Right, I’ve been retired now for two years, but it doesn’t feel like it because like you guys when COVID I was back at the coalface. And I am, I still am, and I’m working on would you believe, I’m not in medical engineering, but I’m doing the COVID vaccination programme with my wife. We’re out there stabbing people, yeah, and the more the merrier. If you’ve not had it get it! Right, now I’ll start.

I’ve put up a little slide here, a little picture that’s been drawn, which says what every single presenter today has felt like as they stand here. Picture says a thousand words. They’re sweating a little, they’re nervous, they’re worried about the attitude of the audience, they’re wondering how it’s all going to go, and if you don’t feel like that you shouldn’t be here. And I don’t care how many times I’ve done this, and I have done it a lot of times, I’m still nervous, and you will be.

Let’s have a look, see where we’re going with this, the overall aim. I always like to set out what you’re going to finish with at the end of my session. Well you’re going to finish with a better idea of how to become a very capable presenter, and a more in-depth thought process over how you’re going to deliver and develop training within your departments. There are some objectives. Every presentation you need to ensure that what you are giving is going to expand the knowledge and take forward the understanding of your audience, and the individual. You’re not speaking to a group; you’re actually speaking to one person at a time.

Now that sounds an odd thing to say, given where I’m stood and what I’m looking upon, but it’s very important to remember we don’t group think. You remember the Borg from Star Trek, we’re not the Borg, we’re all individuals who are all listening in with their own perceptions and backgrounds. When it comes to designing materials to use for training, what’s so important is you have material that is relevant and crystal clear. You’ve only got, like I have, 30 minutes to get it across, and the most important thing about presenting is avoiding the classic mistakes, and there are classic mistakes to doing this. In a sense if you avoid the classic mistakes, you’re really on course to give a good presentation.

Now the next thing I was going to talk about, the second part of my time today is going to be talking in general terms about training in-house: how to plan and develop an in-house training programme. Everybody, I know I heard Joe talking about it, and I’ve worked with Joe over this kind of thing, it’s very important that we start to really get to grips with training and development of staff. It’s not going to happen on its own and a piecemeal approach won’t work in the long run. How do we engage people in that training? How do we develop the enthusiasm for training in the department? One of the best things as a manager if you’re running a biomed department is to have people knocking on your door saying well when am I going on that pump training, when will I get an opportunity to go and work in radiology? It’s what you need. One of the points at the end of that of course is to be able to evaluate, to actually be able to measure and in a sense be able to use people’s skills that they’ve picked up and apply them to developing a result, because at the end of the day that’s what it’s all about. It’s coming out with a result for the hospital.

Measuring long-term outcomes, how do you do it? You’ve got the appraisal system, it works, but also you’ve got like Joe’s got, where he’s got his engineers actually being able to see how much more they’re being able to produce and develop with training. Right, avoiding death by PowerPoint, who’s never suffered death by PowerPoint? Everybody has at some point. Right, the record I had was a course a couple of years before I finished, which was four hours long and had 362 slides. Literally they were coming up at, I calculated it, one every 17 seconds. It didn’t work, needless to say. Before you start with your training, one of the tools I put to one side every time, and any engineering who’s ever worked with me, is I insist upon them using the four Cs: clear, concise, complete and correct. Whatever you’ve written, whatever you’ve put down, whatever you’re going to say needs to meet those standards. You’ve only got so much time, it needs to be accurate, it needs to be concise, it needs to be complete and it needs to be clear. We’ll talk of these in greater depth as I carry on through.

You’ve not come to watch that, you’ve come to listen to me. If you remember that when you’re stood here, that it’s you they’ve come to see. Can you imagine Sunday night at the London Palladium with PowerPoint slides at the side? How ridiculous it would look. What are these? I’ll let you read it for a moment. I’m not going to read it, you can all read. Can you all see it? Yes. If you can read it and you can see it, don’t stand there like a talking book. It’s an aide memoire. It keeps me on the subject. It keeps me going forward through the points I want to cover in a logical order. It’s for me, not you.

Now this is a point that I really think many people fall into the trap, too many points on one slide. If what you’re talking about requires more than five or six points, make two slides. If that slide is too busy and the sentences are too long, you’ll lose the audience. They won’t be looking. They’ll be trying to read it and listen, and it won’t match up. So keep to just a few points. Slide design, keep it simple. One of the great things I’ve noticed today is virtually every presenter I’ve seen has kept it simple a white background, black text. Some people will tell you that to have a black background and white text is even more easy to read, it’s possibly true, but I tend to feel for me this is just as it should look, no more.

