 18 point size
1996
pare several cases or treatments over trends are more obvious with line charts;
with clear labeling
4. Present information
1994
1993
les
two column bullet charts (Figure 3) are useful when highlighting information which has a two tier complexity
l
circle charts allow examination of the parts of a whole. In Figure 5, the percentage of women in a study during 4 years is described.
l
disclosure
listing new point
points
A Two Column
to a l
audience interest retention
Bullet Format
focus
to data characteristics
bar charts (Figure 1) compare the same data over time bar charts may also compare different cases at a single time line charts (Figure 2) typically are used to com-
0 1 2
3 4
Stockholm
Scale
Mild Moderate Severe Very Severe
l
0 1 2 3 4
q
Chart example 3.
Stage Description No attacks Occasional attacks Affect distal and middle fingers Frequent affect all phalanges As in 3 with trophic skin changes
Working with Slides
Surg Neurol 1997;47:308-12
SINGLE BULLET FORMAT l
Idiopathic
l
l
l
Collagen vascular disease Degnerative arthritis of wrist
l
Diabetes
l
Excessive
l
Pregnancy
l
Oophorectomy
l
01
Mellitus l
Use of Hands
Chart example 4.
CANOVERHEAD (TRANSPARENCIES) BEUSED? How
Transparencies are extremely useful in small group presentations. When used during audience discussion they can provide a sense of immediacy and responsiveness to audience questions and interest. Yet the strength of overheads is also its undoing. In large audience presentations the overhead is rarely as usable as the slide. Presenters using an overhead are subject to the inherent problems of the machinery: l
l
the projector must relatively close to the focal distance its the size of the
be centrally located in a place the screen of the overhead projector limimage to lOO%, therefore, pre-
Circle Chart
Women 13% 13% A 57% 17% 8
EaChart example
5.
ml992 !a1993 01994 0ml995
3 11
venting people in the back of a large room from easily seeing the visual presenters are plagued by the brilliance of the projection light as they change transparencies because the presenter must physically change the transparencies, he is physically “rooted” to a relatively small area (in contrast to slides that typically allow movement around the podium or room by using remote control while it is possible to have the slides fall out of a slide tray or to mix them up in some other accidental fashion, mishaps with transparencies are more common. I commonly use transparencies in tandem with poster paper or a board when doing faculty development workshops. Although I am always organized, I rarely have control over the limitations of the room I will be using. Frequently there is little space on which to set a pile of loose transparencies. More often than I’d like to admit, they have dumped onto the floor spilling the transparencies into disorder. I have found two answers to this problem:
place transparencies into hole-punched sleeves. These can be inserted into 3-ring binders for convenient storage and protection from spills. The sleeves are themselves transparent and may be placed directly on the overhead projector. The downside is that the sleeves still must be removed from the binder-again proving to be less flexible than a slide system.
COMPUTERISIN YOURFUTURE A
A second, and far more compelling answer to the transparency dilemma-and a better option than slides, for overall convenience, is the computer pre sentation. Useful in small and large group presentations, the computer allows creation of a presentation without having to develop film copies. The presentation programs noted as an Appendix are ideal for this purpose. In a small group presentation a laptop or other PC is connected to an instrument called an “LCD panel.” The LCD panel sits on top of an overhead projector which displays the information directly from the computer. This process saves the “mess” of transparencies and the burden of carrying a slide tray, while allowing a full color presentation. Interactive presentations are facilitated by typing comments directly into the computer and onto the screen for audience viewing. Copies of the idea
3 12
Surg Neurol 1997;47:308-12
Gelula
interchange can be saved to disk, printed, and distributed to participants. If you own a laptop, you probably have saved the presentation onto your hard drive. If you do not own a laptop, then copy the presentation from the computer used to develop the program onto a “floppy disk” and carry the disk with you to the presentation, insuring that a computer with the slide program you used will be available to you. This is more and more expected and should not cause you a problem. When presenting to large groups, video projection systems are now commonly available. These systems allow the presenter to offer a visual pre-
sentation through the computer/video projections system. In actual presentation format, the slides you developed will look clearer, brighter and have deeper colors than if you were to use 35mm slides. Presenting to a large group using a computer with slides on disk has these additional advantages: l l
l
saves you from carrying a host of slides allows you to make last minute changes based on the specific needs and interests of your audience provides opportunity for immediate changes to a presentation based on the successes and deficiencies identified during the presentation, or as a result of feedback and evaluation
I
T IS NECESSARY FOR THE PRINCE TO POSSESS FRIENDSHIP OF THE PEOPLE; OTHERWISE HE NO RESOURCE IN TIMES OF ADVERSITY.
