Speaker info | Big Sick 2022

Information for speakers at the Big Sick conference in Zermatt Feb 2022


We meet in Zermatt quite soon and we imagine you are hard at work on your talk.

We want to help you succeed.

We have seen even seasoned speakers fail to achieve full impact due to easily correctable patterns of how-things-are-usually-done. Usual culprits are heavy slides with too much content.

We therefore decided to offer these insights. Use what you want.


  • public speaking is like theatre. The spoken word drives the plot
  • visuals in the form of slides will impede or outright kill your presentation if used without focus and intent
  • rehearse your presentation. For your own sake and that of your audience

These 3 insights motivate 3 domains that you need to focus on

  • The Story (p1)
  • The Supportive Media (p2)
  • The Delivery (p3)

All three are important and combine to form your talk. Visit Ross Fisher’s site for more on this “p cubed” mental model. However, the middle one deserves special mention.


Ref: Salim Rezaie

When we feel the need to even do this introduction to presentation theory, in large part it comes down to the common misuse of supportive media, ie slides. So a few words about that.

The visuals of Powerpoint and Keynote have taken over as the main product of many presentations.

We have all suffered through talks where the speaker read out slides like a manuscript or used impossible-to-read text, bullet points and detailed tables, graphs and front pages from articles.

Used this way, slides effectively work AGAINST your presentation. We often refer to it as being “killed by powerpoint”.

It’s an fundamental mistake to put all of the information of your talk up on the screen and use it as a script.

This was never the intention. It’s called a talk for a reason. Your talk is NOT your slides.

Psychology research clearly shows why texty slides are problematic: We can read. Or listen. Not both.

The science is, if you put more than 7 words on a slide most people in the audience will drown out your voice as they hear themselves read that text. You will lose them.

When speaker and slides compete to tell the story

Let your spoken word and the power of your story carry the talk. Everything else is just supportive.

Picture yourself doing your talk sitting around a camp fire. If you have your message, story and delivery in place, that talk will have no distractions and be so much more engaging than anything you could do with slides. Slides of course are not useless, but they are at most a prop in your performance. It’s your name on the ticket, not Microsoft.

Ich bin ein Berliner. Keine slides

I have a dream. No slides


Ref: Duncan C, flickr

In the end you’ll be on stage at Big Sick to make a dent in the world, however big or small. You need to identify what change you seek, your mission so to speak. It may seem grandiose to think of, but you have to know why you’re giving the talk. Somehow, in some way, you being there should change the world for the better.

You will have heard about the concept ”elevator pitch”. The idea is to be able to express in 30 seconds (the elevator ride) why people should want to hear your talk. To do that you need a clear picture of why it matters. If you can’t do that chances are your thinking isn’t sufficiently destilled yet. Before the What comes the Why, or as Ross Fisher would put it, you need to identify not the What, but the So What.


If you take only one thing from this post about preparing a talk let it be this: Do NOT start developing your thinking on the computer. It will distract you and stifle your creativity. It will lure you into putting your talk on screen like a script. The urge will likely be strong as it’s what most of us have been used to. But don’t. It really makes a huge difference.

Go analog. Use paper and pen. Work with your ideas physically. Jot down ideas, push them around. Take a walk. Talk to a colleague. Sleep on it, let it marinate, leave and come back. This is a much better way to set free your creativity and develop the core message and storyline.


Having identified your mission you need to consider how to achieve it.

Any talk is targeted at an audience and they will be the vehicle for your change, so thinking about them is key

Ask yourself

  • who are they?
  • what do you want them to change?

Making people change is not easy. You need to understand the starting position of your audience. Engage them there. Guide them to see the problem through their eyes. Make them care, you must.

Ref: Montrief tweetorial


To do that, you need a story that grips and holds on. Classical rhetorical virtues going back to Aristotle are still in fashion. Concepts like story arcs, performance, and appeal to pathos, logos and ethos.

Again, public speaking is a form of theatre.

There is a common misconception that entertainment and professionalism are at odds. In reality, it is the other way around. If you want to effect change, and why else bother?, you need to be able to entertain. Entertainment is the art of engagement, not the enemy of science.

Now, there are many ways to skin a cat, and your presentation will be all the better for reflecting and channelling your personality, but the successful talk often honours established ideas of start-middle-finish.


Think about a strong start. You need a “hook” to reel in people and get them invested from the get-go.

Something relatable, either a personal experience of your own, a case, or a dilemma that you imagine the audience will be able to see themselves in. Vulnerability and authenticity can be very important tools. There is no cheating in evoking emotions – quite the contrary, there needs to be something on the line.

Try to identify a conflict that needs to be resolved. It’s like pulling back the string of a bow. Your talk needs that tension to propel it forward. That secures buy-in and attentiveness to your arguments as you and the audience together move towards a resolution that will contain the change your want them to enact.


