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A time to talk

Continuing our series on finding inspiration in and out of practice, Ian Davies takes the stage with his guide to presenting as an eye care practitioner

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In 1961 Richard Asher wrote a paper for Central Middlesex Hospital Nurses magazine entitled 'Aren't I lucky I can write'. In the article he dispelled the mystery around medical communication and described how to set about getting an article published in the peer-reviewed press. The article was, like so much that Asher wrote, simple, clear and inspiring and so it is, with apologies to a far more eloquent scribe, this article is sub-titled: Aren't I lucky, I can present.

As eye care professionals we take part in communications every day, with our patients, our staff, our suppliers and our business partners. Communication is critical and indeed a required competency for General Optical Council registration. Yet despite this frequent communication few of us would describe ourselves as communicators and fewer still would regularly stand up in front of an audience and present a structured talk.

Many tend to think of presentations as continuing education talks or lectures at scientific congresses and it is thus easy to dismiss the need to communicate en masse as the domain of the academic or educator, and the associated need to sit through such presentations as the price to pay for obtaining CET points.

But presenting has far wider opportunities and my hope is that more Optician readers will look at opportunities to develop their presentation skills and seek out opportunities to carry out structured presentations to groups of six or more participants.

WHY bother?

Presenting provides a means of sharing information, thoughts and ideas with a wider audience. There are many reasons for doing it; it may be to align a team behind a common objective, to provide input into proposed plans, to promote new ideas or services, to share new information, to obtain support for a new project or simply for the fun and buzz to be associated with a form of performance. Within the sphere of eye care there may be several specific reasons why the practitioner may wish to present, such as to:

? Present practice plans to staff

? Inform staff of practice results and provide recognition

? Train staff and colleagues on new procedures

? Educate the local community on the need for eye care at schools or local associations

? Promote your practice and the services that you provide

? Present case studies at peer-to-peer discussion groups

? Share clinical observations at congresses

? Carry out continuing education presentations at local optical associations

? Build your own self confidence and self esteem

? Learn more about new topics or concepts - every presentation does not need presenting and one of the best ways of learning is to teach

? Have fun in looking at ways of organising information into a compelling story.

WHAT should I present?

When faced with the opportunity to present, the starting point has to be the needs of the intended audience. The second point is the need for the presenter to impart their knowledge. The third consideration then is the desire of both parties to engage in the knowledge transfer. The relative weighting of each of these elements will dictate the content of the presentation and, as we'll discuss later, the style of presenting. Let's look at some examples:

? Legislation update

A new health and safety law, data privacy regulation or change in VAT has come out. You need to make sure that your staff is familiar with the new requirements. They need to know what to do and be able to answer any questions and while neither party has a strong desire to engage in the knowledge transfer, the consequences of not doing so are serious enough to warrant full attention and understanding. The WHAT therefore has to be factual and complete but also pragmatic and put into the context and environment of the audience so that there is no room for misunderstanding.

? Practice promotion

Your local Probus club has invited you to give a presentation on eye care at one of their meetings. You need to promote your practice and ensure that they take away the need for regular eye care for them and their family. You also want them to recognise your skills and the ability of your practice to be able to offer high quality care at a premium cost. Their needs are to be informed and entertained at the same time. Their principal reason for being at your talk is as a vehicle for meeting friends in a convivial setting. They want to learn new things but don't need to listen to you!

Now the WHAT has to align to different needs - you will have to be factual, you will have to make sure that the information you are presenting is relevant to them and their age group. You may want to pull specific examples of conditions that you know will affect this group and provide specific examples of how your technology, service and staff have solved these in the past.

In developing the WHAT you should always find out about previous speakers at events, understand what has gone well in the past and any pet hates of the audience. In a social setting such as this the WHAT needs to be serious enough that it is viewed as credible and informative, but not so serious that it becomes like a classroom exercise.

? Challenging assumptions

You have made some clinical observations that you feel challenge current thinking around an existing topic and potentially can improve patient outcomes. You need to share the information with colleagues to start to validate the information in an environment that will facilitate discussion and debate. Your colleagues, attending whatever forum you are proposing the information, need to be able to engage in discussion and their overarching need is to learn what is new.

