Beyond the slides

Surviving and thriving during your grand rounds.

Memory stick: check. Laser pointer: check. Notes for my first endocrinology grand rounds: check. Flat tire ... we have a problem!

The night before I was slated to deliver my first endocrinology grand rounds, I had discovered a nail in my right front tire and had to rent a car to get to work the next morning.

It was 8:30 a.m. when I was paged, just an hour before I was scheduled to start my presentation. A new consult? No, it was the pathologist who I invited to discuss the thyroid slides of the patient who would be presented; he could not make it due to a last-minute scheduling conflict.

Edward C. Chao

He graciously offered to take me through a crash course in the relevant pathology in the five to 10 minutes before he had to leave. For some reason, I didn’t feel a tremendous sense of worry or even panic.

Fast-forward 90 minutes later and fortunately the talk went pretty smoothly — even those thyroid pathology slides. Although I always believe that there are areas to improve upon, I came away feeling that I genuinely enjoyed the experience, including the process of putting together the talk — from doing the background reading, to the hours of editing my PowerPoint slides, to practicing the presentation.

Now I must say up front that by writing this, I definitely don’t consider myself by any means an expert on presentations. Since we all have to deliver grand rounds as fellows, I hope that you find the five insights below that I picked up along the way to be useful.

Tips for grand rounds

Tip 1: Expect the unexpected and have an alternate plan in case it shows up.

To me, this is very critical. Though it sounds cliché, I’ve found it to be true for just about everything in life. After what happened to me, I can attest to this item. Whether it’s something like my last-minute tutorial on the thyroid pathology slides or that question from the audience that completely throws you for a loop or a computer malfunctions, anticipate and be prepared to improvise or go with another option.

Tip 2: Do your homework.

You are probably saying to yourself right now, “Obviously! Please tell me something I don’t already know.” But I feel that this bears saying. This applies not only to what you type onto those PowerPoint slides.

Equally important is the preparation for the question and answer session that arises following, and sometimes during your talk. Hearing comprehensive questions during the question and answer part of past endocrine grand rounds I attended inspired me to research as much as I could about the topic. This helped me to engage with the audience as much as possible and helped me to learn from the ensuing discussion.

Tip 3: Practice and review your presentation with an attending who will be present in the audience.

He or she can provide invaluable feedback on diverse issues ranging from content to slide design (such as graphs or charts) to how you are presenting to the audience and if there are any areas that need improvement. He or she can also jump in during the question and answer portion and offer assistance if needed, and their expertise can add to the discussion. Scott Lee, MD, my mentor in endocrinology when I was a resident at Loma Linda University Medical Center in California, shared this pearl of wisdom with me.

Tip 4: Run through your talk with maybe one or even two or more additional faculty, if possible, especially one who is an expert in the field, as I did with one of our attendings for my thyroid cancer patient.

They may be able to bring fresh perspectives that you hadn’t considered. Though he was out of town during the morning of grand rounds, I was able to get his take on the latest agents that are currently undergoing phase-2 trials and to incorporate this information into my talk.

Hearing these additional viewpoints will allow you to further hone in on your presentation, as well as expose you to new insights that you may not have considered or gleaned from your research so far. These thoughts can greatly enhance your expertise on your topic, and may even help during the question and answer potition of the session.

Tip 5: Finally, as strange as this may sound, nerves are great!

Feeling anxious in the moments leading up to and before you start (and even during the presentation) is completely normal. I try to view this in a more positive light, rather than interpret nerves as negative. I choose to see nerves as that extra oomph that will fuel what will hopefully be a great presentation.

Certainly, it’s easier to say or think this philosophy than to put it into practice. I’ve found though, that it is very useful and a more motivating way of viewing presentations.

If you get a question that completely and utterly stumps you, don’t be embarrassed to simply respond with “I don’t know” and say you will attempt to find the answer later. Perhaps you could invite those in the audience the opportunity to weigh in.

Preparation complete

At some point, there will be no further slides to add. The day of your presentation will arrive and now all you can do is relax.

You’ve invested countless hours and you’ve worked hard to prepare. You can simply trust yourself at this point and know that you are ready. Now you have the privledge to share what you’ve learned, so get enthusiastic. If you’re not, how can you expect the folks sitting in front of you to be? Try to let that come across to your audience when you speak, and have some fun with grand rounds!

Edward C. Chao, DO, is a Fellow at the University of California, San Diego Medical Center in the Division of Endocrinology and Metabolism and is a member of the Endocrine Today Fellows Advisory Board.