JAMA body slam

Some of my posts on the pharmaceutical industry have been strongly-worded. Or at least I thought so until I read this Globe and Mail piece. It's an absolute smackdown by no less than the editor of JAMA.

Think medical journals, and the studies they publish, can't be influenced by drug companies? Ha! Think again.

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The old one-two

The underdog pharmaceutical industry finally has a wingman in their role of David vs. the Goliath of government regulators! (What's the emoticon for dripping sarcasm?)

This CMAJ article discusses Canwest Global Communication's upcoming challenge to the government's ban on direct-to-consumer drug advertising. Dr. John Abramson, of Harvard Medical School, begs to differ.

But, according to Canwest, the ban is a breach of the Charter of Rights and Freedoms.

Pay no attention to the big bags of cash behind the curtain.

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Healthcare efficiency

Interesting post on "Healthcare Efficiency" (April 17) about preventing hospital acquired infections in the US. Love the last paragraph about healthcare workers resistance to the ideas behind Quality Improvement and change (? Change) in general.

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Culture change

Latest Advanced Access post "Culture Change" AKA Phase I complete!

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Crash and Learn I

I'm still fussed about the presentation I gave at SAHO earlier this week. I've been making notes on what to improve for next time, and I have a strong feeling that I could be doing a lot more with my presentations.

I think I can apply some of the ideas about transparency from today's earlier post to improving my presentations. That is, I'm going to make a commitment to improve, and record my efforts here.

Yesterday, I picked up Crash and Learn - 600+ Road-tested tips to keep audiences fired up and engaged! by Jim Smith Jr. He's described as "a sought-after motivational speaker". It's just over 100 pages and I liked the practical, bullet-point tips and "war story" format.

As is the case for most physicians, I haven't received formal training on how to speak in public, give presentations, or teach a class. Yet, I'm called on regularly to do all these things. I just follow the "traditional" approaches to lectures and Grand Round presentations, i.e. stand at the front (behind a podium) and talk. Non-stop. For the full hour, if not longer.

We've set the bar so low in most "medical" presentations, that it's a rare treat to see a speaker who brings something (anything!) fresh and exciting to their presentation.

Let's see what Sought-After Motivational Speaker Jim Smith Jr. has to offer.

Chapter 1 - Facilitation Mistakes

In this chapter, "Jim's Gems" seem more applicable to facilitators leading interactive sessions than to the lecture format taken in most medical settings. Nice tips on how to involve your audience, get people back from breaks on time, and deal with distractions.

Hmm... Maybe "lectures" should be made more interactive in order to engage audiences. Why don't we do that routinely? Perhaps because we don't have the training, experience and confidence to do it. Plus, if I involve the audience, I might lose control of the session.

Smith emphasizes the need to open the session in a strong, memorable way. Use a story, powerful quote, "get-up-out-of-your-seat" activity, or a surprising, powerful statistic. He has similar suggestions for a strong closing.

I was surprised to read that he avoids closing with questions and answers, suggesting "The wrong question can sour the atmosphere, leaving a bitter closing taste. Moreover, you might run out of time without thoroughly answering the question." So, I guess you need to have a prepared closing that gives a reliable, strong, positive finish to your presentation, and plan to deliver the closing after the questions and answers.

Take-away quote: "View your participants as the most important people in the room. Put your ego in check."

Now, I hate the self-help books that have "reader participation", i.e. write down your action plan at the end of each chapter. But, as I'm committing to doing this publicly, here we go:

My top three mistakes are:

1. Not opening sessions in a strong, memorable way

2. Going off on tangents when answering questions

3. Too much telling, not enough asking during the session

My action steps to correct these mistakes are:

1. Open with a related story

2. Ask for the question to be repeated or restated, or paraphrase the question back to the questioner, so I can focus my answer

3. Structure presentations with points where audience can make suggestions. Or solicit questions during the presentation

I'm committed to correcting these mistakes because:

I want my audience to be engaged in the presentation, keep their energy up, and answer questions to their satisfaction.


I've got a presentation to give tomorrow, so I'll try to come up with a relevant story that I can open and close with.

