How to Prepare and Deliver a Great Talk Wilson Liao MD, Kelly Cordoro MD, Ilona Frieden MD, Kanade Shinkai MD, PhD PII: DOI: Reference:

S0738-081X(14)00041-8 doi: 10.1016/j.clindermatol.2014.02.007 CID 6824

To appear in:

Clinics in Dermatology

Please cite this article as: Liao Wilson, Cordoro Kelly, Frieden Ilona, Shinkai Kanade, How to Prepare and Deliver a Great Talk, Clinics in Dermatology (2014), doi: 10.1016/j.clindermatol.2014.02.007

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ACCEPTED MANUSCRIPT Clinics in Dermatology: Contemporary Dermatology DERMATOLOGIC DISQUISITIONS AND OTHER ESSAYS

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Edited by Philip R. Cohen, M.D.*

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*Please submit contributions to the section to Philip R. Cohen, MD at [email protected]

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(email address)

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How to Prepare and Deliver a Great Talk Wilson Liao MD*, Kelly Cordoro MD, Ilona Frieden MD, Kanade Shinkai MD, PhD

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Department of Dermatology, University of California at San Francisco School of Medicine, San Francisco, 1701 Divisadero Street, 3rd Floor, San Francisco, CA 94115

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E-mails: Wilson Liao: [email protected] Kelly Cordoro: [email protected] Ilona Frieden: [email protected] Kanade Shinkai: [email protected] *

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Corresponding author. Tel.: +1 415 476 8364; fax: +1 415 476 8837; E-mail address: [email protected]

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Conflicts of interest: None to declare Liao Essay-Great Talk Essay-Clin Dermatol 2-14-14

ACCEPTED MANUSCRIPT Introduction Giving a talk—for many—is a high-anxiety, high-stakes experience. Though physicians

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are frequently called upon to give talks to medical and other audiences, formal training in this

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area is uncommon. Surprisingly little information is written in the medical education literature or discussed during medical training about this critical skill in communication and teaching. When

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experience for both speakers and audience members.

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done well, an effective and engaging presentation can be a truly educational and memorable

The goal of this contribution is to serve as a succinct primer on how to create and deliver

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an effective, engaging presentation. Key “pearls” on preparing and organizing the talk, on creating slides, and on optimizing delivery will be reviewed (Table 1). Ultimately, we believe

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that giving a great presentation is a learnable skill, but one that can only be achieved through

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ongoing practice and a commitment to self-improvement. The skills necessary to give effective presentations are invaluable not only for making impactful speeches in the academic setting, but

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also for enhancing communication with patients and colleagues alike.

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Structuring and organizing your talk Determining the content, structure, and organization of your talk is a central element of giving a great, relevant talk. Knowing your audience is where it all starts. Are they early or advanced learners or a mixed audience? The content needs to be geared to the level of the audience; if there are several levels, the talk should include some basic, as well as more advanced information so that that everyone attending the talk will get some “take-away” messages. Focusing on the audience helps to stay true to the intended purpose of the educational activity and avoid grandiosity. Remember, your talk is for the audience’s benefit, not yours.

ACCEPTED MANUSCRIPT One technique that can be particularly helpful in structuring the content is “backward planning,” determining what the core messages of your talk are and building content with these

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messages in mind. This differs from the way many talks you have heard are constructed. For

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example, a talk about a specific disease is often organized like a book chapter, e.g. introduction, history of the disease, pathogenesis, clinical aspects, pathology, differential diagnosis, and

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management. This is usually not the best way to organize a talk for a medical meeting, unless

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the audience is a group of early learners with little knowledge of the topic being discussed. Instead of this format, which often results in information overload, it may work better to think

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about the 3 to 4 key messages that you want to impart. For example, for early learners there might be a few clinical presentations or key mimics of a disease you want to emphasize. For

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more advanced learners, topics might include new developments in understanding of

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pathogenesis or diagnostic or therapeutic updates for a specific disease. Top 10 pearls for Evaluation (or Management of) Condition A or the 5 things you should know about disease X

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are other effective formats for presenting content.

