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Practical Presentation Pearls Evidence-based Recommendations From the Psychology and Physiology Literature

Posted Dec 31, 2018 Updated Apr 10, 2023
By Michael L. Richardson MD , Nicole E. Curci MD , Elizabeth M. Johnson MD , Diana L. Lam MD , James T. Lee MD , Rebecca T. Sivarajah MD
14 min read

Oral presentations remain a common teaching method in academic radiology. The goal of these presentations is to transfer knowledge from the presenter’s brain to brains in the audience in a way that sticks. A number of studies from the recent psychological and physiological literature offer some rather practical and evidence-based advice on ways to optimize our oral presentations. The purpose of this paper is to summarize this work, and to give examples of how it can be harnessed to increase the efficacy of radiology presentations, whether they are for resident education, a continuing medical education course, or for a scientific presentation at a national radiology meeting.

INTRODUCTION

What is the best way to present information to our students so that they remember it? Radiology educators have experimented with many approaches over the years, which boil down to four principle techniques: we show them images, we talk about the images, we give them materials to read (and write), and we teach them to do procedures. In the educational literature, these four learning styles are sometimes summarized with the acronym VARK (visual, aural, reading/writing, and kinesthetic) . Most of our educational presentations involve the first three of these learning styles.

Learning is all the more remarkable, when one considers that we forget most of the things that happen to us in a given day. What is it that distinguishes these events from those that we choose to learn and remember? A number of studies from the recent psychological and physiological literature offer some practical insights into how this happens. It is clear that learning is influenced by the characteristics of particular stimuli and how they are processed. There is also evidence that motivational states can play an important role in information that is consigned to long-term memory.

Much of the early work in educational psychology relied on subjective information from the experimental subjects. More recently, experimenters have employed electroencephalography, positron-emission tomography, magnetoencephalography, and functional magnetic resonance imaging (fMRI) to obtain objective data about which parts of the brain are active during various educational interventions. This type of research has led to some fascinating results. For example, one fMRI study showed that when a speaker and a listener are communicating well, the brain activity of the listener actually mirrors that of the speaker . This synchronization of brain activity has been termed neural coupling, and greater neural coupling between the speaker and the listener is associated with greater understanding by the listener.

Advances in the psychology and physiology of learning have been paralleled by similar advances in pedagogical techniques. However, despite a current trend toward more active teaching techniques, the oral presentation remains one of the main tools in our educational arsenal. This is true not only for residency training but also for scientific meetings and for continuing medical education events . Until oral presentations are someday replaced by more effective methods, we want our presentations to be as effective as possible.

Much has been written on the topic of optimal presentation design . National organizations such as the Radiological Society of North America, the American Roentgen Ray Society, and the Association of University Radiologists have long sponsored programs to improve the presentation skills of their speakers. However, much of the presentation advice in these publications and programs consists of personal preferences, anecdotes, and opinions, and little of it has undergone experimental validation. Fortunately, recent research into the psychology and physiology of learning has led to a number of practical results that have undergone such validation. The purpose of this paper is to summarize some of this work, and to present several evidence-based principles that can be harnessed to optimize radiology presentations.

COGNITIVE BIASES AND PHYSIOLOGIC EFFECTS THAT INFLUENCE LEARNING

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Cognitive Biases

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Serial Position Bias

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Figure 1, An idealized serial position curve for a 24-word list. The 24th word in this list will have a much higher probability of recall than the words in the middle of the list.

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Levels of Processing Effect

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Curiosity Effect

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Visual Channel Effects

Picture Superiority Bias

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Figure 2, A slide which fails to exploit the picture superiority bias. This slide has a lot of gratuitous text, and the image is a mere afterthought.

Figure 3, A slide which successfully exploits the picture superiority bias. This slide makes the image the center of the presentation, with minimal text. Anything the audience needs to learn about this slide can be told to the audience in the form of an oral narrative.

