10 Thoughts on Public Speaking from A Seasoned Program Director

By Eric Warm M.D.

On Wednesday, I gave Grand Rounds.

The night before, I had a classic anxiety dream where Orson Welles was eating blueberry pie and taking too long with my introduction, and I was freaking out that I wouldn’t have enough time to present my material, and when I finally got the presentation going Orson had switched my slides and they were unintelligible.

Which is weird. Because I haven’t gotten nervous for a presentation in a very long time.

Before my first grand rounds more than 20 years ago I was so nervous I couldn’t eat lunch. But now, after thousands of presentations, I’m as calm as can be. I actually enjoy it.

I think I had the dream was because I wanted to get an important message just right.

It made me reflect on how I transitioned from nervous-public-speaker to comfortable-in-front-of-crowds, and I offer these thoughts to those who would like to make the same transition.

1. In public speaking, most people forget what you say shortly after you say it (this is backed up by science).  So why get nervous about it?

2. In ‘private speaking’, (for example: at the bedside of a patient, surrounded by family, breaking bad news) people remember everything you say. ‘Private speaking’ becomes the stories families tell forever (“do you remember that time when that doctor said that thing…”) These are the words you need to get right.

3. Physicians who can’t do public speaking often are great at ‘private speaking’. When I realized I could transfer a skill I had at the bedside (where the stakes are high) to the stage (where the stakes are actually low), I had power.

4. Practice helps. Early on I would practice every presentation many times over. When I got nervous the words fell out perfectly no matter my heart rate because I had practiced.

5. But, don’t let perfect be the enemy of good. Practicing might make you want to do it the same way every time, but this could eventually make you anxious if for some reason you deviate from your plan. When I realized I could be flexible in front of people, I had power.

6. Because the crowd you plan for might not be the crowd you get. Try to know your audience beforehand (it does help), but get to know your audience by paying attention to how they receive your thoughts as they receive them. This is how comedians hone their craft. They listen.  All presentations are a co-production. When I realized this, I had power.

7. People might not remember what you say, but they do remember how you made them feel (happy, sad, enlightened, enraged, etc.). Use that to your advantage. Try to figure our what your audience cares about and present information from that perspective. Don’t be afraid to be entertaining. I usually run things by my wife (who knows funny) and her perspective always makes my presentations better.

8. Ask for feedback. Be specific in your request. Don’t ask: did you like it? Ask, was I clear? What do you think about the ideas I presented? Which of my slides could be improved? Listen, and incorporate these ideas into your next presentation.

9. Don’t be afraid to flop. It happens. Learn from it. Laugh about it after the sting passes.

10. Try again.

To recap:

Nervous speakers: believe it is high stakes, fail to practice, try to be perfect, don’t adjust to the audience, ignore emotion, don’t ask for feedback, fear the flop, and quit.

Comfortable speakers: believe it is low stakes, practice, but listen to and adjust to the audience in the moment, cultivate emotion, ask and incorporate feedback, learn from the flop, and keep going.

I hope this helps. Working on this skill has helped me tremendously in my academic career. You can do it too.