THE HAS
NICCOLO MACHIAVELLI “THE PRINCE,” 1514
B
ENEFITS SHOULD AND IN THAT WAY
BE CONFERRED THEY WILL TASTE NICCOL~
GRADUALLY, BETTER.
MACHIAVELLI “THE PRINCE,”
(1469-l 527) CH. 8 (1514)
Tips for Teaching
WORKING WITH TRANSPARENCIES
SLIDES AND FOR PRESENTATIONS
Mark H. Gelula, Ph.D. Department of Medical Education, University of Illinois at Chicago College of Medicine, Chicago, Illinois
CielulaMH. Working with slides and transparencies. Surg Neurol 1996;47:308-12.
This article provides ideasthat support visual aids. Good visuals will enhance and complement any presentation. Yet, as much as good visuals can strengthen a presentation, so too may ineffective visuals undermine it. “Visuals belong to your audience. They exist to synthesize your main points and to give your listeners a road map of where you are going [l].” Careful attention in planning the visual complement to an oral presentation will assure one’s audience is able to absorb a greater part of the intended message. . . and use it. KEY
WORDS
Undergraduatemedical education, graduatemedical education, instruction, visual aids, slide making. Ten percent is all you get -Audrey Thompson [l]
INFORMATIONOVERLOAD How many lectures have you witnessed in your lifetime? One hundred? Five hundred? A thousand? Among physicians, next to journal reading the lecture is the most desired continuing education format. This is not surprising. A sea of new information covering pharmacologic research, new surgical approaches, multicenter trials, new treatment approaches, and thousands of case study examples engulf physicians daily. A resident graduating today finds his/her fund of knowledge in need of significant updating within 2 years of completing the boards. As recently as 1982, John Naisbitt, author of Meg&rends, forecast that scientific and technical information could be expected to increase at rates that would reach 40%/year. Physicians are at the receiving end of an information processing cycle stemming from the publication of from 6000-7000 Address reprint requests to: Mark H. Gelula, Ph.D., Department of Medical Education (M/C 591). University of Illinois at Chicago College of Medicine, 808 S. Wood St., Chicago, IL 60612-7309. Received May 1, 1996. 0090-3019/97/$17.00 PII SOO90-3019(96)00343-6
scientific articles per day [2]! Clearly lectures are selected as a continuing education method of choice for their efficiency.
TENPERCENTISALL YOUGET The presenter is faced with a “half-full glass;” while efficiency may be a strength, a considerable deficit is that lectures have been found to be an ineffective means of learning. Educational psychologists have found that there is a rapid decline in retention following presentations by even the best presenters. Statistics indicate that 80% of what is taught is almost immediately lost by participants. Of the remaining 20%, 80% of that is forgotten within 3-5 days-unless used immediately. What is the impact of such statistics for you as a physician-presenter? Let’s say you have been invited to give a presentation regarding identification of viable candidates for surgical approaches to Parkinsonism. Your audience is a highly qualified group of primary care physicians. After careful thought you have limited yourself to 20 important points-perhaps the most important points you can identify. There are many interesting points, but they are extraneous to this presentation. Sound familiar? You may not know it but you are in a crucible. The likelihood that 99% of this competent audience will remember more than one single point is extremely remote. This is not due to the audience. Nor is it a function of your presentation skills, or the content. It is a manifestation of the learning process of adult human beings, given a lecture format. There is an upside. Let’s say that you have the potential to be extremely successful. You have followed all of the rules for preparing and presenting a lecture [3,4]. Let us presume that you can teach this group of physicians in such a way that they will 655 Avenue
0 1997 by Elsevier Science Inc. of the Americas, New York, NY 10010
Working with Slides
remember IO%-that they will take away two important points. What presentation will make that difference?
