Neonatal resuscitation at DFTB17

This talk was recorded live at the neonatal session at DFTB17 in Brisbane. Watch out for more talks from our inaugural conference in the coming weeks.

For most of us resuscitating a small baby, lighter than a frozen chicken, can fill us with dread. We’ve tried to make it a little easier with some great posts from Henry Goldstein but sometimes you need to hear it as well as read it. In this talk A/Prof Helen Liley, a consultant neonatologist at the Mater Mothers hospital, takes some of the knowledge gained from being a key figure in the ILCOR’s neonatal task force and translates it into practical advice.

You can listen to this talk as you walk to work on any device that supports podcasts.

And luckily for you all, Claire Chandler has made so,me notes for you…

You can watch her entire talk below…

 

 

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Behind the Scenes – PREDICTing the Future

Researchers are delivering increasingly well designed studies, and validating them in multiple populations, in order to provide the evidence needed to improve care. Furthermore, increasing use of national, and international, research collaborations has improved our ability to test hypotheses and deliver interventions at an unprecedented scale. However while good practice guidance exists for the design, methodology and delivery stages of this research, there is often little practical guidance given to researchers on how best to present their research findings. While dissemination methodologies are widespread (creation of newsletters, embedding in national guidance etc.) a large amount of knowledge translation occurs at conferences between speakers and delegates. While grant awarding bodies and peer reviewers often cast an (objectively) critical eye over the delivery phase of studies the ‘conference’ dissemination phase is less well regulated. To be blunt, often people are afraid to feedback to the experienced researcher that their presentation of their research findings wasn’t very good.

At the recent Don’t Forget the Bubbles conference a unique set of events occurred which allowed, prior to the conference, feedback to be given on slide design to the presenter but also there be an objective ‘reviewer’ in the audience who had seen the presenter’s previous presentation on this topic and was able to appreciate the difference the slide design made. This blog owes much to the good nature of Associate Professor Franz Babl who not only allowed Grace Leo to revise his slides prior to presentation but has allowed his original slides to be published openly.

Below are a selection, but not all, of the slides in a before and after format used in Franz’s talk on “Head Injury Rules in Children”. The aim is to demonstrate how simple changes can produce greater impact without any loss of content. While Knowledge Translation in this case can only be assumed, and not demonstrated, feedback both quantitatively and qualitatively post lecture was highly suggestive the new slide deck was an improved version. 

 

Slide 1: The Title Slide

  • Inclusion of picture in background: This was done to add interest and chose to use a relevant picture which will come up in future slides. The picture was edited to reduce saturation in order to create greater contrast with the talk title. This highlights the talk title as the key component of the slide.
  • Removal of Franz’s title: Titles are important in documentation- however as a conference speaker introduced by a chair and as himself –  Franz already has established credibility.  There was also duplication in the original slide in that affiliated groups were featured both in the subtitles and logos. To simplify things Grace moved the logos to become more prominent and introduced a rectangular bar in the background to create clean lines in the revised slide.
  • Movement of the Predict logo from the top right corner into the white line: This helps simplify the slide and reduce distraction from the main point of this first slide – the title.
  • Additional Note on ‘Theme’: Throughout the entire presentation the default ‘theme’ of the slide was removed. This was done as unless there is an institutional requirement – institute logos can add to the clutter later slides.

 

Slide 2: CT or no CT – Case

  • Conversion of the case slide from one slide into three: This helps to “reveal” information in stages. This makes it easier for the audience to digest the story. It also emphasises the key question at the end (whether in cases such as this – children with head injury require a CT). Grace altered the question from “Does he need a CT scan…” to “Would you CT”. The use of direct questioning was to better engage the audience by asking them to think about what they might actively choose themselves.

 

Slide 3: CT or no CT – facts on head injuries

  • Removal of text into the notes section: Although the text was useful information, it is also the same information Franz would tell the audience himself in his talk. Furthermore lines such as “CT current gold standard” – is something that the audience is likely to be familiar with and is background information.
  • Enlarged graph to full screen: Graph enlargement was important because the graph was difficult to read. By extending it to fill the screen, it can more clearly demonstrate it’s point: attributable risk of death from cancer related to the age at time of CT.

 

Slide 4: What can we do beyond gestalt?

  • Removal of the second line of text: This provides greater opportunity for the speaker and the audience to discuss clinical decision rules without having it explicitly written.
  • Introduction of a picture of a person at a crossroads/two paths: The image was to add interest to the slide and is also relevant in terms of decision making as there are two baths on either side of the central figure.

 

Slide 5: Chalice trial

  • Removal of the detailed guidelines for CHALICE: This was a tricky decision as the CHALICE guidelines are extensive. Discussion with Franz resolved the concern as the purpose of the slide was not to go into the details of the chalice guidelines but to provide a brief overview. This purpose enabled the simplification of CHALICE down to its core – that it is made up of criteria taken from history, examination and mechanism.
  • Removal of screen shot of the title: This is a popular image presentations delivered on the research circuit. Many people use this add a sense of credibility “See! This paper!” and recognise the contributors. However the wording is so small usually screenshots like this are very difficult to read. When asking about the true purpose of screenshots like this – it is probably to enable the audience to locate the paper for themselves at a later time. Therefore – instead of providing everything, we should ask – what is the necessary amount of information required? It turns out when you enter CHALICE Dunning et al 2005 into Google – it will give you the paper as the second hit. Therefore – that itself is sufficient to enable the audience to be able to find the paper and check it for themselves. Keep in mind that by introducing the slide with the journal article for the CHALICE trial in the slide before also helps the audience to locate the relevant paper at a later date.

