PowerPoint: Visual Pearls and Pitfalls for Pros

Donna Magid M.D., M.Ed.

Gen Y is superb with computers and as a result, ironically, students may get too engaged in the endless bag of highly entertaining tricks on tap when designing a professional PowerPoint presentation. Unlike a e-card, awesome Website, Facebook page, or digital slide show of your last vacation, undue creativity can interfere with effective medical visual communication. You all sat through two years of Basic Science (not to mention college)—you are, at least subconsciously, already highly aware of when a slide is well composed and clearly presented, vs. poorly designed, too small, too bright, too hard to read or too crowded to ingest.

BACKGROUNDS: Color has value i.e. a darkness (shade, mixing in increasing black)/lightness (tint, mixing in increasing white) spectrum centered on the pure saturated full-intensity hue. Simple, uniform, and (from a radiologist’s viewpoint) dark backgrounds work best. Radiologists love the dark cobalt blues, black or dark charcoal, dark non-Kelly greens—pay attention in AM Conference to choices. In a darkened room, one wants all the light hitting the retina to come from the information, not the background. The conventional Hopkins standardized slide uses the undergraduate blue, which is too neutral/medium to allow good contrast between either dark or light words (the *medical* Hopkins blue is dark, just a bit brighter than navy!) and the suggested branded Hopkins slide also wastes space on the emblem and transverse line under it.. Light bright words (white, pale yellow), or radiographic images, against dark backgrounds are easier on the viewer over the course of your speech; dark radiographs followed by white-background word slides would keep viewers’ pupils dilating and contracting and gets tiring.

Avoid the pitfalls of the medium or nearly neutral backgrounds - including the greyed-down stone blue background on some of the standard Hopkins logo slides available online (that is, the undergrad Blue Jays blue) —because neither dark not light words/images will be sufficiently contrast-y and viewers will tire of the struggle.

In both background and text, bright red and Kelly green (and most intensely bright saturated hues) are no-no’s - a significant number of males have red/green color blindness; and the glare from these saturated intense hues exhaust every one.

Fades, gradients, or ombres are workable as long as they are simple and uniformly dark across the melding colors. Avoid a background that fades, at any point, to a color significantly less dark than the rest of the background; words crossing that segment will be difficult to read.

No cute animated camels walking around the edge of the frame to reach the oasis, no splashy Art Deco frames or edging, no busy background beds of autumn leaves, berried holly branches, fish, kittens, supernovas, rising and setting suns, twinkling stars, Elf’d colleagues, or an adorable baby (even yours) crawling around the perimeter. Save those gimmicks for personal web sites, social PowerPoints, or humorous after-dinner presentations.

LOGO: if you are including the Hopkins (or other) logo or symbol on all/most slides, make it small and subtle - using up 1/3 of the slide every slide (as with some of the official suggested templates) is counterproductive. Make the logo small, simple, and off to the top, bottom, or corner; or impose a subtle translucent branding stamp/watermark over the background if desired.

WORD SLIDES: Legibility and condensed thoughts are the keys. These are bites, not full course meals.

FONT: The sans serif fonts (Ariel, Geneva, Helvetica) are cleaner, crisper, and more legible than the fussier serif (Times Roman, Bookman, Century).   Italics or decorative fonts (Stencil, Thriller, Old English, etc.) should be avoided; or saved (if you really can’t resist) for one- or two- word Title slides at the most.

SIZE MATTERS: Use the largest font possible, and don’t fall into the trap of leaving too wide a margin around the words. Matting a photo or painting in a wide border looks wonderful on your wall, but the larger the room, the more important it is to expand content into the available space. Looking at the computer screen as you work is misleading; you are too close. Step back about 10 feet - can you still read it? Does it look like a densely-packed page from a book, or more like a billboard meant to ‘sell’ certain condensed thoughts in the brief exposure time of each passing car?

Even in smaller rooms, somewhere past 8-10 lines, and even when points are bulleted and physically expanded to make full use of available space, there is too much information and audiences disengage. As for those charts with 42 boxes, each containing several tiny bits of information or numbers - remember how much you got from them in Basic Science. Ditto flow charts with lots of small boxes framing tiny type, all meshed together with arrows and lines. No one can (or will) follow these, even if you walk through the explanation, if they can’t read the boxes.

TELEGRAPHIC WORD BITES: Do not write out full sentences; you will end up reading them aloud and destroy your natural flow. Full sentences are also too long and stuff the screen with unnecessary words, presenting too much information for the viewer who is both listening and looking. Compare these two slide texts:

  • “Patients with early bone neoplasms may have night or rest pain rather than pain more typically associated with activity. Subtle weight loss may occur. As more of a weight-bearing bone is compromised pain may increase or be more persistent, possibly warning of impending pathologic fracture.”