A VISUALAPPROACH Good slides and other audiovisual techniques provide variety to a presentation. Variety provokes interest, offers specificity, and allows participants to utilize more than one learning process (e.g., aural, visual). Finally, slides or other audiovisual techniques engender a reason for enhanced motivation by audience members-they can be entertaining. Slides and overhead transparencies are useful presentation tools and are ubiquitous among physician presenters. Of the thousands of lectures and presentations observed during my medical education career, I have seen fewer than 10 lectures where 35mm slides, overhead transparencies, or some other form of audiovisual aid was not used. In review courses and other continuing medical education events, 35mm slides are the most common form of presentation aid. Disturbingly, few slides are well made. Fewer still are used appropriately. How many times have you attended a presentation where several slides were copies of a table from a journal article-making them emphatically unreadable to anyone but the presenter? Warning!! If you choose to stop reading here, you should at least read the following three points: Design every slide you create for the people in the back row. If you can read your slide when you hold it at arm’s length, the back row audience will be able to read it when projected. Don’t use extraneous slides. Present only the ideas that you plan to discuss [5].
MAKINGSLIDESSUPPORT YOURTALK Slides must be visually pleasing. Without an inviting visual display a presentation might as well have no slides. The structure and composition of a slide can be effectively used to direct the audience’s attention to your fundamental points. Only a few years ago slide making was an art. There was little evidence of visual technique among all but a few of the most prominent presenters. I recall seeing slide after slide of white lettering on blue backgrounds at a review course I ran in the 1980s. Suddenly there appeared colorful lettering with one doctor’s presentation slides. Afterward I
Surg Neurol 1997;47:308-12
309
asked him how he had accomplished this. It appeared to be an obviously expensive production. “Oh, easy,” he said. “I take food coloring and delicately paint over the white letters to make the emphasis that I want.” This doctor was an artist in slide making. Luckily today such effort is unnecessary. There are a variety of available computer software programs that allow us to make slides easily, quickly, and with appropriate structure and composition. However, like all computer related procedures, these programs require human judgment to be most effectively used. SLIDE Because that are the slide
ATTRIBUTES slides should highlight important points reinforced with the verbal presentation, must have certain attributes:
1. The format should be simple present no more than seven items on a slide (e.g., lines, bullet points) if an algorithm is used, limit the number of blocks to no more than nine use sans serif (e.g., Helvetica) or serif (e.g., Times) typefaces. Fancy script or “Old English” style lettering are extremely difficult to read create your own tables and charts and place them in horizontal format do not copy tables and charts from journal articles; they will not project well keep the focus narrow using small bits of information -. Color adds visual power
make the slide colorful. All of the slide programs noted in the appendix provide colorful templates with appropriate lettering to background color relationship dark blue or black backgrounds work best with white followed by yellow; yellow/gold, orange, green and sometimes red lettering keep the number of colors to a few use no more than two highlight colors on a single slide. Too many color variations can be distracting and begin to “look more like a piece of abstract art” [6] be consistent during your entire presentation, using the same colors, symbols, and typefaces. Arredondo [6] notes that “consistency reinforces meaning.” employ graphs and photographs liberally. Re-
3 10
Surg Neurol 1997;47:308-12
Line Chart
Bar Chart StudyE - Patients with No Hx
l
90 60 70 60 50 40 30 20 10 0
. StudyW - Patient with intermittant Hx
. StudyN - Patients with previous trauma
All
Fe Mat me 88
0
Chart example 1.
member, words
H
it is true that a picture
3. Focus meaning
tells a thousand
l
l
l
l l l
using progressive
progressive disclosure means sequentially build information by adding a growing list over several slides progressive disclosure increases progressive disclosure increases progressive disclosure increases
5. Select graphs according l
l
l
1996
Chart example 2.
time;
bullet charts are most commonly used to highlight information (Figures 3 and 4). Bullet charts are the basic presentation format used to convey information
l
the point of your slide should be immediately clear l focus on only the key information l highlight important words and phrases with large bold lettering or underline l stay with a single color for all text lettering 0 create titles in large 44 point size l easy reading from any part of the room demands that headings, key words, and picture captions have a font like Helvetica or Times and have a point size of 32 l graph labels display well with saris serif fonts at 18 point size
1996
pare several cases or treatments over trends are more obvious with line charts;
with clear labeling
4. Present information
1994
1993
les
two column bullet charts (Figure 3) are useful when highlighting information which has a two tier complexity
l
circle charts allow examination of the parts of a whole. In Figure 5, the percentage of women in a study during 4 years is described.
l
disclosure
listing new point
points
A Two Column
to a l
audience interest retention
Bullet Format
focus
to data characteristics
bar charts (Figure 1) compare the same data over time bar charts may also compare different cases at a single time line charts (Figure 2) typically are used to com-
0 1 2
3 4
Stockholm
Scale
Mild Moderate Severe Very Severe
l
0 1 2 3 4
q
Chart example 3.
