I just returned from the National Disaster Medical Service (NDMS) convention in Dallas Texas. It was a well spent three days full of lectures disseminating useful and interesting information about disasters and mitigating the effects thereof. Predictably it also turned into a three day Power Point presentation marathon. At one time there was a saying in the lecture and educational arena that you could always tell an "expert" because he had traveled a long distance and brought a carousel of slides. Traveling a long distance sill holds true, but now the slides have been replaced by their electronic cousin the Power Point file (mylecture.ppt). After sitting through all those presentations I feel that it is time that somebody try to establish some rules and etiquette when using this new medium for teaching and making presentations.

Verify Your Spelling and Word Use.

Back when it was very expensive to have photographic slides made from an electronic presentation program, the slides were proofread, checked and then checked again. The developer could not afford any mistakes. By "afford" I am speaking in terms of both money and time. In some cases, it cost as much as several dollars per slide and often times took a week or longer to get them back to you. Nowadays you can type out a presentation as easily as you type a letter and thanks to "In Focus" type projectors, they can be projected on the wall without incurring any further costs.

The fallout of this it that because it is so easy to create a presentation, the lecturer/developer too often skips the proof reading step. Actual spelling isn’t the issue much any more, (spell check has cured that) but you need to verify that you have used the correct words. Either intentionally or unintentionally, in too many presentations I saw "an" & "and" confused. These may have been typos but they still look bad. If you are not sure of the difference between "there" and "their" review the definitions BEFORE you show your presentations. Make sure you know which, witch is which. What you are risking is your credibility. You have been asked to make a presentation because you are the expert. Incorrect use of words that should have been mastered in the sixth grade do not reinforce your qualities as an expert.

My suggestion is that once you have finished developing your presentation, get somebody else to read it. If you spent any time at all developing it you are too close to it to see your mistakes. It can be an extra effort to get somebody to do this but it is well worth it in the long run.

You Are There to Teach, Not Entertain.

Power Point was created mainly for the business world not the scientific or academic community. Power point is a powerful program. It allows you to do many interesting things with your text. However, most of the features available to you in Power Point are inappropriate in a scientific or instructional setting. There is a big difference between the lighthearted reviewing of a company’s new marketing and advertising plans and seriously teaching your audience how to mitigate the effects of an epidemic. In medicine our topics are serious, your slides should be too.

When you are developing your Power Point presentation, the cutesy little things that seem to add interest on your desktop computer can look really dumb in front of a serious audience. This begins with your choice of the background slide sets. Pick one without animation. There are some backgrounds that have a ball or asteroid that must pass from left to right before the text can appear and before you can click to the next slide. Two problems with this type of background. First, the moving ball does nothing but hypnotize your audience (especially after lunch). Secondly it limits your ability to pace yourself. If your block of time is shortened in any way (and if you are anybody but the first speaker you can expect the entire conference to fall behind) you will need to be able pick up your pace. You may need to skip a few slides, either to make up time or because you use your presentation for two different groups and some slides are not appropriate for this particular audience. I was witness to one speaker who became visibility frustrated by his inability to click quickly to his next slide. The program would not allow him to skip quickly while in slide show mode and distracted from his presentation. In this particular case the limiting factor was his background choice but it can also be the use of large graphics files too, so be careful.

The use of spinning, flying or dissolving text does not add to your credibility, it instead appears to make light of the important points you are trying to make. Setting up the slide show to add bulleted items individually as you make your points during the lecture is one thing, but enticing your audience to try and guess how your text will appear next, distracts from everything you are saying.

Along these same lines, leave the sound effects off. One lecturer that I ‘endured’ used most every sound effect that was available to introduce his text. There were gunshots, tire squeals, breaking glass. None of it reinforced what he was saying, none of it was associated with what he was saying and when it was amplified through the sound system of a hotel ballroom it was embarrassing for me if not the conference sponsors. When using Power Point remember; Just because you can do something, does not mean that you should.

Consider Your Colors

In case you haven’t noticed many Power Point backgrounds are blue tones and the default text colors are yellow. This is for a reason. When projecting colors on a screen (or wall) much intensity is lost. Colors have to be brilliant and vibrant if they are to show up as natural tones. Whatever your choice of colors, use a high contrast between the two. While you would not likely paint your house a bright blue and yellow, these two colors are easily separated and easily seen. One presenter successfully used this yellow/blue combination right up until the end. On his last slide he wanted the audience to have access to his email and phone number. He put this important information in red text against his blue background. In the faded colors of a 50 foot projection through the less than totally dark conditions of the room, the text was washed out and totally unreadable. Thankfully he made this color change only at the end of his presentation or it might have all been unreadable

As an EMS instructor it is a reality that the majority of your audience will be male. It is also a reality that color blindness occurs at a high incidence in males. When your audience says "I cant read what’s on the slide" they may literally be blind to your presentation. The use of Power Point’s red, black and white ‘triangle’ background always seems to wash out some of the letters of your text whatever color they are in. While it looks interesting by itself, this is not a good background for text or lettering. Remember that there is nothing wrong with a good old fashioned black text on a white background. It offers high contrast and is relatively unaffected by high ambient light conditions

Don’t count on colors for other reasons too. During this conference there were up to seventeen different In Focus projectors operating simultaneously in different lecture halls. I suspect that many if not all of these were rented for the occasion. Rental units receive hard use and abuse. For whatever reason, several of the projectors did not project the color red. Were they out of adjustment? Were they broken? I don’t know, but it was truly bizarre seeing pictures of "bloody" victims who looked like they were covered with Hershey’s syrup. In one lecture the presenter actually turned his laptop screen toward the audience so that the graphic scene could truly be appreciated. The moral here is to not count on an exact color representation when making a presentation.

Maybe You Don’t Need a Full Power Point Presentation at All

When I started teaching at LA County’s Paramedic Training Institute 10 years ago, I found in an old closet the entire paramedic training program on carousel slides! Every lecture, every skill. I don’t know if they were used in their entirety for any one particular class, but here they were and they certainly could have been. The thought of locking 30 people in the dark for 11 weeks and then thinking that when the lights came back on they would be paramedics is astonishing to me. Thankfully by the time I started teaching, each instructor was giving their lectures with the lights on, using slides only to make a point or illustrate an injury. On an EMS website there was a discussion recently about somebody who had endured an entire EMT class on video tape! Each week the instructor would pop the tape in and the VCR would give the lecture for that evening! As an EMS educator you might find this hard to imagine and hopefully you never would do it but because of the accessability Power Point, it is easy to see how somebody could use it to hide behind the darkness when making their presentations.

Giving a presentation or lecture? Maybe you don’t need to use Power Point at all. Power Point does give us an incredibly easy method for taking digital photos and then projecting them for an entire room to see. One picture is worth a thousand words but all one thousand of those words don’t have to be bulleted items. At the NDMS disaster conference, many presenters had some fascinating pictures of disaster damage and relief efforts, but they didn’t all have to put their didactic information into bulleted concepts to reinforce what they were saying. In fact I would encourage most presenters and teachers to come out of the dark and face your audience. Share 30 minutes of your expertise with the lights on then use just 2 or 3 slides to illustrate your point. Again, just because you can do something, does not mean that you should.

Microsoft’s Power Point program is a fantastic tool. It offers great possibilities for increasing learning and retention. However because it is just a tool, we must also learn how it works, the limits of its abilities and the impressions it leaves on our audiences. Validating the use of Power Point in instructional lectures would make for some very interesting educational research.