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Another essential aspect of preparing the content is being realistic about how much time is allotted for the talk. If you have 15 minutes, you need to reduce your key messages and discussion to only the most succinct, necessary points. On the other hand, a 1 or 1.5 hour seminar presents an alternative challenge. A good approach with a longer format session is to break it into several “mini-lectures” with audience participation via questions or discussion after each one. Either way, prepares to use the time allotted and not more. Force yourself to eliminate extraneous slides. Paring down your information helps avoid common mistakes, such as feeling rushed, having to speak faster to get through the talk, skipping slides, leaving no time for questions or comments, or going significantly over the time allotted. Remember that cramming a

ACCEPTED MANUSCRIPT talk full of information and rushing through content does not mean people will learn more. Paradoxically, they may actually learn less. Lectures should have a title, an introduction, middle,

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and an end.

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Name your lecture carefully—be creative but not too “cutesy”; try to make it correspond to the content you will be presenting so that the audience has some idea what to expect. Starting a talk

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with a brief vignette or story is an excellent way to engage the audience. For dermatology

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audiences, try to include visual images as quickly as possible to pique the audience’s interest. As you transition from introduction to the core of the talk, remember to avoid a “forced march”

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through the data/concepts. Many speakers feel obliged to demonstrate that they have read a huge amount of literature in preparation, often showing slide after slide of detailed data, a common

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pitfall we call the “conscientious student.” Instead, the speaker should do the work for the

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audience, offering high yield, and synthesized information. This does not mean that the content should be delivered in terse bulleted format. To

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increase audience engagement, techniques such as using illustrations, analogies, storytelling, or

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audience input (e.g. “How many of you have seen a certain complication of disease Q?”) can be helpful. Another valuable technique for engaging the audience is challenging dogma e.g. you were taught that X was the best treatment for disease Y, but new evidence shows that Z is really the best treatment. Creating Your Slides Well-designed presentation slides achieve three goals: they promote clear communication of content, engage the audience, and provide visual appeal. The following guidelines will help you create effective and memorable slides that will enhance your presentation.

ACCEPTED MANUSCRIPT Structure your presentation into five sections: Title Slide, Roadmap, Main Content, Summary, and Acknowledgments. The title slide should list the title of your talk, name, and

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affiliation. Consider adding your e-mail address for follow-up communication. The roadmap

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slide gives the audience a preview of your talk. Include only a few bullet points that highlight both the content of your talk and also why the audience should care. The main content

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constitutes the bulk of your presentation and is most effectively organized as a story or series of

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stories. The summary slide reviews the major learning objectives. Finally, if appropriate, include an acknowledgments slide listing your collaborators, mentors, funding sources, or other

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individuals or organizations that made your work possible. Elevating others enhances your credibility as a team player and future collaborator.

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As you begin creating your slides for the main content, focus on one rule: keep it simple.

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For each slide, ask yourself what single idea you are trying to communicate and eliminate

your last vacation.

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anything on the slide that does not further that goal, e.g. non-important text, clip art, photos of

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Probably, the most common mistake in creating slides is including too much text. Your slides should not be a point-by-point transcription of your oral presentation, nor should they appear as a detailed outline with subheadings; rather, use text sparingly to highlight the most important concepts of your oral presentation. As a general rule of thumb, use seven or fewer bullet points per slide. Use short phrases—avoid using full sentences, unless you are providing a quote. The most powerful way to enhance your slides is to maximize your use of visuals. Communicate your content as much as possible using pictures, diagrams, graphs, charts, or videos. Place a visual early in the presentation (first few slides) to capture the attention of the

ACCEPTED MANUSCRIPT audience. Pare tables or graphics down to the most important aspects, as detailed graphics are not easily absorbed in a presentation setting. Clearly label and verbally define the axes of graphs

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and relevant components of graphics.

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A number of design tips can enhance visual appeal. Use slides with a simple, not busy background. Selecting a light font and a dark background generally works well. For readability,

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limit text on a slide to no more than 3 colors and use a font size of 20 point or higher. To

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transition between sections of your talk, it can be helpful to insert a blank slide or slide with a short section title.

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How many slides should your talk include? A general rule of thumb is the number of slides should closely approximate the number of minutes (e.g. 30 slides for a 30 minute talk).

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The exception to this rule concerns the use of more clinical photographs and less didactic slides,

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but even in this case, the number of slides should not exceed the number of minutes by more than 1.5 to 2 fold as an absolute maximum. Again, remember that cramming content in a talk

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does not make people learn more!

