Over the last three years there has been a rapid increase in the amount of medical education resources on the web. The contributors tend to fall into three main areas:
Individuals or small groups producing material
Large organisations / universities producing material
Organisations creating sites (such as Meducation) which are one-stop-shops for content and act as a portal for other sites.
Most students are required to produce and present a certain amount of educational material during their studies. Many, therefore, end up with PowerPoints and documents on various topics. The more ambitious may create videos: either animations in flash, or more real-life videos that demonstrate something such as an examination technical. Some of these students enjoy this so much that they have developed sites dedicated to such material. Sites such as Podmedics and Surgery and Medicine are examples of students who have grouped together to upload their work to a central place where it can be shared in the community. They advertise on Facebook and Twitter and gain a small following.
Large Organisations And Universities
Some organisations have realised that there is a market for the production of multimedia resources and have invested time and money into producing them. Companies such as MD Kiosh and ORLive run subscription services for high quality videos and have developed full time businesses around this work.
Universities have also realised the potential for creating high quality media and some, such as the University of California and the University of Wisconsin, have invested into television-like streams, trying to tap in to the students natural viewing habits. As time goes on it seems likely that most medical education will move away from textbooks and towards the multimedia resources. There will always be a need for the written word but it is likely that it will become more incorporated into other forms of media, such as presentations and annotated videos.
The final, and possibly most influential type of contributor is the social network / portal site. Here, all the information from around the web is culminated in one place, where users can go to find what they are looking for These sites act as portals for all the other types of site and help spread their reach well beyond their local community. Here at Meducation, we have contributors from over 100 countries and pride ourselves on making easy-to-find resources for everyone. As time goes on and more users start to discover portal sites, more traffic will flood to the sites they support and the whole infrastructure can grow incrementally.
Computerised presentations are a part of every medical student's / junior doctor's life. Sometimes we give them, often we sleep through them and occasionally we even listen to them. They are the backbone of medical education besides traditional bed-side teaching, having rapidly replaced the now extinct OHR (Over Head Projector) acetate-sheet presentations of years gone-by.
The problem is that Doctors and medical students often struggle with creating and presenting coherent slides. This is most probably due to the general apathy most have for actually talking in front of an audience, or because those asked to present are often taken unawares, and therefore have little time to prepare. In these times of avolition or last-minute hurriedness, people often reach out for the industry standard of presentation production: PowerPoint.
PowerPoint is the most commonly used tool for making presentations because it is simple to use and comes with a whole load of free templates. Unfortunately, most of these templates look disgusting. If a template doesn't look disgusting, then it is most certainly overused and you run the risk of having a presentation that looks identical to the student before you at the weekly seminar teaching - a scenario that can be easily likened to turning up to a lecture wearing exactly the same clothes as another person in the room, which would just be awkward. Another problem with PowerPoint is the phenomenon of 'Death By Powerpoint,' which refers to the general boredom and apathy experienced by those who have received way too much information in way too short a space of time via a series of over-cramped, poorly stylised slides.
But why on earth do you care?
People should care about 'Death By Powerpoint' because if your presentations cause people to zone out, then you are not getting your message across. And if you aren't getting your message across then you. are. not. presenting. at. all. (take a moment to reflect on that particularly Zen statement).
Let me explain using a metaphor, if I am a sales person and I present my talk with well-designed slides, in an enthusiastic and well-rehersed manner to an appropriate audience I will make more sales than if I present using poorly designed slides at the last minute. Similarly, in Medicine if I present well designed, aesthetic slides I am more likely to convey accurate information to my colleagues that may very well be retained and enjoyed by all involved.
Of course, this blog assumes a degree of presentation-related Altruism. The recommendations I am about to make require you to 'step out of the mould' and say 'no' to poor presentations. They require you to forgive others for the presentations they have inflicted on you in the past. You will 'lead by example'.
Unfortunately I am not capable (or qualified) to make you an excellent designer, nor can I give you the motivation to feel as passionately about design aesthetics as i do when all you've got to do is slam some slides together for your monthly journal club. But what I can do is present to you a series of resources that might tempt you away from the horrific PowerPoint templates that currently infest medical student seminars and young doctors presentations.
If you really couldn't care less, then I suggest using Prezi, a website where you can make quite eccentric looking presentations rapidly and for free. The only problem is that Prezi became cliched even before its debut and you risk inflicting travel sickness on your poor audience, what with all the funky zooming in and out of slides that occurs during a typical Prezi presentation (you will know what I mean if you've ever seen one).