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von Restorff Effect

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Figure 4, Scatterplot using the von Restorff effect to call attention to the data point for radionuclide imaging (RN). The open circle in this plot stands out from the solid black circles (CT, computed tomography; MR, magnetic resonance imaging; PF, plain films).

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Color Vision Deficiency

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Figure 6, The scatterplot in Figure 5 as seen by someone with deuteranopia. That scatterplot will look something like this to the 8% of your audience with color vision deficiency (CVD) (CT, computed tomography; MR, magnetic resonance imaging; PF, plain films; RN, radionuclide imaging).

Figure 5, Scatterplot using the von Restorff effect to call attention to the data point for radionuclide imaging (RN). The red circle in this plot stands out from the green circles for most viewers (CT, computed tomography; MR, magnetic resonance imaging; PF, plain films).

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Figure 7, The optimized color palette from Table 1 . This also includes simulations of how this palette might appear to persons with three different types of color vision deficiency, similar to the chart from Okabe et al. [35] .

Table 1

A Color Palette Optimized for Persons With Color Vision Deficiency

Color Name RGB (0–255) RGB(hexadecimal) CMYK (%) Black 0,0,0 #000000 0, 0, 0, 100 Orange 230, 159, 0 #e69f00 0, 50, 100, 0 Sky blue 86, 180, 233 #56b4e9 80, 0, 0, 0 Bluish green 0, 158, 115 #009e73 97, 0, 75, 0 Yellow 240, 228, 66 #f0e442 10, 5, 90, 0 Blue 0, 114, 178 #0072b2 100, 50, 0, 0 Vermilion 213, 94, 0 #d55e00 0, 80, 100, 0 Reddish purple 204, 121, 167 #cc79a7 10, 70, 0, 0

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Figure 9, The same information from Figure 8 with redundant coding. Each line is now thicker and has its own color, point style and line style. Labels have been placed immediately next to each line, making it much easier to tell which line refers to which body part.

Figure 8, Line plots encoded only with color. The line and point styles are identical for all 4 lines. To distinguish the lines, the viewer has to refer to the figure legend, which is somewhat distant from the lines.

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Visual Embellishments

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Figure 10, Chartjunk. This plot uses gratuitous 3D images of a gift-wrapped box to form a bar chart.

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Auditory Channel Effects

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Dual-processing Model: Interactions Between the Visual and Auditory Channels

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Figure 11, Optimal transfer of information in the dual-processing model. This occurs when one’s eyes see images and one’s ears hear a story about the images.

Figure 12, Least effective transfer of information in the dual-processing model. This occurs when one’s eyes see on-screen text, and one’s ears hear the presenter reading that same text.

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Cognitive Overload

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Visual Channel Overload

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Overload of Both Channels

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Overload by Extraneous Material

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Overload by Confusing Presentation Style

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Overload by Need to Hold Excessive Information in Working Memory

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Conclusions

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Table 2

Evidence-based Principles for Improving Presentation Efficacy

Effect Main Concept Recommendations_Serial-position bias_ 1st & last items in list are best remembered Place most important points at beginning & end of presentation_Levels of processing effect_ Deeper levels of mental processing enhance recall Frame key points so as to require more mental processing_Curiosity effect_ Curiosity about a subject enhances recall Start session with quiz or mystery case_Picture-superiority bias_ Recall is higher for pictures than for text Use more image slides & less text_von Restorff effect_ The stimulus most different is best remembered Use differences in size, shape, & color to emphasize key points_Color vision deficiency_ ≥ 8% of North American population has some form of this Use color-safe palette & redundant coding to clearly emphasize key points_Visual embellishments_ Appropriate visual embellishments can enhance recall but increase cognitive load Sparing use of embellishments for key points_Auditory channel effect_ Voice-only communication enhances empathic accuracy Use black or blank slides during emotional appeals_Dual-processing model_ Learning occurs in visual & auditory channels; some interactions may hamper recall Present mostly images & tell stories about them

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Academic Radiology, Volume 26, Issue 1
Journals General Radiology
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