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Presenting your content

Presenting your content well requires advance thought, practice, and honest reflection to improve. Do not forget to make the content king! Capture your audience’s attention; inspire by telling them how you became interested in the subject. Explicitly speaking to their motivation is an alternative—for example, “I hope this information will help you with your test preparation” for a board review course. Dive into the key content as quickly as possible and do not waste precious time with lengthy introductory material. As you speak, do not recite (the quickest way to lose an audience). Share expert opinion or technical jargon matched to the level of your audience. A timely ending is critical and appreciated by all: the meeting runs on schedule, the

ACCEPTED MANUSCRIPT speakers after you are content, and the audience has time needed for breaks or moving to other conference rooms to hear their next lecture. You may need to adjust your talk while in process

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in order to end on time.

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The Art of Delivery

The educational value of a presentation is related to the strength of the content. The

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power of a presentation, or the ability to positively impact an audience, is related to the strength

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of its delivery. Elevating your delivery skills starts by taking an inventory of your style: speaker, know thyself. Analyze your strengths and weaknesses and work to find your comfort zone,

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using your natural style with which you can convey information with ease and authenticity. Deliver with grace, humility and appreciation. Thank those who invited you. These personal

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connections set the stage for a rewarding shared experience between you and your audience. The

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following tips highlight the key aspects of delivering a winning presentation. Arrive early! Do not wait until you are called to the podium to learn the set-up. Before

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the session, meet the AV technician, run your slides, and familiarize yourself with the sound

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system, lighting, microphone, pointer, and slide advancer. Understand the timer if one will be used. A confidence monitor is the screen that mirrors your slides for your reference. It is positioned on the podium or on the floor in front of you. Look at the confidence monitor, rather than the audience’s screen beside or behind you, to maintain eye contact with the audience and project your voice forward. If you point to something on the main screen, remember to return your focus forward. Judicious use of the pointer is essential—do not draw circles or zigzags across your slide content, as this distracts your audience. Your “stage presence” is comprised of your posture, gestures, eye contact, tone and volume of voice, attire, and overall energy. Ideal body posture is confident and composed but

ACCEPTED MANUSCRIPT not rigid nor too informal. Use occasional hand gestures for emphasis and to break the monotony of stiff arms and a fixed stance. Eye contact with the audience maintains a connection

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throughout your presentation. Fix your gaze on an individual, make your point, and then shift

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your gaze elsewhere with the next point—this makes all of the members of the audience feel “spoken to.” Avoid rapidly scanning the audience. Fixing your gaze on the floor, ceiling, or

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back wall can make you appear disconnected and disinterested.

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Strategically adjust the tone and volume of your voice. If the audience must strain to hear or understand you, they may lose interest and confidence in you. Be sure the microphone is

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placed appropriately, and if in doubt ask if people in the rear of the room can hear you. Similarly, overly loud voices are harsh and distracting. Maintain a moderate speaking pace;

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varying your volume, pace, and cadence will optimize the flow and add interest. Overly

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rehearsed presentations are reflected in a monotonous cadence that can lull audiences into disinterest. Verbal pauses (“umm”, “uhh”, “so”, “sort of”) are tiring and detract from your

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material. Practice with a listener or recorder to identify your verbal pauses and eliminate them.

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Silent pauses are effective and welcomed: silence is golden! A pause between thoughts or subjects will refresh and refocus your audience. Remember, delivering a powerful presentation is a learnable skill, but it takes work and practice. No matter what, stay calm and be yourself. You will occasionally draw a blank, lose your place, and experience technical glitches. Maintain a positive demeanor and move forward no matter what. Your audience wants you to succeed. If you keep these delivery tips in mind, you will! Handling Questions and Answers

ACCEPTED MANUSCRIPT A well-executed question and answer (Q&A) session is often the hallmark of expert speakers and turns an informative presentation into a memorable experience. As the talk

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concludes, queue questions by announcing: “I’ll start with a question at microphone #3, then take

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a question from the gentleman in the navy blazer in the front row.” Use an open palm to invite the question or comment rather than pointing. This gesture welcomes the individual into the

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public discussion. Paraphrase each question using the microphone so the entire audience can

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hear it: “The question is about the long-term side effects of medication X.” Offer the most concise answer possible. If your explanation is met with a quizzical look or dismissive

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comment, asking “did that answer your question?” extends your opportunity to discuss the audience member’s question and indicates your commitment to answering it. If faced with a

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heckler or overly talkative questioner, calmly display your willingness to engage them if

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possible. One effective technique is to acknowledge the importance of their question or comment and offers to discuss the question “off-line” (e.g. at the back of the room after the

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session). Sincere intent to better understand the question through further discussion will diffuse

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a challenging situation, preserve your reputation, and leave a positive lasting impression on your audience. In the most difficult situations, “agreeing to disagree” and moving on may be the most diplomatic approach.