Ref: Same as above

The middle should investigate the details of the defining issue and its possible solutions. You would do well to consider a worthy opponent’s counter arguments and address them.

Be cognizant of these different sub plots of your talk and what each of them achieves. Build a mental map of them. It can be helpful to put them on paper as a physical storyboard which will also help you when you rehearse your delivery.

Surprises can work effectively as you develop the plot, maybe things aren’t what they seemed to be? However, as listeners we find it easier to follow a talk where the overall structure of the presentation is not surprising. It can be useful to deploy a clear structure and signpost different parts to be covered, circling back and doing recaps as you move along. Good story telling often employs repetition. There is a reason 3 and 7 feature so prominently in fairy tales.

Your time slot is deliberately not more than about 20 minutes because we know it is almost impossible to keep people engaged longer than that. Even then, it is often a valuable addition to your talk to specifically activate the audience, by for instance putting up a vote or asking them to discuss a dilemma for a moment with the person next to them.


Overall, having presented the driving dilemma and investigated its details and possible solutions you’ll be building to a central point in your talk where you resolve the conflict and the core message lands. Make sure this can not be missed. It should be as clear as day and contain one or at most a few actionable take homes. You’ll hopefully have convinced the audience of the necessity of the change you suggest and made them own that idea.


When your talk is fully developed, you should be able to give it with little or no added elements. This is when you start looking at things that will help you enforce the performance.

Think of it like ‘props’ in your theatre.

Physical objects can work, sometimes surprisingly well. Music and sounds are also very evocative elements.

But oftentimes we rely on visuals and, and as we have a projector, powerpoint or keynote is a logical tool to employ so a few words about that.

How to better use slides

Illustrate, don’t annotate

Remember, the audience needs to hear your arguments, not read them. Your slides should support the story, not contain it. They are neither your script nor your handout.

A recurring problem is using too much information. We often know it. Who in all earnest has not apologised for a slide that was a bit “busy”?

Text is especially problematic, as that will leave the audience reading to themselves, but cut-outs with complicated tables or graphs are also hard to decipher quickly. Realise that processing these takes a chunk of the bandwidth of your audience and you risk losing their attention.

We don’t need every p-value, subgroup analysis and forrest plot. You are on stage precisely because we know you’re an expert in your field. We are interested in your take on the data, your summation of it, the meaning of it. By all means argue your case, but don’t give us every little detail.

Start with blank slides, preferably with a black background as there’s little reason to light up the room with a lot of white. Avoid templates from work – they come off drab and add nothing to your talk. We know where you work.

Cut down. Don’t compete with your slides. There doesn’t have to be something on the screen all the time.

Even Less being Even More. Best slide in the world?

Consider intermittent empty black slides to pull the focus and connection back to you.


Pictures, they say, convey more than a 1000 words. Consider using them. They are great at setting a mood and can illustrate in a second what’s at stake. Pictures with a few words in big font work potentially even better. You’ll find examples on this page.

Use pictures of high resolution unless you have a specific creative idea going low res. In general fill the frame for maximum immersion. Crop and center as needed to highlight what’s most important.

You can find good free images from unsplashflickr,compixabay.compexels.com, and this “openverse” search engine. You will also likely have access to paid stock image libraries through your workplace that will be OK to use for education.

A word of caution: If you use google image search and filter for open access images you need to check with the actual source page as google often gets this wrong.

Videos can be an excellent addition to your talk, but make sure you download and embed them as you cannot expect online to work. Be mindful that videos from youtube and vimeo in general have copyrights and are not necessarily OK to be used in your presentation.

Sometimes using images, audio and video of your own making will be more personal than “stock” footage that you try to make fit your message.

What about the data?

Some will argue it can’t all be pretty pictures and that this approach dumbs it down, that we need to discuss the data. Of course we do. It’s a bit of a straw man. The above just advocates, based on good science, that you engineer your slides according to basic human constraints of perception. We have all trained extensively in CRM principles and this is just applying that same human factors appreciation to the speaker-audience dynamic.

Of course you should do a deep dive on those amazing details in the data when that propels the story. Share your enthusiasm, geek out, but don’t have us choose between following your talk and reading the slides.

Make sure you design your media to support your points, data slides included. They should be understood in seconds. Work on their signal to noise ratio. It’s not Where’s Wally (or Waldo). If you include important text, allow people time to read and pause talking while they do.

Fundamentally, there is only so much you can convey in 20 minutes. The reason you are there is you have spent thousands of hours condensing the data for us. That data can’t all go on the slides and is better left referenced in a handout, the form of which these days might be along your talk online. That will allow people to dig deeper at their leisure.


Jenise Jans, unsplash

Rehearse your talk.

Every talk will be markedly better for it. Don’t underestimate what this will do for your audience, but equally important, for how you feel on stage.

Again, public speaking is like theatre. The Big Sick stage has a backdrop, lights, AV, a set programme with intermissions and a discerning audience of a 100 people, plus online.