  • “Early Bone Neoplasm
  • Night/rest pain
  • Subtle weight loss
  • Advanced Neoplasm:
  • Increased/persisting pain
  • Impending/early path fracture”

If the audience is carefully reading the first version, they cannot concentrate on what you are saying. The second version telegraphs the main points, condensing and organizing the major points for easy note-taking or rapid preview of what you are about to say. The first slide also becomes harder to read in a larger room, especially if smaller font needed.

DEFINE any abbreviation or acronym the first time used; e.g. “ACR (American College of Radiology)….”. It can be defined in smaller type if preferred. Or not.

While the inexperienced or more stage-wary presenter may feel more secure with that full script on-screen, it undermines the entire point of an in-person presentation. Bullet and abbreviate the main points, preserving them adequately to re-jump start your brain should TIA, nerves, or distraction derail your train of thought; but be rehearsed and familiar enough with material to be able to phrase thoughts and full sentences effectively without following a word-for-word script on-screen. An occasional glance at your bullets keeps you on-line, while allowing you to spend more time making eye-contact with the audience to keep them engaged and to assess their level of comprehension/attention.

IMAGE or DIAGRAM SLIDES: Radiology is a visual field. Your audience is usually no more experienced than you. If you weren’t sure you understood or clearly saw the finding, neither did they. Crop and expand selected images to fill the slide space, just like the word slides; presenting a 3 or 4 mm finding on a 2x3 foot image is annoying and distracting. Use arrows or labels. Add drawings or diagrams if they would clarify classifications, findings, margins, whatever. If gathering your resources from online, remember there is a lot of old and suboptimal visual debris out there - photocopies of old textbooks, poorly reproduced images, non-clarity, all hurt your ability to transmit meaningful information to the audience. Saying “this isn’t a very clear example but…” or “This is really hard to see but…” does not help nor excuse. Find better examples, or change your topic.

If using Hopkins cases DE-IDENTIFY (names, hx numbers, etc.) or become an unemployed and de-matriculated HIPAA violator. If culling material on-line, ACKNOWLEDGE source, every slide (not just end-slide Bibliography). And use more than one or two sources; it becomes a less honest and less educational (for you as well as audience) glorified ‘book report’ if all points and/or images came from one or two key articles or chapters.

Flow charts, complex data charts, and paradigms: most become uninterpretable on the big screen. Acknowledge it is a suboptimal visual (“This big chart may be helpful to reference in the future, let me summarize it …”), do not leave it up while hitting the talking points—too distracting/discouraging/boring. Condense them down, make a hand-out, or summarize them; the tiny print and multiple tiny boxes are huge turn-offs.

FLOW: Start with a clear title, and your name. An Objectives slide is helpful; briefly tell them what you intend to teach them. (One of my professors phrased it, “First tell them what you are going to tell them. Then tell them. Then tell them what you told them.” It works - repetition is the key to learning.)

Lead into the topic—perhaps relevant history or background, perhaps an illustrative case, perhaps a review of epidemiology, incidence, distribution, costs, recent relevant news: why is this topic worthy of focus?

Near the end, a Summary or Conclusion slide of condensed take-home points helps to close the loop. Review most salient content and reduce the presentation to the items you feel would be most important to retain.

Make it clear you have finished - surprisingly it is not always obvious—with a “Thank You” or “Questions?” slide.

TIMING: Eight minutes is both longer and shorter than you think. It will be very clear to the audience if you have some idea of how long your Presentation actually is. Ideally, time it out several times to be slightly short—just over 7 minutes—so you can relax, speak more slowly and clearly, gather your thoughts if necessary, and perhaps avoid the “ummmm. …ummm… so…”. Finishing just under the clock also allows you to ask, “Any questions?”.

SLOW DOWN: no one wants to hear you galloping through so as to fit more into the time frame. LESS is MORE. Remember Basic Science, when a lecturer would glance at his/her watch and say “We’re almost out of time here…so let me race through these last 6 dozen slides so we can finish up (in a totally annoying and meaningless fashion).” - incomprehensible and unprofessional at best, seizure-inducing at worst.

PROFESSIONAL VERBALIZATION: While practicing, be aware of the need to use full (preferably short) sentences, rather than stringing each thought along with “ummm…like….so…uhhhh…” linkage. Medical and professional English is crisp, articulated, clear, and divided into sentences, and eschews unnecessary filler mumbles. No UpTalk!!

PROFESSIONAL COMPORTMENT: Dress appropriately and in something with which you do not fiddle—no yanking at hems or ties, no rearranging lapels, no dangling flipflops off of toes while jiggling leg. Keep hands off face, neck, hair. (Hey check APPS OF STEEL, -- lots of same ground rules though certainly less formal an event than a Residency Applicant Interview)

Donna Magid MD, M.Ed

(as always—an Editorial Opinion!)