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Blogging to a better you

This Globe and Mail article struck a chord with me. While I haven't been blogging about the intimate topics (personal financial disasters, obesity/weight loss) discussed, I have had some of the same thoughts expressed by the bloggers interviewed.

The article's theme is: Making your personal goals public will boost your resolve.

A small example in Plain Brown Wrapper was my New Year's resolution to wear my name tag at work. I'm sure no one at the hospital reads PBW, but the possibility that someone might catch me without my tag and comment "Didn't I read your blog..." was a motivator. I've been pretty consistent in wearing it.

My Advanced Access blog has put our project into the public eye. We get about 700 hits every 2 weeks. Just knowing that so many people are following our progress keeps me focussed and excited about the project.

I agreed with many quotes in the G&M article, like "... she receives some of the best feedback from readers when she posts entries that make her feel vulnerable." and "... blogging is not for the faint of heart."

But, I take issue with "Openly failing, however, is a blog risk... many bloggers opt for anonymity." Certainly, some problems like addiction may be so stigmatized that open discussion would jeopardize one's personal and professional life. But I've found that people are generally understanding of your shortcomings, particularly when they're revealed in the context of an improvement goal. Anonymity makes your commitment much shallower.

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Oh, the irony!

I've been quite liberal in my derision of poor Powerpoint presentations. But Mr. Smarty-Pants stepped in it big-time this week.

I appreciate an excellent presentation. At meetings or rounds, I really enjoy a speaker who has taken the time to put his/her audience first. Who makes sure the audiovisual material is appealing and appropriate. Who checks that all the necessary equipment is available and functional.

I like to give a good presentation. And I cringe when something goes wrong. Like earlier this week.

I was invited to present our Advanced Access project to the annual meeting of the Saskatchewan Association of Health Organizations in Regina. I was excited to be asked and put a lot of work into the presentation.

I used lots of graphics and photos, and kept text to a minimum. (Only one bullet point slide out of 42!) I stuck to 3 main points. I included some video clips to illustrate my points.

And that's where the wheels came off the wagon.

There was no speaker system to amplify the sound from my laptop. It wasn't a big room, but people at the back couldn't hear the clips. What better way to have your audience's attention wander?

To make it worse, one of the themes of my presentation was "It's all about your audience". I was trying to apply the metaphor of a performer and his audience to the concept of patient and family-centred care in our Advanced Access project. I went on and on about how important it is to think about what engages and entertains your audience (or what's important for your patient). Then, I play the video clips and half the audience can't hear them.

Just to balance my karma, another theme was "Do it", meaning, don't be afraid to try new things and fail at them, because it's always a chance to learn from mistakes. This was the first time I'd included a lot of video clips, so it was a nice demonstration of how to screw up when you try something new. Irony was having a field day.

My first inclination was to blame the conference organizers. I'd given them plenty of notice that I needed to plug into an audio system, but nothing was provided. But, I have to take responsibility myself. I've often seen speakers stymied when they couldn't get a computer or projector going, and thought "That's pathetic that you are so reliant on your slides to speak about this topic. You should be prepared for tech glitches." It was my turn to be stymied.

For next time, I'll have to see about getting a small, portable speaker that I can connect to my laptop. Oh, geez, I just had an esprit de l'escalier moment: I should have taken off my lapel mike and laid it on the laptop's speaker!

Anyway, thanks to everyone who was kind enough to come to my presentation. Sorry for the glitch. Try me again and I'll have it fixed.

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What's wrong with this picture? - XIII

This is the Brandt Centre in Regina. It's an arena/events centre.



And avalanche area!



Unbelievable! They built it with a sloping, ridged roof that dumps chunks of ice and snow onto bystanders.

Kids... Don't slam the car door!

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What's wrong with this picture? - XII

Chef?!


Oh, yeah... The new Buffalo Chicken Bite with Ranch dressing!

C'est magnifique!

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Front page news! Engineering techniques improve health care.

This wasn't on the front page of the Globe and Mail, but it should have been! Check out the examples of "using math and technology to re-engineer how the system works".

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