As with the first example, the information must be factual and to the point. Ideally your observations should be supported by statistical analysis, presented in an objective and clear manner. As with the Probus club presentation it is worth understanding the styles of communication the group you are presenting to are used to and any particular pet dislikes or strong preferences they might have.

In each case you should put yourself into your audience's shoes and try to hear what you have to say through their perceptions and beliefs. You need to understand the level of formality that the audience will expect to hear from you and the depth of technical information that they will find acceptable. Being over-simplistic can be viewed as being patronising just as being overly technical could be seen as arrogance.

WHEN to present

As with comedy, the trick to good presentation is timing. The first consideration in timing is to make sure that you have something worth presenting as we have just discussed. The next is to understand the planning horizon of the organisation you wish to present to as well as the needs of your audience. Here are some examples:

? Scientific meetings

The dates of most professional and scientific congresses are set at least 12 months in advance and some planned over a five-year time horizon. Presentations at such meetings are generally chosen by a scientific committee based on submitted abstracts. The deadline for submission of abstracts is around 4-6 months before the event.

Most congresses define what they are looking for from an abstract and it is critical that these requirements are met in terms of number of words and required content. Most congresses publish abstracts and look for sufficient detail within them to enable the reader to know what the outcomes of the communication are. If reporting on a clinical study, it is important to state the results that you find - expressions such as 'The results will be presented' are rarely accepted. It is no longer acceptable to write an abstract on work yet to be completed in the hope that it will be accepted. Planning and writing the abstract is at least as important as the presentation itself and requires dedicated time to be put aside.

Local clubs

Opportunities to present at local clubs, societies and organisations also need careful planning. Most organisations work on an annual planning cycle and look to publish these at the start of their 'year', often in autumn. There are a number of considerations that you should think about in terms of timing:

? The topicality of your message - if, for example you wish to present on hay fever and the eye, choose to present just before they hay fever season starts

? Likely attendance - if you are keen to try and present to the largest number of people try and find out how attendance varies throughout the year - recognise that presenting in the middle of winter may reduce attendance for some groups, as might children's holiday seasons for those with children at school.

? Staff briefings

Arranging a suitable time to present to your support staff requires significant planning. It is always tempting to avoid practice hours, but this is potentially unfair on those who may have other commitments. If you are presenting business critical information, then it is important that you have a receptive audience and it is probably best to arrange any meeting during normal work hours and close the practice during this time, choosing a time that you know will be less busy.

WHICH medium to use?

The medium should suit the message, the occasion and the needs of both audience and presenter. People learn using four core methods: visual, auditory, reading and kinesthetic. Everyone uses a different balance of the four as they learn, and presenters should consider the relative balance of each when preparing their presentations. There are many different formats of presenting and each has its advantages and disadvantages.

? Presentation software

Presentation software has all but replaced the traditional use of 35mm slides as the preferred means of communicating to audiences. Of all the software available, PowerPoint is the most recognised. However, others, such as Keynote for Apple and Prezi (www.prezi.com), provide a broader functionality.

Advantages: Used with a data projector, images can be screened to audience from a handful to thousands. It is relatively easy to produce presentations and multiple media can be used. Presentations can be produced quickly and printed out in a variety of formats.

Disadvantages: There is a relative lack of flexibility in presenting, with sequence generally pre-determined. There is a tendency to place too much text on a chart and overcomplicate builds. This method is also hardware dependent (on both computer and projection system).

Top tips: Only use the top two-thirds of each slide area and keep colour palettes simple. In presentation mode, pressing the B key on a keyboard will black out the image so that the audience can focus on you or any other visual aid. Pressing a number key will move the image forward to that numbered slide. Never read what is on your slide unless your audience struggles with language. Most software allows you to use the mouse to write or annotate on the image, which makes it more interactive. Always carry a spare bulb for a projector, if you own one, or have a backup plan in case the hardware or software fails.

? Flip charts

Flip charts, electronic white screens or tablet software is the medium of choice for getting the highest engagement and most fluidity in a presentation and is ideal when the presenter needs to collect and collate input from the audience.

Advantages: These methods allow you to capture and show feedback quickly; by arranging flip chart sheets around the room the audience can visualise and input on the content.

Disadvantages: These methods depend on the legibility of your handwriting. They require pre-planning for the presenter to map out the flow of any session. The material collected needs to be collated post event and a mechanism used to capture all the information.

