Salty Death to Animation – A Conference Reflection

How much can you learn in less than 2 days in Singapore? Wait, I should clarify a little there – at a conference, not just out and about. A couple of weeks ago I blogged about preparation for a small group session at the 2014 Australian and New Zealand College of Anaesthetists Annual Scientific Meeting and it’s time to beat the experience into some form of useful life (and PhD) lesson.

Conferences are vital in broadening horizons and engaging in the soaring nobility of the research community (I’m not even attaching sarcasm font to that bit). They are something at which I am many different shades of horrible. (For insights into how to actually do the networking type stuff, read this by @thesiswhisperer and @tseenster.) As a PhD student, they are also a good chance to reflect on what is excellent when engaging, what is terrible and what will change what I do. For this particular conference, I couldn’t get freed up from work for the first 3 days which is obviously limiting, but here’s a (very abridged) conference in review – the good bits, the bad bits and the bits that will influence my future work.

You may insert your own generic movie trailer voice over guy saying something inappropriately overblown – “44 hours. 5 sessions. One dinner. One doctor dares to learn.”

 

1. Simple Things Work (The Old Story)

Anaesthesia is a critical care specialty so we’re inclined to be excited by fancy stuff and shiny toys.  One of the best sessions in a series of blood-related sessions I went to covered the implementation of guidelines from the National Blood Authority. Addressing blood product usage matters – not only does transfusion cost big money, but there’s increasing evidence that as bad as anaemia is, a quick top-up of juicy blood has significant problems associated with it. While addressing the whole chain of when blood products are given there was some really basic stuff.  Dr Ed O’Loughlin talked about something really simple – check for anaemia pre-operatively and correct it. It might be just one element of the chain, but various people from WA got up and showed huge drops in use of blood products. They didn’t need shiny machines either. This was a serious lesson. I’ve returned thinking much more about getting basic stuff right.

2. Talking to People is Good (Don’t be Put Off by the Packaging)

The meeting was a joint one with the Royal Australian College of Surgeons. Now I may find surgeons obtuse sometimes, and I can’t quite understand why they all spent the meeting conducting peacock displays in suits, as if they need plumage rather than the quality of their interaction to be taken seriously (seriously surgical people, you’re all precious snowflakes). Operative care happens in teams though, and sharing ideas and insights can only be good. The best sessions I attended had input from people of multiple backgrounds. Progress happens with teams whether introducing the comprehensive blood management programs described above, undertaking operations or working in research. More medical conferences should do diversity like this.

3. Coverage (Tick)

Anaesthetists are a little used to working in the twilight. This is a pity because anaesthesia has many good things going for it. I’m also tired of having to confirm I’m actually a doctor. Not all conferences get a lot of mainstream media coverage, so hats off to the organisers for inviting Julia Medew from The Age along who provided coverage of some really interesting stuff on anaesthesia and cognitive dysfunction (really wish I’d made that one earlier in the week) and publicised the clean bill of health given to laughing gas. A double tick given earlier coverage from conferences has a bit pre-emptively caused grief (witness the earlier release from the same team about laughing gas).

4. Front Loading Conferences (Maybe a Fail)

I’m influenced by the words of others here precisely because I couldn’t make it to the first half of the week. But I spent two days hearing a particularly tiresome loop – “All the other days were way better”. Is this a common thing? I’ve certainly been to a few other conferences where the interest in the program peters out over the equivalent of a beach house weekend when it’s supposed to last a business week. If you can’t fill 5 days, why book 5 days?

5. Social Media? (Close, but not quite)

There are exceptions that are ahead of the curve, but medical conferences are still getting up to speed here.  For this conference, an app was created which had the program plus lots of updates and the scope to ask questions in real time. It only worked on tablets. Blergh. There was a website which offered some of the functionality, but I found it really clunky on the phone. On the other hand, the Twitter conversation was exceptional and entertaining and informative. It’s the first time I’ve been able to enjoy multiple rooms in a conference at once. It was spectacular. And pretty much unmoderated by the organisers, so no questions through that medium.  When it comes together, this will add so much.

6. Good Presenters (Are Thin on the Ground)

Interesting topics. Lots of potential. Exactly the setting to see that doctors don’t really get trained in presentations. I have to break this down further:

Where are the stories?