So, without further ado, here are my top 5 tips for making your presentations look smoother and more polished... Irrespective of whether the contents of your talk are any good.
Step One: Typography
Get yourself a good font. Typography is really important, when you speak to someone you use a variety of tones and gestures to convey the meaning of the words you are using. Fonts are effectively the printed version of your tone and gestures. Good font choice can help give 'umph' to a particular point in your presentation and help give character to what you are saying. Of course, it's important to remain professional so 'Wingbats' might not be your first choice, but anything that you could envisage on a nice business card is probably a good shout. Fonts are usually something you have to pay for if you want anything beyond the set given to you when you download Microsoft Word (for example). However, there are whole hosts of free fonts available from sites like [dafont])(http://www.dafont.com). The key is to be willing to trawl through these sites to find fonts that are actually useful! Beware those fancy fonts unless you know your audience can take it!
If you are stuck on choosing a font, which is a common complaint, then maybe this flow diagram will help!
Oh yeah, and never ever use Comic Sans. Ever.
Step Two: Colour
A good font isn't going to get you very far on its own. You need a solid colour scheme to bring your presentation alive. It seems blunt to say, but some people are not very good at picking colours that go well with one another. This is well evidenced in PowerPoint presentations where the yellow-text-on-blue-background is far too common. I mean yeah, in theory blue and yellow 'compliment' each other, but thats where the relationship between blue and yellow should stay... in theory. Luckily there are some useful colour palette websites available out there, which will match colours for you...
Step Three: Structure
After you've picked a sensible font and a suitable colour scheme, it's time to think about the structure or layout of your slides. It's absolutely crucial that you avoid putting too much information on your slides even if you are giving an academic presentation. An overloaded slide is about as useful as a dead cat. At this point, some of you may be tempted to resort to those dodgy PowerPoint default templates but there is another way! There are sites out there that have some pretty fresh templates you can use and they are completely free! They are sure to add a bit of spice to your slide's aesthetic.
There will probably be a separate tutorial on this in the future, but basic principles apply. As a general rule stick to Left Alignment *and avoid *Central Alignment like the plague.
Step Four: Imagery
Images help to spice up a presentation, but try and keep them related to the topic. Google Images is a great resource but remember that most images will be a low resolution and will be poorly suited to being shown blown up full-size on a presentation screen. Low resolution images are a presentation killer and should be avoided at all costs.
For high-quality images try sites like Flikr or ShutterStock.
Step Five: Consider Software
The interface of Powerpoint does not lend itself well to having images dropped in and played with to make nice looking layouts. I would recommend Adobe Photoshop for this kind of work, but not everyone will have access to such expensive software. Cheap alternatives include Photoshop Elements amongst others.
Once you have created slides in Photoshop it is quick and easy to save them as JPEG files and drag and drop them into PowePoint. Perhaps that can be a tutorial for another time...
Step 5: Additional Stuff
Presentations typically lack significance, structure, simplicity and rehearsal. Always check over your presentation and ask 'is this significant to my audience?' Always structure your presentation in a logical manner and (it is recommended you) include a contents slide and summary slide to tie things together. Keep your verbal commentary simple and keep the slides themselves even more simple than that. Simplicity is crucial. Once you have produced your beautiful slides with wonderful content you will want to practice them. Practice, Practice, Practice. Rehearsing even just once can make a good presentation even better.
This blog entry has covered some basic points on how to improve your medical presentations and has given a series of useful online resources. Putting effort into designing a presentation takes time and motivation, for those without these vital ingredients we recommend Prezi (whilst it is still relatively new and fresh). Perhaps the rest of you will only use these tips for the occasional important presentation. However, I hope that soon after you start approaching presentations with a little more respect for their importance and potential, you too will find a desire to produce high-quality, aesthetically pleasing talks.
LARF - Mood: damn tired and feeling guilty that I just wrote this blog instead of revising haematology notes.
Follow me on Twitter.
Follow the Occipital Designs original blog.
Check out my Arterial Schematic.
Thanks to those who read my last post. I was encouraged to hear from my colleagues at Med school that the post sounded very positive and hopefully. A few of them queried whether I had actually written it because there was a noticeable lack of sarcasm or criticism.
So... the following posts may be a bit different. A little warning - some of what I post may be me playing "Devil's advocate" because I believe that everything should be questioned and sparking debate is a good way of making us all evaluate what we truly think on a subject.