Top tips: Have flip charts pre-prepared with the titles that you will use ahead of the session and use masking tape/Post-it notes on the charts so that you can easily find them. Photograph charts with a digital camera to save information. Make sure that pens do not 'write through' paper and mark either the sheet below or the wall. Always check pens are full of ink before the session.

? Posters

Poster sessions at conferences provide a great forum for discussion and presentation of data without the relative stress of presenting in front of an audience.

Advantages: Posters allow you to discuss information with people who are selectively interested in the data without time pressure.

Disadvantages: In some instances it can be tough to get visibility in a crowded poster session and you may not always be able to communicate to as many people as you might like.

Top tips: Having a compelling abstract is critical if you want to engage with a wide audience. Always get your poster professionally printed with a long enough lead time to be able to make changes if needed. Having a visually exciting poster will help get it noticed.

HOW to prepare and present

The starting point of every presentation has to be to articulate what you want the take-home message to be and then to create the framework around which you wish to tell the story. In every case this is best done with paper and pen, either as a list of points that you want to make or using a spider diagram. Once you have defined the messages you want to communicate, you should start to lay out the story. In any presentation it is important to create a framework into which your presentation will fit.

For this article, inspired by Richard Asher, I have followed the lines from Kipling's poem: 'I keep six honest serving-men (They taught me all I knew); their names are What and Why and When And How and Where and Who.' The purpose of a tool like this is to guide your audience through the story that you want to tell and provide them with clues as to where you are in the story at any given time.

Notwithstanding the mechanism that you use to tell the story, the presentation should always have three core elements:

? An introduction - to yourself to establish credibility and set up what you are going to say and why it is important

? The core of the message

? A summary/conclusion to reinforce any changes in behaviour that are requested/needed.

Another way of summarising this is to: 'Tell them what you are going to tell them. Tell them. Then tell them what you've told them and sit down!'

The duration of a verbal presentation needs to bear in mind the complexity of the message that you need to communicate balanced against the attention time span of the audience. Average attention span during a lecture is unlikely to be more than 10 minutes; so to keep attention you need to do something every 10 minutes to break up the talk.

This could be the use of suitable humour (never anything that might cause offence), ideally incorporated to reinforce a point made. Unless you are a natural comedian, be very careful about the use of humour and cultural anecdotes, both of which need to match the audience's sensibilities and understanding. They should be used as an aid to the points being made rather than a means in themselves.

Another technique is to stop and ask for audience participation or feedback or to ask the audience to break up into groups of three and formulate questions around a point that you are making. Getting people to stand up or move around, as long as it can be controlled in the environment is also a good technique to use.

The final 'how' is around personal preparation for a presentation. The first few times that you present can be daunting but there are techniques that can help you overcome nerves:

? Practise - in front of a friend, colleague or relative. Practise how long the presentation takes (always plan for 5 per cent less time than is allocated) and get as much feedback as you can

? Dress appropriately - Wear what you are most comfortable in and which give you the most confidence, but make sure that your clothes match the expectations of the audience. If in doubt dress more formally than the audience might expect rather than less

? Don't be afraid of having notes - these can be on postcards, paper, a tablet PC or a couple of well positioned Post-it notes. Just practise with the notes and know where you will have/hold them during the presentation

? Always learn the opening two or three sentences of your presentation and the last two or three sentences - having a strong opening is a confidence booster, as is knowing exactly how you are going to finish. Practise the opening and closing, ideally in front of a mirror, until you have them just as you'd like them

? Take the opportunity to go to as many presentation skills classes as possible - learn from as many different presenters as you can and look for opportunities to see the best presenters present. Keep a notebook of good presentation ideas.

In summary, becoming a proficient presenter takes time and practice but also has great potential rewards. Good presenters are able to motivate their staff, build confidence with their customers and respect among their peers, all of which adds up to greater personal and job satisfaction. Opportunities to present exist at multiple levels within eye care and can exist across multiple media. With preparation, practice and an understanding of the audience's needs, presenting is fun and fulfilling. And so to finish:

WHO should present?

If not you then who? If not now then when? (Frank Dick OBE, inspirational speaker). ?

Resources

Asher R. Talking Sense. Churchill Livingstone, 1972.

? Ian P Davies is vice president of The Vision Care Institute, Johnson & Johnson Medical