Stage Description No attacks Occasional attacks Affect distal and middle fingers Frequent affect all phalanges As in 3 with trophic skin changes
Working with Slides
Surg Neurol 1997;47:308-12
SINGLE BULLET FORMAT l
Idiopathic
l
l
l
Collagen vascular disease Degnerative arthritis of wrist
l
Diabetes
l
Excessive
l
Pregnancy
l
Oophorectomy
l
01
Mellitus l
Use of Hands
Chart example 4.
CANOVERHEAD (TRANSPARENCIES) BEUSED? How
Transparencies are extremely useful in small group presentations. When used during audience discussion they can provide a sense of immediacy and responsiveness to audience questions and interest. Yet the strength of overheads is also its undoing. In large audience presentations the overhead is rarely as usable as the slide. Presenters using an overhead are subject to the inherent problems of the machinery: l
l
the projector must relatively close to the focal distance its the size of the
be centrally located in a place the screen of the overhead projector limimage to lOO%, therefore, pre-
Circle Chart
Women 13% 13% A 57% 17% 8
EaChart example
5.
ml992 !a1993 01994 0ml995
3 11
venting people in the back of a large room from easily seeing the visual presenters are plagued by the brilliance of the projection light as they change transparencies because the presenter must physically change the transparencies, he is physically “rooted” to a relatively small area (in contrast to slides that typically allow movement around the podium or room by using remote control while it is possible to have the slides fall out of a slide tray or to mix them up in some other accidental fashion, mishaps with transparencies are more common. I commonly use transparencies in tandem with poster paper or a board when doing faculty development workshops. Although I am always organized, I rarely have control over the limitations of the room I will be using. Frequently there is little space on which to set a pile of loose transparencies. More often than I’d like to admit, they have dumped onto the floor spilling the transparencies into disorder. I have found two answers to this problem:
place transparencies into hole-punched sleeves. These can be inserted into 3-ring binders for convenient storage and protection from spills. The sleeves are themselves transparent and may be placed directly on the overhead projector. The downside is that the sleeves still must be removed from the binder-again proving to be less flexible than a slide system.
COMPUTERISIN YOURFUTURE A
A second, and far more compelling answer to the transparency dilemma-and a better option than slides, for overall convenience, is the computer pre sentation. Useful in small and large group presentations, the computer allows creation of a presentation without having to develop film copies. The presentation programs noted as an Appendix are ideal for this purpose. In a small group presentation a laptop or other PC is connected to an instrument called an “LCD panel.” The LCD panel sits on top of an overhead projector which displays the information directly from the computer. This process saves the “mess” of transparencies and the burden of carrying a slide tray, while allowing a full color presentation. Interactive presentations are facilitated by typing comments directly into the computer and onto the screen for audience viewing. Copies of the idea
3 12
Surg Neurol 1997;47:308-12
Gelula
interchange can be saved to disk, printed, and distributed to participants. If you own a laptop, you probably have saved the presentation onto your hard drive. If you do not own a laptop, then copy the presentation from the computer used to develop the program onto a “floppy disk” and carry the disk with you to the presentation, insuring that a computer with the slide program you used will be available to you. This is more and more expected and should not cause you a problem. When presenting to large groups, video projection systems are now commonly available. These systems allow the presenter to offer a visual pre-
sentation through the computer/video projections system. In actual presentation format, the slides you developed will look clearer, brighter and have deeper colors than if you were to use 35mm slides. Presenting to a large group using a computer with slides on disk has these additional advantages: l l
l
saves you from carrying a host of slides allows you to make last minute changes based on the specific needs and interests of your audience provides opportunity for immediate changes to a presentation based on the successes and deficiencies identified during the presentation, or as a result of feedback and evaluation
I
T IS NECESSARY FOR THE PRINCE TO POSSESS FRIENDSHIP OF THE PEOPLE; OTHERWISE HE NO RESOURCE IN TIMES OF ADVERSITY.
THE HAS
NICCOLO MACHIAVELLI “THE PRINCE,” 1514
B
ENEFITS SHOULD AND IN THAT WAY
BE CONFERRED THEY WILL TASTE NICCOL~
GRADUALLY, BETTER.
MACHIAVELLI “THE PRINCE,”
(1469-l 527) CH. 8 (1514)