With no further a do, let's get on to the subject of today's post ....
An Introduction to Clinical Medicine
The previous year was my first as a clinical med student. Before we started I naively thought that we would be placed in helpful, encouraging environments that would support us in our learning, so that we were able to maximize our clinical experience. My hope was that there would be lots of enthusiastic doctors willing to teach, a well organised teaching schedule and admin staff that would be able to help us with any difficulties. I hoped these would all be in place so that WE medical students could be turned from a bunch of confused, under-grad science students into the best junior doctors we could possibly be.
It seems that medical school and the NHS have a very different opinion of what clinical medical teaching should be like. What they seem to want us to do is 1) listen to the same old health and safety lecture at least twice a term, 2) re-learn how to wash our hands every 4 weeks, 3) Practicing signing our name on a register - even when this is completely pointless because there are no staff at the hospital anyway because the roads are shut with 10 inches of snow most of the time, 4) Master the art of filling in forms that no one will ever look at or use in anyway that is productive, 5) STAY OUT OF THE WAY OF THE BUSY STAFF because we are useless nuisances who spread MRSA and C.Dif where ever we go! How we all learn medicine and pass our exams is any ones guess!
Undergraduate Co-Ordinators - Why won't you make life easier for us?
While at my last placement I was elected as the 3rd year student representative for that hospital. While I was fulfilling that role it got me wondering what it is that Under-grad Co-Ordinators actually do? I thought this may be an interesting topic of debate.
1) Who are they and how qualified are they?
2) what is their job description and what are they supposed to be doing?
3) Are they a universal phenomena? or have they just evolved within the West Midlands?
4) Does anyone know an under-grad Co-Ordinator (UC - not ulcerative colitis) who has actually been more benefit than nuisance?
1) UC's as a species are generally female, middle aged, motherly types who like to colonize obscure offices in far flung corners of NHS training hospitals. They can normally be found in packs or as they are locally known "A Confusion of co-ordinators". How are they qualified? I have absolutely no idea, but I am guessing not degrees in Human Resource Development.
2)I am fairly certain what their job should involve: 1) be a friendly supportive face for the poor medical students; 2) organise a series of lectures; 3) organise the medical students into teaching firms with enthusiastic consultants who are happy to give them regular teaching; 4) ensure the students are taught clinical skills so that they can progress to being competent juniors; 5) be a point of contact for when any students are experiencing difficulties in their hospital and hopefully help them to rectify those problems to aid their learning.
What do they actually do? It seems to be a mystery. I quite regularly receive emails that say that I wasn't in hospital on a certain day, when I was in fact at another hospital that they specifically sent me to on that day. I often receive emails saying that my lectures are cancelled just as I have driven for over an hour through rush hour traffic to attend. I sometimes receive emails saying that I, specifically, am the cause of the whole hospitals MRSA infection because I once wore a tie.
I never receive emails saying that such and such a doctor is happy to teach me. I never receive emails with lecture slides attached to them so that I can revise said lectures in time for an exam. I NEVER receive any emails with anything useful in them that has been sent by a UC!
Questions 3 and 4, I have no idea what the answers are but would be genuinely pleased to hear people's responses.
The reason I have written this blog is that, these people have frustrated my colleagues and I all year. I am sure they are integral to our learning in some way and I am sure that they could be very useful to us, but at the moment I just cannot say that they are as useful as they should be.
To any NHS manager/ medical educator out their I make this plea
I am more than happy to give up 2 weeks of my life to shadow some UC to see what it is they do. In essence I want to audit what it is they do on a day to day basis and work out if they are a cost-effective use of the NHS budget? I want to investigate what it is they spend their time on and how many students they help during a day? I would like someone with a fresh pair of eyes to go into those obscure offices and see if they can find any way of improving the systems so that future generations of medical students do not have to relive the inefficiencies that we have lived through. I want the system to be improved for everyone's sake.
OR if you won't let a medical student audit the process, could you manager's at least send your UC's to learn from other hospitals where things are done better! If we (potential future) doctors have to live by the rule of EVIDENCED BASED MEDICINE, why shouldn't the admin staff live by a similar rule of EVIDENCED BASED ADMINISTRATION? Share good ideas, learn from the best, always look for improvements rather than keep the same old inefficient, pointless systems year after year.
