Authenticity, truthfulness, credibility—virtues that are considered fundamental not only in medicine or teaching but in every person of good. The public in general and our students in particular take it for granted (or, at least, wish to believe) that the information and knowledge we present to them are authentic and true. Our credibility as knowledge deliverers will influence the learning of our students: studies show that people accept the information provided by what they consider credible sources to a greater degree than when it is obtained from sources who they do not consider trustworthy (1,2).
Many factors determine the credibility of a medical speaker: his/her reputation or professional position, how he/she holds views about a topic, personal conflicts of interest, and other heuristics (simple rules about categories of people considered to be credible) (3-6). Unfortunately, when we deliver knowledge or provide information through our presentations we do not always “sound” authentic or credible. Slides read verbatim, paragraphs tediously recited, statements lacking citations, non-referenced images and even a monotonous or overacted speech undermine our credibility. Regardless of the excellence of the content of a presentation, if it is not properly presented, the chances of being accepted as valid by those listening to it will be remarkably lower.
In her book “Presenting with Credibility”, presentation expert Bruna Martinuzzi (7) defines “credibility” as the quality of being credible or trustworthy. It is not a virtue that we can claim for ourselves: it is our audience who will attribute it to us. Martinuzzi allocates the credibility of a speaker to four essential dimensions: expertise and competence, authenticity, personal presence, and dynamism.
The purpose of this perspective is to suggest some recommendations to enhance speakers’ credibility as communicators and presenters in each of these four domains.
The four domains of a credible presenter
- Expertise and competence: these are the basis of our credibility and the reason why we are presenting the subject in question. Our audience assumes that we know the subject, that we are updated, even that we are leaders or experts in the topic. To demonstrate our expertise and competence in the subject with credibility some recommendations to keep in mind are:
- Know your audience (8): few situations are more frustrating for an audience than perceiving that the speaker is disconnected from their expectations. The audience will be disappointed if content is presented at a too high or too basic level for their knowledge of the subject, either because they will not understand what the presenter is talking about, they will not find the topic relevant, or they will get bored. Relevance forms the basis of adult learning theories and should be kept in mind when designing any educational activity: adults become ready and are motivated to learn things they need to know and be able to do in order to cope effectively with their real-life situations, or when they perceive that learning will help them perform tasks or deal with problems that they confront in their life situations. Try to get as much information as possible about your audience in advance, and prepare the learning objectives of your presentation according to their level of knowledge and interests (9).
- Organize your presentation: organized lectures are easier to understand and follow; meticulous lecturers show they care about their audience (10). A classic structure for presentations is as a three-act play, consisting of an introduction, the body, and the conclusion (11,12). The introduction is a crucial moment to gain the student’s attention. This could be achieved by a number of techniques, such as the presentation of a clinical case or anecdote, open-ended questions to activate the learners’ previous knowledge about the topic (and also to ascertain what students know), or a small group discussion or brainstorming related to the issue that will be presented (these techniques may also be used at intervals during the lecture in order to regain the audience attention and make the lecture more active). The introduction should also include a few learning objectives, which will let students know what they should be able to do or know at the end of the lecture. Learning objectives should be specific, realistic and attainable thanks to the lecture, so the most appropriate objectives for lectures stay usually on the cognitive or attitudinal domain (i.e., lectures are not an appropriate strategy for teaching skills if not complemented by a hands-on experience). It is also fundamental at this time to articulate the importance of the topic for the audience, which also serves as a prompt for attention, motivation and understanding of the topic: how the topic will be useful and practical for them at work or in real life. Finally, an outline of the content to be addressed should be presented at the beginning of the presentation delineating the main topics or aspects that will be covered during the lecture; should the lecture be long it is useful to recur the outline at appropriate moments to remind the audience of what has been covered and what still remains. The body of the lecture covers the content itself, and suggestions for its presentation will be developed in the following paragraphs. The third part of this structure is the conclusion, which is also of utmost importance, as people tend to remember better the last moments of a presentation than the early ones. Conclusions should be meaningful and include a helpful message to take home. It can take the form of a summary, a synoptic table, a nomogram, or a review of the most important concepts covered during the lecture. Irrelevant, superficial or disconnected from the content conclusions should be avoided.
- Introduce yourself to your audience: tell them your qualifications and why your experience and education are relevant to the topic you will be presenting. This will make your audience more confident and help establish your credibility and authenticity as an expert in the subject (12).
- Hold your arguments with high quality evidence, and reference it: sometimes speakers present knowledge that was produced by others; it is therefore important in these cases that the evidence supporting the speaker’s statements is up-to-date and of the best quality possible. Do not forget to include the reference in the slide, but be careful: long citations in tiny print will not be useful to the audience, even when they show that you “did your homework”. It is usually enough to include the first author, journal, year, volume and pages of the publication, in a legible font size; your audience will be able to search for the article with this information.