Flashy transitions, PowerPoint is wonderful, you can do all sorts of things with it, can you not, circles and things flying in and colours rippling off, and fading this and that. Well let me give you an example. Tonight when you go home just before the BBC news comes on right, you’ll see a short video of people drinking tea or swimming in a lake, you know, just a few, and it means absolutely nothing. It’s very clever, it’s very pretty, but once you’ve seen it once there’s no message to it. And it’s lost. You’re waiting for the news. Well when you’re presenting you haven’t got time for that. You’re not here to entertain them with graphics; you’re here to entertain them because they’ve come to listen to you.

Good quality images say a lot. They’re really useful. A picture says a thousand words. Just like that very first slide, it told you everything about how I was feeling. It would take me minutes to explain all of that, but it said it in an instant. Ensure that the images are relevant, that they have impact. And I don’t mean to say you’re all going to sit up and go wow, but they’re relevant to what I’m talking about. Don’t flip through slide to slide. Let people absorb. I’ll come to this in more detail, but it is important that you don’t chase through. 60 seconds to 90 seconds per slide is a really good rule of thumb. Try and keep to that and you’ll keep people with you. When we all sat down to dinner last night, and we had a three course dinner, we knew it was going to take between 30 minutes and 45 minutes thereabouts. It wasn’t going to take an hour and it wasn’t going to take 15 minutes. It’s the same with slides. Consider it like a five course meal. You’ve got to have time to absorb, to think, consider.

The professional presenter, make sure you know what you’re talking about. That sounds easy to say doesn’t it, but make sure that you’ve not only learned your subject, but you’ve learned even more beyond it. And if necessary, if somebody wants to put their hand up in the middle, and you’re all free throughout this to interrupt and ask, make sure you know a bit more. And if you can’t answer on your feet, don’t be embarrassed and shy about it, say it’s a great point, it’s fairly complex, would keep us here for a good while, so what I’ll ask you to do is I’ll come and I’ll speak to you either personally or in a group after the presentation. Project confidence, easier said than done many might say, but that confidence comes from your real solid knowledge of your subject. Know that and you’re away. Clarity, don’t mumble. People talk about projecting their voice in an auditorium like this, well of course with microphones you don’t need to do that. But speak at a rate and a way that if somebody was two yards from you, not close to, but two yards, they’d be able to listen very clearly. If you think about it when somebody’s sat very close to you, you tend to quieten your voice, mumble a bit and mutter, and the words in a sense, well they become, the sentences become a little jumbled. We get lazy the closer somebody is. So remember talk to the audience at a rate that everybody can understand, without labouring it.

Eye contact, now this is something that does take a bit of practise. As I’m standing here I’m focusing on one person at a time, and everybody else is eavesdropping. They’re not an audience. I don’t look to the back of the room and talk up there and say well I think, because everybody goes he’s not talking to anybody. So I’m talking to friends and friendly faces I see around the audience, and look all around and I make sure I good eye contact, stick with them for a few moments, and then move on to next, so I don’t embarrass them by staring either.

Mannerisms, we’ve all got them. Mine is at the moment to stand back and then walk forward. Don’t be shy about them. And don’t try to eliminate them. Don’t get self-conscious. You’re you, be you. That’s how you are when you’re normally speaking.

Control and engagement, this is something that takes a bit of skill sometimes. If I was up here and I was talking for instance as I once did about not using OEM batteries, using third party batteries in medical devices - and I’ll never forget it. The audience, half of it wanted to rip me to pieces. It was really contentious. But I had to maintain control over what was going on. So be careful about what you say, engage people, allow them to speak, but of course what you need to be able to say is when somebody starts, and sometimes they do when you’re doing this, particularly with work colleagues, because at some point virtually all of you are going to have to do a presentation to work colleagues at least, maybe to an audience like this, make sure that you have control. You don’t allow it to run wild. It’s great what you’ve said there Billy, really appreciate it, it needs further explanation, let’s leave it for now and we’ll come back. Get people back on your side, get everybody around you to agree, isn’t that right everybody? Yes they say. Now you’ve not been rude to Billy, but he knows we need to move on.

Questions, if you want to keep people listening in, you’ve got to keep them engaged, and one of the best ways to keep them engaged is to pose a question. Let me give you an example, and I’ll ask for the answer to this at the end. How many of you have all worked on syringe drivers? So, quite a good response and virtually everybody here knows something of a syringe driver, well I want you to think, as I’m going on, at the back of your mind, I want you to think about three methods that a syringe pump can tell whether or not it’s jammed, whether or not it’s not being able to deliver. There are three electronic systems within a syringe pump that can be used. Not all the syringe pumps have them, but there’s three that are available. Can you think about that? Now what I’ve done in doing that is I’ve engaged you in thinking beyond what I’m saying. Kept you on subject, we’re talking medical engineering, but I’ve asked you to think, and that’s when you keep people engaged.

