We continue our series in which Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab…and beyond. In this column, he considers meetings.
For UK healthcare professionals only
I recently received a promotion for a meeting some months hence, along with an outline of the programme and directions to the venue. In addition, there was a list of distinguished speakers (not including me, obviously) and the planned timing of their various presentations.
Both professional and domestic pressures mean that, increasingly, I find myself only at meetings in which I am due to speak, moderate, operate, chair or, in some other unique way, contribute. So, in this case, it was neither the appearance of the A5 brochure itself nor the layout of the blurb spread out within, that attracted more than my usual degree of notice, and thereby diverted my attention from the remainder of that morning’s mundane collection of mail.
It’s all in the timing
It was the intended chronology of each of the presentations that caught my eye. A 14-minute talk was scheduled to start at 10.33 a.m. After six minutes for questions and a 16-minute coffee break, the now ubiquitous debate was due to kick off at 11.09 and occupy no more than 42 minutes. The resultant panel discussion was scheduled to finish at 11.58.
‘Keeping to time’ is rule number one for any presentation (well … I do wonder whether ‘at least make it interesting’ might occasionally push this into second place). If a chairperson does nothing else, then at least he or she should ensure that all the invited speakers actually get the opportunity to do just that; speak. It may be optimistic to hope that the running of a meeting should adhere to such a tight timeline, but did the organisers of this one really wish events to occur more precisely than to the nearest five minutes (which in my experience is the traditional time interval used)? Were all the contributors required to synchronise watches beforehand?
There are many courses, conferences, meetings and workshops, adverts for which descend upon us almost daily. The subject matter is always of interest, at least to someone, but the important thing is to find a novel angle that would make this get-together on say, ‘Primary PCI’, for example, different from the multitude of others. It is then necessary to encapsulate that innovation into a snappy headline and in this regard there are two important points to note.
First, in the title itself … somehow, somewhere, the word ‘paradigm’ has to be incorporated. It doesn’t matter how it’s done or where it goes, but it has to be up there. Example: “The evolution of myocardial infarct care: a shifting paradigm?” Second, as you will have noticed, there is the question of punctuation.
Thirty years ago, in the heyday of the Junior Cardiac Club, I presented a paper on the apparent increase in punctuation contained within the titles of British Cardiac Society meeting abstracts. The heading, “Presenting to the BCS: is the colon important?”, illustrated entirely the purpose of the research, namely that over a 20-year period both the actual number and the variety of punctuation marks, had significantly increased (yes, I did include a few ‘p’ values).
Anything to declare?
An increasingly common requirement is for all presenters, at the beginning of their talk, to declare any ‘conflicts of interest’. Many of our colleagues are seen as KOLs, or key opinion leaders. They often pop up, quite rightly, as faculty members at conferences because they are able speakers, well recognised in their field and can be relied upon to give authoritative contributions. However, these individuals are also a pivotal resource to the pharmaceutical and the device Industries, giving direction and guidance on intended developments, as well as providing a useful clinical perspective on upcoming research projects, product positioning and marketing plans.
These two elements may appear to create a tension. Hence, declaring upfront any commercial role at least allows members of the audience to put any presentation into context and enables them to make their own interpretation of the data presented and the conclusions drawn. In reality, the qualities that make an individual ‘commercially valuable’ are often the same as those that conference programme committees require to make their own meetings attractive.
The criteria upon which one is obliged to declare any interest are debatable. Should it be a finite pecuniary amount or the financial equivalent of ‘payment in kind’? Either way, it is up to the probity of the individual concerned to decide whether their relationship with industry might be reasonably perceived to represent a potential conflict of interest. If so, then he or she should make a list of any such associations and put it up on the opening slide. (Caution: I would suggest limiting this to one slide … max).
Cutting a long story short
The layout of the programme has to allow, not only sufficient time for coffee/tea breaks and lunch, but also – and most importantly – for the audience to be given the opportunity to ask questions and discuss issues raised by the various talks. So often, a provocative or controversial presentation is not given the chance to be aired, or even commented upon, because either the speaker has gone on far too long in an attempt to ‘share his views with the audience’, or because the preceding speakers were guilty of the same offence.
There have been laudable attempts to curb the practice of speakers overstaying their welcome. It is always tricky, if not embarrassing, for the chairperson to intercede and bring the lecture to an abrupt conclusion. A sequence of warning lights, visible only to the speaker behind the lectern, is commonly used to alert him/her that their allotted time is ebbing away. These colour signals may vary but greengenerally means keep going, and amber is a two-minute warning. Red indicates one minute to go, while flashing red confirms that ‘time’s up and you can stop anytime now!’
From then on it is debatable as to what steps could be taken to halt an enthusiastic lecturer who is either consumed with self-importance, or possibly red/green colour blind. Turning off, simultaneously, both the microphone and the projector would address the former possibility, while a claxon or siren might address the latter. Other ingenious concepts might include increasing strengths of electric discharges delivered through the slide advance button or, failing that, an appropriately positioned trapdoor.
Below, I submit a programme template, which is applicable to any meeting you might be in the process of arranging. Feel free to give it a try:
Registration Welcome Introduction Programme summary and meeting objectives Outline of the day Speaker 1. ‘How I do this’ Speaker 2. ‘How I do that’ Panel discussion
Small-group work streams Work stream feedback Speaker 3. ‘Why I do this’ Speaker 4. ‘Why I do that’ Panel discussion (again)
Debate (to be arranged, but must pep up ‘the graveyard slot’) Speaker 5. ‘You shouldn’t do this’ Speaker 6. ‘You shouldn’t do that’ Panel discussion (not again, surely?) Session summary
Keynote lecture (TBA, but someone decent so audience stays until end) Panel discussion (yet again?) Speaker 7. ‘I should have done this’ Speaker 8. ‘I should have done that’ Evaluations and concluding remarks from (you’ve guessed it) the panel! Finally, and in order to improve the quality of future conferences, forms allowing individual speakers to be scored are distributed to the audience. Once completed and returned to the organisers, they are then sent to the speakers who are thereby able to see how well they fared in comparison with the rest of the faculty. (For some reason it is thought that this type of feedback is really valuable). As it happens, the response rate for these evaluations is often disappointingly low, so, as a favour to the organisers of meetings in which I am speaking, I usually offer to complete them myself.