- Avoid information overload (13): your role is not to dwell on all existing knowledge about the subject (probably you will not have the time to do so anyway). Your main goal will be to introduce a difficult topic, to deal with a controversial point, to provide up-to-date information in an advancing area of knowledge, or to describe your personal experience related to the topic (14,15). “The good, if brief, twice good” says the Spanish proverb, and this is also true for presentations. Organize your content in “chunks” (small pieces of meaningful information) to allow your audience process the content in their working memory. Working memory is where new information is processed before being apprehended, and has limited capacity; avoiding your audience overload of working memory will allow them learn more effectively (16-18).
- Be prepared to answer questions: if the content you present is interesting and motivating your speech will probably generate questions from the audience. Be prepared to answer them truthfully but also with solid knowledge on the subject. Think ahead about controversial or difficult points and look for supporting scientific research to answer them. Be honest: if you do not know the answer, admit it and help your audience find possible sources to find it.
- Authenticity: authenticity is related to the perception of those who are listening to us that we are telling the truth and that we are sincere in what we do and in what we say. Communication expert Nick Morgan lists four powerful aims to keep in mind for giving an authentic presentation: to be open with your audience, to connect with them, to be passionate about your topic, and to listen (19).
Other tips to help you prove your authenticity:
- Be an accessible speaker: in her book Evidence-based Training Methods, instructional psychologist Ruth Colvin Clark points out that one of the hallmarks of an outstanding presentation is that it leverages social presence, i.e., communication between the speaker and the audience and among members of the audience (13). The speaker accomplishes this by being accessible instead of “standing onto a pedestal”, using a colloquial tone and language, free of inflated or artificial words, engaging the audience experience and knowledge through meaningful questions (20,21).
- Be honest: while it is important that your presentation is based on solid and up-to-date evidence, it is equally necessary for you to expose your own personal opinions and experiences about the topic: how you put it into practice, how it worked for you, what difficulties you encountered, how you sorted those challenges out.
- Personal presence: this is usually the first thing that people notice when we are ready to give a presentation: the calmness in our demeanor and our appearance, as well as our flexibility and adaptability to the needs of our audience. Some suggestions to enhance our personal presence:
- Rehearse your presentation (more the more inexperienced you are or newer the presentation): this fundamental action will allow you to not only calculate the time your presentation takes but also to hear how you sound. You may even record yourself or present in front of a mirror. This will put you into a “simulation” situation of what your actual presentation will be. You can correct phrases, clarify concepts, and familiarize you with your slides to avoid being surprised by their content.
- Get organized as early as possible: get there early, try the computer, the projection and sound system, see the layout of the room before people enter the room if possible. Carry your presentation in various formats and storage media: upload it to the web, take it on a USB stick and even on your phone; this will avoid big frustration for those occasional times when nothing works. The earlier you finish to prepare, the more leisure time you will have to relax, use the restroom, drink water and talk informally with the early birds in your audience, all of which will help you relax.
- Enjoy the moment: you know the topic, you prepared it properly, you know how to present it, and you are generous and brave enough to share it and teach it to others. Enjoy this unique act of teaching through your speech, your words, your gestures, your passion. Do not hide behind the podium, and do not overact: speak with confidence, talk to your audience with knowledge and also with honesty, help them discover the interesting and useful aspects that you discovered in the subject (22).
- Dynamism: this is the energy that we put in action when presenting: how we talk, move, gesticulate and interact with the audience. It is the demonstration of your passion to teach and to engage with the audience. Some suggestions to increase the dynamism of the presentations:
- Engage your audience: try to make your presentation a dialogue with the audience at all times: maintain eye contact with various sectors of the audience, address the audience by alternating areas, but do not leave any zone aside; include them all (23).
- Do not read your slides: few situations are as boring as sitting down to listen to a lecturer who reads all of his/her slides with endless lines of text. That is not the speaker’s role: that is what books are for. The presenter’s role is to elaborate the content through his/her verbal message; the role of the slides is to help the speaker to transmit the message in a clearer, more organized and effective way (hence their name of “visual aids”) (14). Ideally you should be able to give your message without using the slides.
- Explain the data (12): what could be the purpose of a slide with a cut and pasted table from a scientific publication, overflowing with data in an illegible font size, shown by the lecturer without further explanation only to go immediately to the next slide? If you must present data, do it as clearly as possible. Use visual graphics (pies, bar charts) to show differences between numbers. Simplify and keep the data you need to show to a minimum, and verbally explain what it is important for the audience to focus.
- Use pictures, graphics, and videos rather than text: Images are remembered more easily than words, and are considered more accessible by students than written text (24). Instead of using bulleted text lists, replace texts with a picture, graphic or video, and explain the images with your words.
- Avoid distracting your audience: Studies show that the audience's attention and retention capacity (and therefore, learning) decreases when extraneous elements are used in presentations (irrelevant images, excessive use of animations, music, etc.) (25). Keep your slides simple: the interest of the presentations must arise from the content, not from additional objects of entertainment (26).
- Ask questions to arouse curiosity and keep the attention of the audience: Creating cognitive dissonance (that is, realizing that there is something they do not know or about which they have a different conception) through questions will motivate them to try to find the answer in your speech. There are a variety of response methods you may try: automatic response systems (27,28) or small group discussions (buzz groups) are among the most frequently used. If this is not possible, you can simply pose a question even without waiting for a verbal response: the intention is to generate doubt in the mind of the listener.