Now, it’s very easy for me to talk about this, because sometimes as you’ve seen there isn’t enough time to deliver what you wanted to deliver. You can’t stretch time and you can’t compress information - remember five course meal, there needs to be a pause for people to reflect. And this is a very important one: what’s the maximum length of time you think most audiences will sit for and listen, anybody? 10 minutes, 20, 30, what’s the maximum? 40, about 40 minutes. They can only listen for as long as their backside lets them. We’re not normally sedentary sat listening. This is a very unusual situation for those in an audience. At work you’d have been out of your chair every five minutes, 10 minutes, or whatever. Even if you were putting data on a computer, you’d be taking a break or a thought process would come or whatever. They can only listen for so long.

Now, rehearsal, if you’re doing like this guy rehearsing in the toilets, you’ve left it too late. You really have. You’re cutting it very fine. Practise, you want to make a good presentation, you want to make it sound really fun, you’ve got to go on stage. Like you would do if you were working at the London Palladium on a Sunday night, it’s got to be absolutely free flowing, what’s coming next has got to have been said by you before. Practise, it brings confidence. It brings ease. I know what’s coming. It’s all lined up in the back of my head one sentence at a time, and it’ll just spill out and it’ll make it look as though wow it’s cool. It develops your timing, and timing is everything. If you notice sometimes I’ll pause between a sentence or two, just to allow people to catch up, to keep with me.

Pitch, if I was, this is the graveyard shift straight after lunch isn’t it? Everybody’s eaten well, they’re rather, not quite sleepy but not the best. Well pitch is a great way. Now I might say the next five minutes I really need you to sit up in your seats and listen, because the points I’m going to go through are absolutely critical to my presentation. That’s what I might say. I’ve used the pitch of my voice to emphasise what’s coming next, and people will go oh right OK, give me my pen and paper let me listen.

How to check it’s been heard. Well sometimes I’ll say right, I’ve gone so far, let’s just review a few things, which part really did you have trouble, did you have any trouble with my early parts of this presentation, maybe the bit about being nervous, has anybody got any thoughts? And what I’m doing is I’m eliciting from you what I’ve already said, not just word for word, but your interpretation. And I guarantee when you start this, other people listen, they learn as much from other individuals in the room as they did from the guy on the podium. So it’s very important that you use questioning to get that feedback to make sure everybody’s really with you.

Allow time. I suspect I’ve been up here now about 12 minutes, my timing should be. 25, way out then Dave, I’m way out!

Provide evaluation, both qualitative and quantitative, now I don’t know John, I’ve lost all track, qualitative and quantitative, yes provide a form, an evaluation form. And you might ask for scores between one and five for this, and one to five for that, and then you’ll ask for some qualitative information. In other words please enter what you thought, your own personal thoughts, and then when I review the qualitative information what I go through is looking for themes that keep coming up. Well he spoke too fast, and that was on three out of the six reports I got, or something like that. So you don’t necessarily have to have it as a quantitative, you can have it as qualitative information. And in some ways from qualitative information you learn even more.

Now, the professional presenter, there’s a couple of smiley faces on there, which will become apparent. They’re intriguing. Why show those three people? We all know who they are, do we not? Right, this is the most single important thing you can bring to the stage. If you haven’t got that sit down! It’s not worth getting up if you really don’t believe in what you’re talking about. It should be an enjoyable and rewarding experience for you, the presenter, as well as for the audience. You’re not a textbook, so don’t sound like one. Make sure that you sound like a human being. Your humanity is on show when you’re up here. Use humour. You’ve got to be careful with humour. Self-deprecating is fine, so long as it doesn’t get ridiculous, but never target anybody, even your closest colleagues, never be tempted to use this podium to take the mick. No matter how opportunistic it might feel.

Anybody know the answer to that one? It’s a python. It’s terrible. Now the three faces will come in. At this point, at this very moment 90-something percent will either have face one or face three. What won’t be happening is there’ll be very few with face number two. Because if they weren’t listening before, sat around when people start to chuckle and giggle or groan, they look up and they go what was that all about? At that point you’ve got them for the next few minutes. Whatever you deliver after a small joke is listened to. It’s surprising but it does, it really engages them.

