Christine writes:

>I wanted to ask you: when you give your
>tPA lecture, are you reading or have you
>pretty much memorized it or are you just
>talking? I got the feeling that the sentence
>structure seemed too well-thought-out to
>be off-the cuff, and you spoke in a very
>measured cadence, like someone reading.
>But at the same time, you seemed well engaged
>with the audience and didn’t noticeably look at
>your notes.

I learned most of what I know about presenting during a one-hour lecture I attended as a second year medical student six years ago. In the first two years, medical students are subjected to an endless stream of presentations at the hands of people who have no training in how to present, namely, doctors. Some of them are good at it, some are horrible. I didn’t think much of what made a good or bad presentation, though, until Dr. Foster gave us his diabetes talk.

Daniel Foster is a diabetes expert, and was the chairman of internal medicine at the time. He waltzed into the auditorium a few minutes late, while 150 of us waited. He grabbed a piece of chalk and wrote something on the blackboard and spoke. Every few minutes, he wrote a word or two on the blackboard. He never stopped speaking, except to ask questions to the audience. He spoke about diabetes the way someone would speak about a recent road trip. 150 pairs of eyes on him, totally engaged. How did he do it? It’s not like diabetes is an exciting subject.

There are two parts to any presentation, content and delivery, and they are equally important. Developing good content requires an appreciation of what your audience is interested in and a mastery of the topic. I won’t say anything more about content, but that’s only because getting people to develop good content is complicated, while improving delivery is straightforward and more interesting. But content is crucial; the problem with getting a degree in writing is that the most important part of writing is something you can’t teach, namely, having something to say.

It’s easy to see how Dr. Foster held our attention when you contrast his lecture with the usual powerpoint presentation, where the presenter reads her slides. When your parents read you to sleep, sometimes you would follow along in the book, and it was stimulating, but that is because you barely knew how to read, so hearing written words vocalized was minor magic. As an adult, hearing someone read causes a reflex boredom response, and hearing someone read words that you can see causes a reflex boredom response so severe that most people will focus their attention on something else (like the folds in their pants) to stop the pain.

The reason that presenters prepare slides full of text, which they proceed to read to the audience, is that reading your slides is the easiest way to get through a presentation. But reading your slides sucks. Stop it.

Ideally, we would be able to present like Dr. Foster, promptless, emphasizing important points as they come up by writing them on the blackboard, but that requires a degree of familiarity with the topic that is really hard to achieve, and most of us won’t get there for most of our presentations because most of us are not experts on most of what we present. What we *can* do is recognize what it is about that approach that makes it so engaging and try to emulate it.

The problem with powerpoint is that it takes the audience’s attention off the presenter and onto the screen, which, when the screen is filled with words, is less interesting than a human face, especially when the human is reading the words on the screen. The key to presenting well is to make sure that when the audience’s attention is on the screen, what is on the screen is more interesting than your face. Fortunately, there’s a lot of stuff out there that is more interesting than your face, in fact, just about anything is more interesting than your face, except words that you’re reading.

Once the text is off of your slides, the challenge is to remember what to say. I learned to do this by delivering wedding speeches. Most speakers at weddings stare at the sheets they’ve prepared and read their speeches, which invokes the reflex boredom response. Better speakers look up every few words, which is better, but they’re still reading. To avoid the reflex boredom response, you can’t read your speech. You can use prompts, like an outline on note card, but sentences coming out of your mouth have to sound spontaneous, which for those of us who aren’t actors means the sentences have to *be* spontaneous. I write a wedding speech out in its entirety, then I read it a few times, and then I make an outline that fits on a note card. Then I practice the recitation from the note card, referring to the speech as needed, you can actually do this in your head, on an airplane, it’s easy. After a couple of iterations, you don’t need the speech. After a couple more iterations, you don’t need the note card.

I do the same thing for my presentations. I write out exactly what I want to say, slide by slide, and then I read it a bunch of times. When I think I’ll know a lot more about what I’m presenting on than my audience, I can either be prompted by the pictures on the slides, or plug pithy prompts into the slides (this of course is why Dr. Foster can be so flippant and therefore so engaging – he knows more about diabetes than anyone). In other cases, I’ll deliver the presentation from an outline. When I’m presenting to people who know more about the topic than I do, I present straight from my “speech,” trying to look up and sound as natural as possible. This allows me to feel safe in that I won’t forget my lines, while keeping the audience interested. As I become a more experienced presenter, I read less and spontaneously say more.

Special mention should be made of whiz-bang features in powerpoint that drop or twirl words onto the screen, allow for special effect transitions, blink, or make noise. These are gimmicks in the lowest sense: they replace content with fluff. I am sure there is an inverse relationship between the concentration of powerpoint gimmicks in a given presentation and the amount of time spent in its preparation.

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