 

Slide 6: PECARN trial

  • Removal of journal screenshot: See commentary on slide 5.
  • Enlargement of the PECARN decision tool: Through enlarging and cropping the decision rule – it enabled the guide to be easier to see. The decision to keep much more details about the PECARN trial was made as the PECARN is discussed in greater detail later in the talk.

 

Slide 8: APHIRST further discussion

  • Removal of journal title screenshot: Reduces text and highlights that the focus is the findings of the APHIRST trial.
  • Removal of screen shot of journal table: If your audience believes and trusts your authority – then instead of showing the original printscreen of the data – it may be more helpful to focus on the point – which is the comparison in terms of sensitivity, specificity and the numbers of children missed in each trial.
  • On the absence of table lines: As there were not many lines in the table Grace elected to make the table lines mostly invisible. Through increasing the spacing between the sensitivity/specificity results and the “missed” column – it helps the audience more easily identify relevant numbers.
  • The use of the ‘blackboard’ backdrop: See slide 5 commentary

 

Slide 9: Great – let’s use PECARN!

  • Original Slide was split into two halves: The slide was divided into the initial impression and then the “reveal” (which was taken from information from the following slide). As the original slide is a transition slide and had few words – Grace was able to make the text more prominent by placing it centrally and in a larger font.
  • Background image: This image was chosen to reflect the mood of the remarks with the imagery of illumination/ a large light  as symbolic of a new idea or revelation.

 

Slide 13: Implementation of PECARN

  • Reduced word count: This helps reduce the amount of words the audience is asked to read/consider. This allows the audience to focus on what Franz has to say.
  • Reformatted information into two columns: This created a more obvious comparison between the study in America vs Italy
  • Inclusion of map icons: Given the international nature of the research, Grace used an icon of each country. Part of the factors influencing this choice was America and Italy are easily identifiable countries as well. The visual input of the picture of the countries could also help audience retention in remembering that there was a comparison between American and Italian studies.

 

Slide 19: Are we too good for rules?

  • Increase in font size, inclusion of background image: See comments on  slide 4. This question forms part of a theme of questions to be answered.

 

Slide 23: Thank you

  • Change to picture: Thank you is a common end slide. There are quite a lot of pictures online that can be used for this purpose.
  • Getting rid of this slide: There are also different alternatives to the traditional ‘thank you’ slide that could have been used 1) a question slide 2) ending with a strong conclusion point 3) quote 4) details for how to contact the speaker 5) a call to action 6) a ‘teaser’ for what might come next or 7) a ‘full circle’ slide– for example a picture of the 14yo boy from the opening case – back at home/school/playing sport.

 

Conclusion

Medicine is full of overlaps with other fields. We can learn repetitive skill training from elite athletes, checklists from aeronautics and learn to reason and critique cases like lawyers. By emulating aspects of different fields we can find skills and ways of thinking which may improve are own practices. Therefore we can also communicate effectively like good teachers or marketers. The latter is particularly true when presenting at conferences. An effective presentation with helpful slides can help to make your message clearer. This enables your audience to think and engage with the material better and improve the translation of knowledge. However there is very little training in medical school on how to present well and consider the function of your story. There is a growing movement in recognising the importance of this – seen in growing resources online, presentation skills workshops at conferences like SMACC and DFTB17’s own experimentation by introducing a speaker-liaison role. 

It is very easy to get stuck in the same way of doing something. If you aren’t challenged over your presentation approach – it can be difficult to consider how it could be improved. We hope this post will encourage anyone presenting at a conference, whether a senior academic or a first year student, to review their slide set and consider how they may improve the transfer of knowledge to their audience.

Resources

This post was written by Damian Roland and Grace Leo with the kind permission of A/Prof Franz Babl, whose slides will never be the same again.

PREDICTing the future – Head Injuries – Franz Babl

This talk was recorded live at DFTB17 in Brisbane and marks a great collaboration between the PREDICT (Paediatric Research  in Emergency Departments International Collaborative) group and DFTB.

The PREDICT network was set up in 2004 to bring together multidisciplinary teams to undertake multicentre paediatric emergency medicine research. Franz Babl is Director of Research at the Royal Children’s Hospital in Melbourne and is the founding chair of PREDICT. In this talk he takes us through some of the finer points of the APHIRST project.

Babl FE, Borland ML, Phillips N, Kochar A, Dalton S, McCaskill M, Cheek JA, Gilhotra Y, Furyk J, Neutze J, Lyttle MD. Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study. The Lancet. 2017 Apr 11.

You can listen to this talk as you walk to work on any device that supports podcasts.

Here is what one of our resident doodlers, Grace Leo, made of the talk.

 

And here is the full talk…

 

 

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed. Please embrace the spirit of FOAMed and spread the word.

 

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