Clinical Orthopaedics and Related Research®

Clin Orthop Relat Res (2016) 474:1577–1580 / DOI 10.1007/s11999-016-4711-9

A Publication of The Association of Bone and Joint Surgeons®

Published online: 28 January 2016

 The Association of Bone and Joint Surgeons1 2016

Pearls Pearls: Avoiding Bad Slides Joseph Bernstein MD

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high-quality presentation requires more than good slides. Necessary ingredients include a compelling message, logical organization, and masterful delivery. Good slides are not enough to rescue a talk that has nothing to say, that is disorganized, or is delivered in slipshod fashion. On the other hand, bad slides can undermine an otherwise excellent talk. Making slides can be quirky, but based on my experience on both sides of the podium, I have discovered a few pearls to keep you away from bad slides:

Note from the Editor-in-Chief: We are pleased to present the next installment of ‘‘Pearls’’, a column in Clinical Orthopaedics and Related Research1. In this column, distinguished surgeons, scientists, or scholars share surgical or professional tips they use to help surmount important or interesting problems. We welcome reader feedback on all of our columns and articles; please send your comments to [email protected]. The author certifies that he, or any member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related

1. 2. 3. 4. 5. 6.

Avoid slides that render the narrator superfluous. Stick to large, bright text on a dark background. Observe the T-shirt rule. Use pictures instead of words, where it is possible to do so. Do not use animations (except to control the flow). Do not apologize for figures that are too small to be read.

Pearl No. 1 is based on a fundamental principle: Your talk is what you have to say, not your slide deck itself. As such, if the slide set makes sense in isolation—without the speaker—the slides are likely to be flawed. The slide should be at most a cue card for you, and visual supplementation for the audience. It cannot be your script. Research1 editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of Clinical Orthopaedics and Related Research1 or The Association of Bone and Joint Surgeons1. J. Bernstein MD (&) Department of Orthopaedic Surgery, University of Pennsylvania, 424 Stemmler Hall, Philadelphia, PA 19104, USA e-mail: [email protected]

(You may cite this rule, correctly, when you decline a conference organizer’s request to include your slides in a booklet handed out to the audience; instead, consider offering a written summary of your take-home points). Slide-making programs offer many font and color combinations, but as Schwartz et al. [2] have noted, too much choice can lead to unhappiness. In this case, availing yourself of all possible color and font choices will make your audience miserable. You must keep it simple: One dark background color (I say blue or black); one bright foreground color (white or yellow); one font, easy on the eye (any sans serif such as Calibri); and only two sizes (roughly 72-point font for titles and 54-point font for text). Note that if the room in which you are speaking is brightly lit—and it behooves you to be familiar with the room—black text on a white background may be more comprehensible. I also recommend avoiding borders, logos, or a slide counter—indeed, anything but the message itself. The choice of font and color will help the audience read, but you really do not want them reading more than fleetingly; you want them listening. Thus, keep the words to a minimum. (When you try to make a slide with 72-

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Fig. 1 This slide uses the classic combination of yellow text on a black background with plenty of blank space remaining. The title is in 72 point; the text below is 54 point. Although all six are discussed in the text, I do not feel compelled to clutter the slide with each pearl. I would discuss pearl No. 2 and pearl No. 3 under the rubric of ‘ Text must be legible.’’ The comments about animation and avoiding figures that are too small to be read are expressions of the ‘ Figures are clear’’ rule. (Published with permission from Joseph Bernstein MD).

Fig. 2 I would not expect the audience to read the dense table from the article by Cram et al. [1]. Still, if I wanted to discuss total spending, I may elect to show the entire table briefly just to demonstrate that I copied it faithfully. (Published with permission from Joseph Bernstein MD).

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and 54-point fonts, you will realize that not too many words can be accommodated—and that is a good thing). Try also to make sure that no more than half of the slide’s ‘‘footprint’’ is actually covered. As the name of the rule implies, place no more words on a slide than would be printed on a T-shirt: Namely, no more than about a dozen words in total (Fig. 1). You can economize on words by using good graphics. Back when Kodak was a thriving company, many speakers used dual projectors: Text slides on the left screen and graphics on the right. Now, using a single projector you can either embed the graphic on the text slide, or transition to a second slide with graphics alone (and perhaps then transitioning back to the text). Which of these options is best is an aesthetic judgment, but generally, if the graphic functions as ‘‘eye-candy,’’ it can be placed directly on the text slide (such as a photo of a downhill skier when talking about ACL tears); and if the audience is expected to actually scrutinize the image, it should be placed on its own (such as a photo showing precisely where ACL reconstruction tunnels are located). And your mother was right: Be stingy with the candy. You do not want a vivid, but largely irrelevant, image to distract the audience. Generally, people are more visual than auditory learners and will pay more

Volume 474, Number 7, July 2016

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Fig. 3 After showing the slide depicted in Figure 2, I would immediately transition to a close-up view of the area of interest. I also would feel free to edit the table slightly. In this instance, I would elect to remove the numerals to the right of the decimal point, along with the footnote symbols and other annotations. (Published with permission from Joseph Bernstein MD).

attention to what you show than what you say (even if you don’t want it that way). You also have a lot of options for slick animated transitions between slides: Fade in, fade out, swipe, dissolve, and so on. These animations should be shunned—in almost all instances. The exception is when you

want something to appear only after you have introduced it. For example, if you present a list of, say, four items but want to discuss them one-by-one, you should not present a slide showing them all at once. (If you show all four at once, the audience will be reading entries two to four while you are still speaking about number one). Rather,

use an animation function to have each item appear only when you command it (typically, with a click of the ‘‘advance’’ button). Similarly, when you discuss labeled regions of a figure—an arrow on a subtle fracture line, for example—have your label appear only after you have verbally oriented the audience. The final pearl, ‘‘Do not apologize for figures that are too small to be read’’ is actually incomplete. You should never apologize for such figures … because your talk should have exactly none of them. If you have a busy 20-by20 table and want the audience to concentrate on line 5, column 9, present that cell only. If you feel compelled to convince the audience that you have faithfully reproduced the data (Fig. 2), you may show the too-busy image for brief moment, but you should then immediately transition to a close-up of the item of interest. (Fig. 3) Most of these rules must, at some time, be broken. After all, the presentation is your talk, not your slides. However, if you break all of these rules at once, you are likely to have a

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Fig. 4 This slide violates all of the listed rules—and some others, too. (Published with permission from Joseph Bernstein MD).

hot mess on your hands (Fig. 4). That is, adherence to the principles above will not guarantee a good presentation, but will help ensure that you do not weaken an otherwise strong presentation with ineffective slides.

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References 1. Cram P, Ravi B, Vaughan-Sarrazin MS, Lu X, Li Y, Hawker G. What drives variation in episode-of-care payments for primary TKA? An analysis of Medicare administrative data. Clin Orthop Relat Res. 2015;473:3337–3347.

2. Schwartz B, Ward A, Monterosso J, Lyubomirsky S, White K, Lehman DR. Maximizing versus satisficing: happiness is a matter of choice. J Pers Soc Psychol. 2002;83:1178– 1197.

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