- Encourage questions from the audience as well. Be kind, generous and honest with your answers.
“Credibility is the holy grail of presenters” (7). If we are experts in the content but are not able to present it adequately we have few possibilities that people pay attention to what we say, and disregard us as credible experts. Working through ways to improve in each of the four dimensions (our expertise and competence, authenticity, personal presence, and dynamism) will help us deliver the knowledge we have in a more interesting, dynamic, and passionate presentation.
Conflicts of Interest: The author has no conflicts of interest to declare.
- Hovland CI, Weiss W. The influence of source credibility on communication effectiveness. Public Opin Q 1951;15:635-50. [Crossref]
- Petty RE, Wegener DT, Fabrigar LR. Attitudes and attitude change. Annu Rev Psychol 1997;48:609-47. [Crossref] [PubMed]
- Fulton RB. The measurement of speaker credibility. J Commun 1970;20:270-9. [Crossref] [PubMed]
- McGarry J, Hendrick C. Communicator credibility and persuasion. Mem Cognit 1974;2:82-6. [Crossref] [PubMed]
- Meffert JJ. Key opinion leaders: where they come from and how that affects the drugs you prescribe. Dermatol Ther 2009;22:262-8. [Crossref] [PubMed]
- Walker MJ, Rogers WA. Reasonableness, Credibility, and Clinical Disagreement. AMA J Ethics 2017;19:176-82. [Crossref] [PubMed]
- Martinuzzi B. Presenting with credibility. Practical tools and techniques for effective presentations. San Francisco: Six Seconds Emotional Intelligence Press, 2012.
- Lupia A. Communicating science in politicized environments. Proc Natl Acad Sci U S A 2013;110 Suppl 3:14048-54. [Crossref] [PubMed]
- Cantillon P. Teaching large groups. BMJ 2003;326:437-40. [Crossref] [PubMed]
- Copeland HL, Longworth DL, Hewson MG, et al. Successful lecturing. A prospective study to validate attributes of the effective medical lecture. J Gen Intern Med 2000;15:366-71. [Crossref] [PubMed]
- Brown G, Manogue M. AMEE Medical Education Guide No. 22: Refreshing lecturing: A guide for lecturers. Med Teach 2001;23:231-44. [Crossref] [PubMed]
- Stahl SM, Davis RL. Best Practices in Medical Teaching. New York (NY): Cambridge University Press, 2011.
- Clark RC. Evidence-based Training Methods: A Guide for Training Professionals. Alexandria: The American Society for Training and Development, 2010:188.
- Harden RM, Laidlaw SL. Chapter 21: The lecture and teaching with large groups. Essential skills for a medical teacher. An introduction to teaching and learning in medicine. London: Elsevier, Churchill Livingstone, 2012.
- Newble D, Cannon R. Chapter 2: Teaching in large groups. A Handbook for Medical Teachers. 4th edition. Kluwer Academic Publishers, 2001.
- Clark R, Nguyen F, Sweller J. Efficiency in learning. Evidence-based Guidelines to Manage Cognitive Load. San Francisco (CA): Pfeiffer, 2006.
- Cook MP. Visual representations in Science education: The influence of prior knowledge and cognitive load theory on instructional design principles. Sci Educ 2006;90:1073-91. [Crossref]
- Smith RM. Conquering the content. A step-by-step guide to online course design. John Wiley & Sons, Inc., 2008:63-81.
- Morgan N. How to become and authentic speaker. Harv Bus Rev 2008;86:115-9. [PubMed]
- Ambrose SA, Bridges MW, DiPietro M, et al. Chapter 1: How does students’ prior knowledge affect their learning? How learning woks. Seven research-based principles for smart teaching. John Willey & Sons, Inc., 2010.
- Knowles MS, Holton RA 3rd, Swanson RA. The Adult Learner. 7th ed. Burlington (MA): Elsevier, 2011:189-94.
- Bliss M. Speaking for results: how to make presentations with confidence and credibility. Tenn Med 2009;102:35. [PubMed]
- Chaudhury SR. The Lecture. In: Buskist W, Groccia JE. editors. Evidence-Based Teaching. San Francisco (CA): Jossey-Bass, Wiley, 2011.
- Price L. Lecturers’ vs. students’ perceptions of the accessibility of instructional materials. Instructional Sci 2007;35:317-41. [Crossref]
- Mayer RE. Multimedia learning. 2nd edition. Cambridge University Press, 2009.
- Duarte N. slide:ology. The art and science of creating great presentations. Sebastopol (CA): O’Reilly, 2011.
- Mayer RE, Stull A, DeLeeuw K, et al. Clickers in the classroom: Fostering learning with questioning methods in large lecture classes. Contemp Educ Psychol 2009;34:51-7. [Crossref]
- Nelson C, Hartling L, Campbell S, et al. The effects of audience response systems on learning outcomes in health professions education. A BEME systematic review: BEME Guide No. 21. Med Teach 2012;34:e386-405. [Crossref] [PubMed]
Cite this article as: Palis AG. A fundamental (often neglected) lecture skill: presenting with credibility. Ann Eye Sci 2017;2:38.