 You have a room of people who have chosen to apply their science in the care of people. Often people with challenging health problems. I promise if you include stories of actual things in your presentation, far fewer people will be practising eyebrow dancing. Having a narrative through presentations keeps things anchored back to the patients that we look after. It’s far more engaging.

Basic slide etiquette

When you’re in the audience, it is so obvious what you don’t want people to do with those all important slides. Why do we forget that when we’re preparing? A quick editing exercise – write your talk with your slides. Now remove three-quarters of the slides. Then remove three-quarters of what is on the slides.

If you’re talking on a topic, I assume it’s because you know stuff. So please don’t throw up repeated tables with 6 columns and 28 rows to torture my focal abilities. I don’t want to know that you’ve read lots of stuff. I want to know how you put that stuff to use. You’re just ensuring I’ll miss the key messages.

Here’s the best slide I saw. When I shared it around, it started a conversation that lasted more than a day on Twitter. Weeks later, this deliberately provocative statement suggesting our old treatments in traumatic bleeding don’t help is the thing that sticks the most.

 

Not sugar coated.

Not sugar coated.

Then there’s this bit …

Animations are not your friend

I get it, they’re pretty exciting. They’re a great way to procrastinate when working on your actual talk. The thing is they almost never reveal something great but all too often conceal the point. There was a speaker who first flashed up a slide with a 30 line table, then overlaid 15 animations and pictures in 60 seconds. I have no idea what he was talking about, but I remember wondering how I’d hit my present age without training killer bees to do my bidding at crucial moments.

There is an exception to the “down with animations” rule. If you add animations with as much vigour and life as this, you may go to town and I will train those same bees to personally deliver honey to your tongue.

Stick to Time

This is so basic. In one of the rooms, a keynote speaker went more than 20 minutes over time. There is so much failure there. A failure of regard for the other speakers or the audience. Perhaps a failure to bother sticking to the brief, or to work harder than pressing reheat on an old talk that was  approximately relevant. Either way, there’s not much of an excuse. Though of course there’s another failure here …

If you’re a moderator, be a moderator

Chairing a session is a tough and somewhat thankless job. It’s an important job though. If a speaker is going overtime, stop them. Have an agreed system, send signals, spray a fire hose if you have to. Don’t worry you are disrespecting a speaker. You’re stopping them disrespecting everyone else in the room.

7. Open Disclosure (Can Go Further)

A great feature of this (and other) conferences I’ve been to recently is a full and open disclosure of all potential conflicts from speakers. The transparency continues to improve. In one of the sessions though I had a small but reverberating realisation. The speaker, during a good bit on factor concentrates for transfusion management, put up a slide with three papers mentioned. I spotted immediately that one was funded by the drug company pushing the product. This wasn’t disclosed. The thing is I don’t think it ever gets disclosed. I certainly never have, and I suddenly realised that there is no good reason for that. From here, my aim is every reference in every talk will get a check for any conflicts to make sure the audience knows about them too. This will change all my presentations from here on in.

 

The lessons about how to make the most of a conference then? Talk more. Look for the simple stuff that will produce bigger changes. Seek out the disclosures that inform your consideration of the evidence. And if talking, do less.

And find some bees.

 

 

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Bigger Fears in the Smaller Room

I could not be more lost in a small room with a bunch of new people. I anticipate the prospect with approximately as much joy as if the offer were to come to a toenail clipping party. You can imagine my delight then to be charged with running a “Small Group Discussion” session at an upcoming anaesthetics conference.

The Small Group Discussion clearly has a very different set of challenges than the more common ‘deliver a talk in a big room of mostly empty chairs and iPads supported by biological life forms that occasionally seem interested’ that I’m more used to. So in the interests of transparency on how I’ve come to tackle this here, with the aid of an amphibian support crew, is my “Plan for Staggering Small Group Brilliance that Might Not Work”. (This also means please set me straight if this looks awful.)

The Brief

When I was first approached to do this session, I was asked to “do a hands-on workshop on paediatric trauma care, maybe with a bit of prehospital stuff too”.  To me, a workshop implies that it will be a little bit hands on. So I suggested maybe we dial that back. Not just because that’s a lot of work for 1 person. The logistics of reproducing a kid getting hit by a truck or something just seemed a bit challenging, particularly in Singapore. You can’t have an actor playing a truck driver if they can’t smoke and chew gum, right?