My final point on the subject - at the end of every term we have to fill in long feedback forms on what we thought of the hospital and the teaching. I know for a fact that most of those forms contain huge amounts of criticism - a lot of which was written exactly the same the year before! So, they are collecting all of this feedback and yet nothing seems to change in some hospitals. It all just seems such a pointless waste.
Take away thought for the day.
By auditing and improving the efficiency, of the admin side of an undergraduate medical education, I would hope the system as a whole would be improved and hence better, more knowledgeable, less cynical, less bitter, less stressed junior doctors would be produced as a result. Surely, that is something that everyone involved in medical education should be aiming for.
Who is watching (and assessing) the watchers!
Shattered. Third consecutive day of on-calls at the birth centre. I’m afraid I have little to show for it. The logbook hangs limply at my side, the pages where my name is printed await signatures; surrogate markers of new found skills. Half asleep I slump against the wall and cast my mind back to the peripheral attachment from which I have not long returned. The old-school consultant’s mutterings are still fresh: “Medical education was different back then you see....you are dealt a tough hand nowadays.” I quite agree, it is Saturday.
Might it be said the clinical apprenticeship we know today is a shadow of its former self? Medical school was more a way of life, students lived in the hospital, they even had their laundry done for them. Incredulous, I could scarcely restrain a chuckle at the consultant’s stories of delivering babies while merely a student and how the dishing out of “character building” grillings by their seniors was de rigeur. Seldom am I plied with any such questions. Teaching is a rare commodity at times. Hours on a busy ward can bear little return. Frequently do I hear students barely a rotation into their clinical years, bemoan a woeful lack of attention. All recollection of the starry-eyed second year, romanced by anything remotely clinical, has evaporated like the morning dew.
“Make way, make way!...” cries a thin voice from the far reaches of the centre. A squeal of bed wheels. The newly crowned obs & gynae reg drives past the midwife station executing an impressive Tokyo drift into the corridor where I stand. Through the theatre doors opposite me he vanishes. I follow.
Major postpartum haemorrhage. A bevy of scrubs flit across the room in a live performance of the RCOG guidelines for obstetric haemorrhage. They resuscitate the women on the table, her clammy body flat across the carmine blotched sheets. ABC, intravenous access and a rapid two litres of Hartmann’s later, the bleeding can not be arrested by rubbing up contraction. Pharmacological measures: syntocinon and ergometrine preparations do not staunch the flow. Blood pressure still falling, I watch the consciousness slowly ebb from the woman’s eyes.
Then in a tone of voice, seemingly beyond his years, the reversely gowned anaesthetist clocks my badge and says, “Fetch me the carboprost.” I could feel an exercise in futility sprout as I gave an empty but ingratiating nod. “It’s hemabate....in the fridge” he continues. In the anaesthetic room I find the fridge and rummage blindly through. Thirty seconds later having discovered nothing but my general inadequacy, I crawl back into theatre. I was as good as useless though to my surprise the anaesthetist disappeared and returned with a vial. Handing me both it and a prepped syringe, he instructs me to inject intramuscularly into the woman’s thigh.
The most common cause of postpartum haemorrhage is uterine atony. Prostaglandin analogues like carboprost promote coordinated contractions of the body of the pregnant uterus. Constriction of the vessels by myometrial fibres within the uterine walls achieves postpartum haemostasis. This textbook definition does not quite echo my thoughts as I gingerly approach the operating table. Alarmingly I am unaware that aside from the usual side effects of the drug in my syringe; the nausea and vomiting, should the needle stray into a nearby vessel and its contents escape into the circulation, cardiovascular collapse might be the unfortunate result. Suddenly the anaesthetist’s dour expression as I inject now assumes some meaning. What a relief to see the woman’s vitals begin to stabilise.
As we wheel her into the recovery bay, the anaesthetist unleashes an onslaught of questions. Keen to redeem some lost pride, I can to varying degrees, resurrect long buried preclinical knowledge: basic pharmacology, transfusion-related complications, the importance of fresh frozen plasma. Although, the final threat of drawing the clotting cascade from memory is a challenge too far. Before long I am already being demonstrated the techniques of regional analgesia, why you should always aspirate before injecting lidocaine and thrust headlong into managing the most common adverse effects of epidurals.
To have thought I had been ready to retire home early on this Saturday morning had serendipity not played its part. A little persistence would have been just as effective. It’s the quality so easily overlooked in these apparently austere times of medical education. And not a single logbook signature gained. Oh the shame!
This blog post is a reproduction of an article published in the Medical Student Newspaper, February 2014 issue.