Intended for healthcare professionals


Making PowerPoint presentations work

BMJ 2008; 336 doi: (Published 05 April 2008) Cite this as: BMJ 2008;336:s124
  1. James Richardson, professor of orthopaedics1,
  2. Vinu Raj, locum specialist registrar1,
  3. Emad S B Saweeres, lecturer and consultant orthopaedic surgeon2,
  4. Tajeshwar Aulakh, research fellow1
  1. 1Institute of Orthopaedics, Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG
  2. 2El Sahel Teaching Hospital, Cairo, Egypt
  1. jamiebrichardson{at}


You’ve been asked to make a presentation at a medical conference. How do you make the most of the technology? James Richardson and colleagues show you the way

Education and the communication of research can benefit from new technology, but technical problems can mar an otherwise excellent meeting. A review of speaker evaluations at a national radiology meeting showed that 26 of 81 speakers (32%) received one or more negative comments related to poor quality of PowerPoint slides.1 We offer some solutions.

Preparing your presentation

Use colour

Words should be in contrast to the background, either dark words on a light background, or vice versa. Blue background gives a pleasing appearance and works well with white or yellow text. Avoid clashing or jarring colour schemes. Keep the colour schemes constant throughout your presentation. Colour blindness affects 8%-12% of men of European origin with red-green colour blindness being by far the most common form, so it helps to avoid red text or lines.2

Use a large font size

Most people advise between five and six bullet points a slide, and a similar number of words in each line. Use a minimum point size of 24 and take care that your slides can easily be seen from all corners of the room. Use capitals for abbreviations, but otherwise sparingly. The eye recognises letters by the shape of their upper half. Shape recognition is easier in lowercase letters because the top half is distinctive and stands out against a contrasting background. Conversely, when a word is in capitals, the eye is presented with a rectangular shape that is more difficult to read and less intuitive.

Use common fonts. If you have a new version of Windows, avoid the temptation to use a new font, because these fonts may not be enabled on the host computer, which may have an older operating system. The interesting slide you made at home could well be incomprehensible when projected to the audience.

Spell checkers

The default language can be set as UK English or US English for your spell checker. You may want to avoid a US English specific dictionary.


A picture is worth a thousand words and is more interesting than text. People generally remember 20% of what they hear, 30% of what they see, and 50% of what they see and hear.3 To avoid any copyright infringement, acknowledge your sources and have permission from patients to use any images from which they can be identified.


It has been reported that PowerPoint presentations have become 18% less effective because complex graphics distract the listener from the presenter’s real message.4 Movement usefully attracts attention but complex builds should be avoided.


Difficulties in running video have led to people avoiding it in their PowerPoint presentations. The first mistake is to paste in a video.

Large files such as video are connected to the PowerPoint show by a link only, and the file is not actually incorporated as it would make the PowerPoint file too large. Testing the presentation on your own computer will appear to show all is well, as the video is on your hard drive. Transferring the PowerPoint show to another computer will not necessarily include the linked video, and so the video will fail to run.


If your slides have sound clips or audio files, make sure that your computer output is connected to the amplifier. If larger than 100 kb then the explanation about linked files for videos applies here too.

Giving your presentation

Transfer media—package for CD

It is always advisable to save your presentation on CD using PowerPoint option “package for CD,” which ensures that any linked files such as True-type fonts, sound, or video are included in the CD directory, thus avoiding the ever so common problem of video files not playing when you click them.

Using the Macintosh

The recent Macs have specific Mac OS Microsoft Office tools available for use, which makes compatibility and transfer of presentations less of an issue. The earlier versions of Mac have Keynote installed, which will make it imperative for the laptop to be carried to the venue, to avoid hiccups. Even with PowerPoint for Macintosh you are not guaranteed compatibility with the Windows version, so an early check that the computer at the meeting copes with your presentation is advisable.