The audience, we’ve all come here with totally different experiences, totally different backgrounds, cultures and everything else. 25,000 people at a football match. How many games of football are seen? 25,000 plus the two teams, and the referee and the linesman. Each and every one had a slightly different point of view about what went on. They already came with preconceptions, don’t forget that. Don’t think that what you’re teaching isn’t going to be evaluated and absorbed with their interpretation on it. So learn to use it. This is one of the most important things I think I’ve ever learned about teaching: you don’t learn when you listen, you learn when you take what you’ve heard and you test it. Now that is particularly important the older you get, because there’s so much information coming at you that you reject it. And it’s only when it’s relevant and matches what you already need to be doing that you say yes I’ll accept that. Subconsciously you do. Does it add up, does it make sense what is said?

Any points so far, because I’m going on to the next bit about training. Am I all right for time John?

DR JOHN SANDHAM

Three minutes.

DAVID MULVEY

Three minutes, great thanks.

DR JOHN SANDHAM

Time is everything.

DAVID MULVEY

Time is everything. Right, picture says a thousand words. How many times when you go back to work next week will you be seeing this scene, or something like it? Quite a lot I would suspect.

How to make it effective in a biomed department - it’s not given to everybody, even some of the best engineers don’t necessarily make good trainers, good teachers. It’s to do with personality. I’ve worked with engineers who I knew were infinitely better as engineers than myself, but they had no ability in teaching it and conveying that to me whatever they’d learn. When you do decide, or you’re working on training in the department, and you’re going to use engineers to do it, make sure you get the right people, and they’re not necessarily the best engineers.

These are three points, four points that are so important. And the one that I’d draw your attention to is you can’t develop a training programme that covers everything in the next 12 months, it’s not possible. Training programmes need to be looked at over say a three or even five-year period. But the one point I’d make clear to you that is very important is to look at vulnerability for the trust. Three monitors in theatres go down, can you cover it? Yeah, not a problem. Three anaesthetic machines go down in theatres. Hmm we’ve got a problem. So look at the trust vulnerability in terms of equipment when deciding to do what training.

Evaluate the engineers, don’t assume, check with them what they already know.

Cascade training - it’s important that you have a programme that really can go on year in year on. If you’re teaching say even anything as simple as [SPHIGS 0:29:28] or tympanics that somebody can show it, and show it consistently to the same standard each and every time. This is a mistake I hear again and again. And the amount of biomed managers I’ve heard, I’ll send Billy to the course, and when he comes back he can teach everybody else everything he learned. It ain’t going to happen. You are not going to be able to do this to the same standard as a manufacturer or supplier. He’s way more experienced and knowledge of the subject. So get real with your expectations about what you can use cascade training for.

Speak to the people who are coming before they come to the course. Check what it is that they already know, or what they think they know. Make sure the materials are prepared, make sure you’re on top of your game, you’ve got it all lined up. And this point, so aims and objectives. I did it for this presentation, I do it for everything. So everybody knows at the outset what they’re going to finish with. The amount of times, just go to the end of the bench the three of you, and he’ll go through it with you. And the phone’s going and the mobiles are going and somebody’s asking you to go up to ward six or whatever. Forget it. If you’re going to do training that way it isn’t going to work. Take yourselves off, leave the phones, tell them you’re out for two hours or three hours and go. Right yeah, I’m coming John.

Measure the theories test and practical demonstration. Clinical, this has been said earlier today. You can’t successfully and with total confidence repair medical equipment unless you know the clinical that goes with it. The anatomy, the physiology, the clinical implications if you get it wrong, start with that first and then, must know, should know and could know. Be realistic in what you can convey in the time you’ve got. Sort it out before in your own mind when you develop the training.

Information and time - seven course meal as you’ve heard me talk about it.

Lesson plans - write up what needs to be involved.

Principle over detail - this is absolutely fundamental to teaching. If they don’t understand the principle, then there’s no point in showing them the service plan. Because if they can follow the service plan and can’t answer for what they did because they don’t know the principle, you’ve got a problem. They’re not safe. And I say that with all sincerity.

Styles of learning - remember people come from different cultural backgrounds, have different experiences and learn differently.

What is said is not necessarily what is heard. I have a great fault in that I use colloquialisms. I once said on a training course it’s as much use as a chocolate fireguard. Many of my contemporaries knew exactly what I was talking about, but people who didn’t who came from different cultures and things, what’s a fireguard? You know, it’s simple things like that, so be careful with language.

Use anecdotes - I’m finishing John, I’ll leave it at that anyway. Thank you for listening.

David Mulvey's presentation Effective Training and Presentation