So 15 people, and they’re supposed to learn about paediatric trauma care, with both prehospital and in-hospital pearls to take away. 90 minutes. Got it? Here’s the plan and the preparation.

1. Set the Stage

The small group discussion will only work if those attending are keen to converse. That requires setting the environment up to facilitate chatter. That’s easier said than done. My natural instinct is to be the guy hanging in the corner giving the impression I’m really interested in conference room partition systems to hide my awkwardness. Probably not going to cut it.  Setting up an environment where people feel free to speak up is actually a key part of crew resource management when you work with aviators. The same goes for working in theatres. Both of those situations are dependent on people of any level being able to speak up when they see a need to contribute. It’s just a different spot to make that happen. I’m going to start with dressing casual.

This Rufous-eyed Brook Frog is trying to be friendly. (that's Duellmanohyla rufioculis if you prefer to be formal)

This Rufous-eyed Brook Frog is trying to be friendly. (that’s Duellmanohyla rufioculis if you prefer to be formal)

 

2. Share a Story

Nothing gets people on board like a cracking yarn. Is it really that likely that I could string together a bunch of random concepts into a discussion without a strong narrative? A good story should put a group of anaesthetists into a zone they feel comfortable with – thinking about a patient. It will hopefully trigger their recall of a hundred other cases. It adds natural timing and pace. A story is a natural thing to share, and I’d like everyone doing that. Of course, to tell someone else’s story, you also need to get explicit permission.

This tree frog is ready to talk. (it's a Kuruxalus sp.)

This tree frog is ready to talk. (it’s a Kuruxalus sp.)

 

3. Shut Up

In a big room conference bit, you kind of have to talk. That’s your job. This is a discussion so I’m hoping to spend most of my time listening. I’m well and truly in the earlier part of my career. There will hopefully be some people with great experience and a different way of looking at things for me to learn from.

Its seems like this Australian Lace Lid would have a unique way of looking at things. (Littoria dayi)

Its seems like this Australian Lace Lid would have a unique way of looking at things. (Littoria dayi)

 

4. Be Transparent

Setting up an environment for open chat necessarily involves being open, particularly where you don’t have the answers. Historically there’s been the suggestion that doctors aren’t so great at acknowledging when we’re not sure, but that’s not my experience. Any story of a case will involve instances where things could have been done differently. My plan is to identify them up front.

I'm aiming for as transparent as this Green-Striped Glass Frog (Hyalinobatrachium talamancae)

I’m aiming for as transparent as this Green-Striped Glass Frog (Hyalinobatrachium talamancae)

 

5. Free Stuff

By now we all know that doctors are keen on free stuff. This is because they are actually fairly human and it turns out that most humans quite like free stuff. It’s long been known that this marketing can influence doctors in all the wrong ways (although happily things are moving in the right direction and scrutiny is helping). Of course, it is possible to harness the positive vibes from generosity for good. So the current plan is to provide all the relevant reading material I can find on a USB drive for everyone who joins in. That way people get relevant stuff to look at later and the feeling that they’ve got the equivalent of a two-for-one deal at the service station without their insides getting assaulted by more [insert generic stomach-rotting cola beverage here].

Everyone appreciates not having to do the legwork. (Odorrana sp.)

Everyone appreciates not having to do the legwork. (Odorrana sp.)

 

7. Get Some Experience

Just like delivering a presentation, practice is worthwhile. I’ve had two cracks at working through the case and each time I’ve picked up some worthwhile pointers and tips. It’s pretty annoying when you get to any small group session and half the planned stuff is missed or it doesn’t fill the time. How many things do you get better at without practice? Not many. Maybe practice then.

This Vietnamese Mossy Frog kind of looks like he's been through some stuff. Experience. (Theloderma corticale)

This Vietnamese Mossy Frog kind of looks like he’s been through some stuff. Experience. (Theloderma corticale)

 

The last point to challenge me is that the session is on the last day. After the conference dinner.  Now where’s the frog that can give me the right tip for that one?

 

Acknowledgements:

All the amazing frog pictures came, with permission, from the excellent Dr Jodi Rowley, an amphibian biologist at The Australian Museum. This is only the smallest selection of photos from her beautiful site, which you can find here.