Don’t just sit and sift through your slideset trying to memorize it. Only when you stand up and actually say out every word and advance every slide do you experience where your story and delivery works and where it can be optimised.

The more times you do so, the better. Scott Weingart, educational master of EMCrit fame recommends 7 levels of rehearsal. While that is beyond most of us, it is true that every take will find details to correct. A superfluous slide. A timing that needs to change. A flawed logic. Kill your darlings.

Use the mindmap of stages of your talk, post it notes can help, so you know how far you’ve come and where you are headed.

Know your slides and transitions by heart. Work to come in at significantly under your allotted time. No one ever complained about a talk being too short. That way you have room to breathe and enjoy yourself. Which you will if you have the confidence from rehearsing well.


Your delivery of the talk is not just remembering it all and having slick slides. You need to act it. Again, public speaking is theatre.

Rhetorical studies tell us body language and voice is more important than any of the content you share in persuading an audience.

Rehearsal will help tremendously with this. It will also take your nerves off.

Think about what energy you bring. Your body language. The tone of your voice. Your pitch, the volume. The use of your arms. Your breathing. Where do you look? Do you have vocal tics? Do you smile? Do you pause?

Don’t overload the audience with a non-stop monotone stream of info. Experiment with pauses and shifts in tempo and volume. Leave points some time to land. People will relax and listen more if they have some time to digest and reflect. Try to be authentic and connect with the audience. A joke can go a long way. Relax and enjoy being on stage. Nobody expects perfect and we quite enjoy someone human, flaws and all. Remember, the audience wants you to succeed.


As you rehearse, it is a really valuable eye opener to set your mobile phone to record you. It might make you cringe, but you will learn a lot and be able to address your performance imperfections in a targeted way.

When you are ready, consider letting family, friends or colleagues give you feedback. Choose people you trust. They will notice things you never could and give you invaluable feedback.


It might sound like there’s one perfect and unattainable way to do things. There isn’t.

In some ways it’s the other way round. We want to move away from the one-way-it-has-always-been-done which objectively has not worked, and empower you to try your own way. We put a high price on variation and geekiness. Use your imagination and above all, have som fun with it.

I remain open for sparring about anything related to your talk. Reach out to me on twitter or email and if you haven’t yet consider signing up for the delegate/speaker BigSick FB group.

Wanna see how deep the rabbit hole goes?

If you want more on presentation and learning theory I suggest these resources as a start.

I’ve shamelessly used some of their material above.

Ross Fisher

Ross is a paediatric surgeon in Sheffield on his day job, but more widely known for his great passion for helping the field of medicine improve the yield of presentations, one keynote and one workshop at a time. This has taken him round the world including to our shores and he is a major inspiration. His website is full of excellent posts. I can specifically recommend you start with How to do a presentation and this case study of him preparing for a talk of his own.

Ross recently delivered two webinars for our local Scandinavian anaesthesia society which have a homy, intimate feel to them. If you get a chance to go to a workshop with him, do so.

Garr Reynolds

Presentation sensei and author of Presentation Zen, a seminal text that set off Ross on his path.

He also has a great website with tons of good stuff. Worth a follow on twitter.

Better Presentations – Kate Jurd

Kate Jurd is an educationalist from the University of Queensland.

She is behind this very well presented open access masterclass on improving presentations that goes in much more details with everything than I could. It covers the science quite well too. Great one stop resource.

Powerpoint and Meth – Scott Weingart

This post nicely illustrates the work behind the success of the man and his EMCrit site. That stuff doesn’t happen at random. As of recent subscribers only.

Fixing a slideset – case study

Ass Prof Franz Babl handed in his usual academic slideset for a pediatric conference and courageously allowed presentation geek Gracie Leo to work with him on a transforming it into a modern version.

Very illustrative on how to successfully convert dense data slides.

Find it on Don’t forget the bubbles. More on presentations from Gracie here.

Getting feedback on your performance

Reuben Strayer, NYC EM physician and frequent speaker, had the guts to get professional feedback from an acting coach on a very well rehearsed talk at SMACCDub. Lots of insights from another profession.

Tim Montrief

While revisiting this topic I happened on this tweetorial with 10 tips for better presentations which I found excellent and to the point. If you’re the twitter kind you can find more convo on the topic of presentations at #presentationskills and #htdap (how to do a presentation).

PIXAR in a box

If you are curious about how some of the brightest minds in the creative industry craft a compelling story and deliver it I recommend this series from PIXAR, now hosted on KhanAcademy. It is quite clever and engaging (you’d hope so, case in point). Although the scope and tools extend well beyond doing a talk there are some principles of story telling here that are very applicable.

Scandinavian paediatric anaesthetist / intensivist.
Digital MedEd
Co-founder scanFOAM.org
Co-organiser CphCC & TBS (aka The Big Sick)
Medical lead REPEL (resilience in pediatric emergency life support)
Web dev SSAI.info

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