Dr. David Yousem Interviewed by Dr. Vivek Yedavalli — Part 2

David Yousem, MD, MBA is a world renowned neuroradiologist who served as the Past President of ASNR in 2007-08. He is currently a Professor of Radiology at the Johns Hopkins University School of Medicine. Dr. Yousem is a prolific researcher, clinical educator, and guest speaker. One of Dr. Yousem’s noted accomplishments is receiving the 2018 RSNA Outstanding Educator Award in part for his sponsored 30-part online course on the Business of Medicine, which is often used to fulfill the business of radiology ACGME curriculum requirement in radiology residency training programs. I recently interviewed Dr. Yousem on his advice for junior faculty on how to improve when presenting. Many thanks to Dr. Yousem for taking the time and sharing his wisdom.

What are your tips for making and delivering effective presentations? 

First and foremost, start and stop on time! This is possibly the only thing you can count on when assessing your talk. Attendees will tell you they like or hate your lecture but the one thing you should always do is be respectful of their time and the time of the next speaker. If you have to err, err on stopping early. People are always grateful if you end early.

It is also incredibly important to be adaptable in creating and performing your presentation. Practice makes perfect. Do your talk in front of your spouse or other family members. Ask their feedback. “Where did I lose you?”  You need to keep the audience engaged with the material and honing your talk to keep people’s attention is imperative. Initially when I was giving these types of talks, they were 60-minute didactic sessions. Be interactive. Good luck trying to hold an audience’s attention for that long in the mobile phone age without some sort of interpersonal approach. I was one of the first people in the 1980’s to purchase the “Option Finder Electronic Polling System” and I used to drag 50 button boxes and an antennae to my talks because I recognized that people wanted to participate in the learning. At larger meetings, I did  my own polling with button boxes until the RSNA and ASNR adopted the audience response systems (during my year as ASNR Program Chairman in 2006), but with trainee lectures, I used it liberally, especially with case-based reviews.  Now I often use Nearpod.com with attendees’ cell phones as the module.

Adapt. If you are presenting internationally, know the culture and audience! In some countries, there is an immense respect for authority and seniority where sometimes audience members won’t even ask questions because they perceive it to be disrespectful. Here, in the US, we have a relative disregard for hierarchy where even a first-year resident has no qualms about challenging a seasoned expert speaker. Another aspect is to adjust your speech in countries where English is not their first language. Slow down and be prepared to not have many questions in public at the end of the talk because people may be shy to speak in a language not their own. Expect that, as soon as you step off the podium, those same people will want to talk to you one on one. Regardless of where you go and who you give your talk to, the one thing you can count on is starting and stopping on time!

What is your advice regarding speaking most effectively? 

It is really important to have some self-awareness about how you sound. Varying the tone of voice is essential. I had a former fellow who ended up being one of my most brilliant colleagues later on. He struggled with his monotone delivery when giving residents lectures even though his content was fantastic. I mentored him, “Use higher pitch and lower pitch and variations in volume to emphasize points in your talk and to keep the audience engaged”.

Repetition is key! Repetition is key!  One of my former mentees and now my role model, Laurie Loevner, really stands out to me as one of the most effective communicators. One of her timeless techniques in ensuring rapt attention from the audience is repeating the pivotal points in her talks. She often repeats verbatim the same sentence to add emphasis and drive home that point’s importance.

Silence is golden. You may notice that when a speaker suddenly pauses in their talk, people in the audience stop looking at their phones or laptops and look up. (“What’s going on??”) Use this technique to emphasize key points and let them sink in for audience members. That’s one way of regaining their attention. Be silent. Or shout. Or clap.

Think global and act local. This is one technique that politicians frequently engage in to move their audiences. They tell a story about someone they met on the campaign trail. It brings a point home. For example, you can make a broad statement, such as MRI is more effective than CT in diagnosing a stroke, then back it up with a great illustrative case example where DWI showed a stroke that CT Perfusion did not…. to solidify your point.

What are some areas that you see Young Professionals struggle with when presenting at conferences and seminars? 

The most common struggle that I have seen is the ability to adjust when things go awry. You can see the panic that some younger, less seasoned individuals feel  when there are technical difficulties with the microphone or Zoom or the animation in their Powerpoint presentation itself. Show poise,. Show equanimity. Proceed ahead.

Another thing, I get offended when speakers apologize for errors or poor quality in their slides. Do your due diligence in making your presentation worthy of its audience! Scrutinize your presentation with a critical eye for things like the font size being too small and the slide being too dark….and then fix it or replace it. Honor your audience. Don’t accept a low quality example.

Know your material inside and out. The best speakers know their material so well that they can give the talk without the slides to prompt them (see disasters above). One of my most respected role models was Dr. Peter Som, the Master Head and Neck Radiologist from Mount Sinai. He has since passed but is of blessed memory. He would lecture without text slides, just image slides for his head and neck talks and was able to rattle off the statistics and associations of the pathology without hesitation. He just knew the literature THAT well. Impressive. That is how you provide knowledge above and beyond the slide. You HAD to listen to him to learn; it wasn’t on word slides. It was in his brain!.

Do NOT read off your slides. I never put full sentences on my slides that the audience can read equally well as me. There is no added value to the speaker who just reads off his/her word slides in that scenario. Think Peter Som!  You are there to provide your expertise beyond the slide. Give the audience reasons why it is necessary for them to be engaged when YOU present your talk.

Do you have recommendations on resources to learn to speak more effectively? 

Watch a presentation of yours and critique yourself. Do it in front of your spouse or other family members. Get their feedback. Be cognizant of how you look when speaking. I realized, for example, that audience members responded more favorably to my material when I smiled more. So I smile more. Be happy on stage.

At Hopkins, we have a number of resources and courses that help you including a course entitled “Speak Like a Pro” where the instructors tape you and critique you.. There are also great independent organizations like Toastmasters International that help individuals gain confidence with public speaking.

With such practice you can avoid placeholders like “um”, “uh”, “you know”, “like”, and so on. If you want to eliminate or at least minimize these, just slow down and think about what you wish to say and suppress these filler words. Pause as needed. Silence is good. Eliminating these filler words and speaking slowly and clearly will make you sound more authoritative.