Plan B

In orthopaedic surgery we always prepare for the worst eventuality, and the travelling lecturer is wise to do the same. Problems we have seen include luggage that is delayed, lost or stolen; a computer left at security in the airport; power supplies for the computer being left at home; and a fractured electric cable. A hard drive can freeze at any time after it is bought; a password for the pen drive encryption gets forgotten; new hospital-encrypted pen drives may fail on Windows Vista. Have multiple backups, such as a copy of the talk on CD, or an unencrypted pen drive in your jacket pocket. It is advisable to close pen drives properly before removing them from a computer.

Store your documents on Google docs or apps, or email them to yourself. This gives you the flexibility to edit documents via the internet by people in different locations, making coordination easier. If there are any patient identifiers in your file, encrypt it before putting it onto the internet. Check the availability of broadband and internet speeds at the venue.

A computer will run video best if it is on the hard drive. Naming the folder with your own name acts as an indication of the contents, which is useful for the meeting organiser.

Presenter view

The “presenter view” facility makes it easier to present information:

  • You can use thumbnails to select slides out of sequence and create a customised presentation for your audience

  • Preview text shows you what your next click will add to the screen, such as a new slide or the next bullet in a list

  • Speaker’s notes are shown in large, clear type so that you can use them as a script for your presentation

  • You can black out the screen during your presentation and then resume where you left off. For example, you might not want to display the slide content during a break or a question and answer period.

Custom shows

This is another useful tool in PowerPoint that is very rarely used. By creating a custom show you can adapt a single presentation for a variety of audiences. Use a “basic” custom show to present an independent group of slides from your presentation, or a “hyperlinked” show to create a pathway to a group of slides in your presentation. The basic type can be useful if you wanted to present the same topic to different audiences (eg, medical students, trainees, physiotherapists, or at a national meeting).

Using your own laptop

Cables and connections

Some conferences allow presentations to run only from their dedicated computers. This requires all speakers to hand in their presentations on CD or USB drives before the session starts. You may still wish to carry your laptop around, however, to revise your presentation and make any last minute changes.

There are a few considerations if are going to use your own laptop:

  • Always have another copy of your presentation on a transfer medium, and always load it on the computer present at the venue, as a backup

  • If the conference venue has a VGA switch attached to the video projector, you can connect your laptop to the second VGA cable. Do this before the session starts and test it to make sure you know how to switch from the main computer to your laptop

  • Although new technology can help, there are still some basic guidelines for presenting at a meeting.


In a busy meeting the timing is important, and this requires practice in front of an audience. It is arrogant to overrun, and a good chairperson will prevent this. A countdown clock that is visible to the audience in a corner of the projector screen will help. Time yourself before the presentation, and practise. The average attention span during a lecture is 15-20 minutes, after which time the mind wanders involuntarily.5 If you are comfortable then use the timing facility on PowerPoint. It advances the slide automatically after a set duration. Do this only after extensive practice as it can easily go wrong, but it does make you stick to your timing. Occasionally, it gets switched on during the show and can cause chaos, so learn how to switch this option off.


One and a half hours is a good maximum time for a session. Discussion can be held after each paper, or at the end of the session. Scientific papers lend themselves to the former, and teaching around a particular subject suit the latter. In both cases the discussion time is best protected and identified on the programme.


Get abstracts before the meeting, or even better get the full paper. Meet your speakers before the session starts. Remind them about timing, and do not be embarrassed to stop those who overrun. Have questions ready as the audience may be slow to develop questions.

Be prepared

It is best to send your presentation in ahead of time. You can then be assured that the technician has time to identify and solve problems, ensure video runs, and you can contribute to the meeting instead of making last minute changes to your presentation.

All these technologies continuously evolve and it is necessary to keep abreast of developments. It is always good to check the podium you will be speaking at and familiarise yourself with the controls, and meet the IT technician because you may need their help.


  • Acknowledgments: Thanks to Frank Cook, PACS manager, Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry.


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