The Road to Self Improvement When your presentation is concluded, it is not over. Review your slides soon after your presentation to note typos, animations, or other aspects that did not work smoothly. Seek honest feedback from a trusted colleague—sometimes, this will require an advance request. Read official evaluations with the most open mind possible and commit to growing from the feedback—this is perhaps the most important step to improving your speaking skills. Do not

ACCEPTED MANUSCRIPT become discouraged by negative feedback, especially by an outlier comment; move forward, commit to continuing what is positively highlighted by your evaluations, and view each talk as a

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talk is a life- long process and we hope you enjoy the journey.

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step in a growing process, as you improve your skills as a presenter. Learning to give a great

Acknowledgments

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Marsheila DeVan, whose seminars on effective communication at the American

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Academy of Dermatology Leadership Forum, provided a helpful framework for the present work.

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The following resources have helped us in our own public speaking and which may prove helpful:

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The Better Presenter Blog by Sean McClelland: https://blogs.library.ucsf.edu/betterpresenter/

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Presentation Zen: Simple Ideas on Presentation Design and Delivery, by Garr Reynolds, Publisher: New Riders; 2008. Blog: http://www.presentationzen.com/

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Made to Stick: Why Some Ideas Survive and Others Die, by Chip and Dan Heath, New

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York, Random House, 2007

ACCEPTED MANUSCRIPT Table 1. Pearls for creating and delivering a great presentation

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Organizing and structuring your talk Know your audience: plan content appropriate to their knowledge level and interests Keep the level of detail appropriate for the time allotted Plan backward: Identify 3-4 key take home messages and structure your talk around those messages Avoid the “forced march” through well-known data and concepts Engage the audience through illustrations, analogies, and storytelling

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Creating your slides Structure your presentation into five parts: Title Slide, Roadmap, Main Content, Summary, and Acknowledgments Keep your slides as simple and focused as possible; eliminate extraneous information Minimize use of text: use short phrases, limit to seven bullet points per slide Maximize use of visuals, including pictures, diagrams, graphs, charts, or video. Avoid tables. Use a light font over a simple, dark-colored background; use text size 18 point or higher Number of slides to include = number of minutes in your talk

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Presenting your content Inspire your audience with your motivation to learn more about the subject matter and jump into the key information as quickly as possible Connect with your audience by sharing information, avoid technical jargon Don’t recite: this is the quickest way to lose the audience Stay on time

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The art of delivery Arrive early to speak with the audiovisual person and learn the set-up Body posture: confident and composed, not rigid or too informal Hand gestures: use occasionally for emphasis Eye contact: fix your gaze on one individual, finish your point, then turn your head to another individual; do not scan Voice: vary your volume and cadence, avoid verbal pauses (e.g. “umm”), utilize silence to refocus the audience Demeanor: stay calm and composed, even in the event of a technical failure

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Question and answer session Queue the questions Don’t point; use your outstretched palm Repeat (paraphrase) the question Concise answers are best, followed by asking: did that answer your question? Deal with hecklers/ audience confrontations off-line, not at the podium The road to self-improvement Make changes to the talk as soon after delivering the presentation, while it is still fresh in your mind Seek honest feedback; sometimes this requires advance requests for feedback from trusted colleagues Review evaluations and be open to learning, growing Do not focus only on negative feedback, especially if an outlier

ACCEPTED MANUSCRIPT Biographical information Drs. Kelly Cordoro, Ilona Frieden, Kanade Shinkai, and Wilson Liao are faculty

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members in the Department of Dermatology at the University of California, San Francisco

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School of Medicine. Though they all enjoy public speaking now, they acknowledge that speaking engagements were—and sometimes continue to be—tough professional (and personal)

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experiences. They believe that effective presentations are an entirely learnable (and eventually

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enjoyable) skill. This article evolved from a workshop they created to coach dermatology residents on how to give presentations. That local workshop transitioned into formal sessions

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available through the Leadership Institute at the meetings of the American Academy of

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Dermatology.

How to prepare and deliver a great talk.

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