Terry Irwin is a consultant surgeon in Belfast, Northern Ireland
working for the National Health Service (NHS), which provides healthcare
free of charge to
all UK citizens. In addition, he is Director of Surgery at the
Royal
Victoria Hospital, the main regional centre in Northern Ireland. His
surgical
specialty is colon and rectal surgery - always a good conversation stopper
when people ask him what he does. His response is that he repairs waste
disposal systems!
Terry is also a long time PowerPoint user and co-author of a book on PowerPoint
geared towards the designing of medical presentations. He is married
to Jenny, a nurse who teaches travel medicine and has
become quite an expert in using PowerPoint in recent years!
Geetesh:
Tell us more about yourself, and how your work involves PowerPoint.
Terry:
I started using computers when I was appointed as a consultant in 1989.
Initially it was all about word processing. At that time slides for
presentations were typed on plain paper and photographed. The really cool
guys used negatives to get a black background, and the nerds stuck
transparent tape behind the text to get multicoloured monstrosities!Then
along came Harvard Graphics, and finally PowerPoint and everything changed.
It is not that long since we did our first presentations using a computer
and projector - perhaps 15 years, but it seems longer!
Now PowerPoint is a daily part of all hospital doctors' lives. We present
cases, results, research and plans for the future using this ubiquitous
software.
Geetesh:
What's different in the way that the medical community works with
PowerPoint? What are the challenges they face?
Terry:
Doctors use graphic rich presentations, because medicine is very visual,
especially surgery. Video is now very common, especially with laparoscopic
(key hole) surgery and endoscopy. Both systems provide beautiful
full colour high resolution video output, ideal for teaching. Previously
you could only look over someones shoulder to see what they were
doing, and hand held cameras were always difficult to get good images
with. The big challenge is to get video to work!
Radiology systems now output very good digital images of X-rays. It is
always fun explaining to intelligent people that these are greyscale images
and if they learned where the button was to convert them to greyscale, they
would reduce file size a lot!
Doctors are busy people, they love presenting but take too little time
learning how. The major challenge is trying to get them to unlearn bad
habits, such as over-busy slides, reading their slides, overused animations
etc.
Geetesh:
What are the typical presentation scenarios in the medical
community?
Terry:
Teaching and training are a major part of the teaching hospital doctors
workload. PowerPoint is the workhorse for this. We also use it to
present management data -- linked Excel spreadsheets are a great
advance. I feel that PowerPoint is sometimes overused. We don't
use it at the bedside, but when people are presenting cases at a
meeting, it is used. In these cases it is more to prompt the presenter,
than for the audience and I try to resist that.
Geetesh:
Tell us more about your book on PowerPoint. How does it address the
field of medical presentations.
Terry:
Perfect
Medical Presentations, the book came out of a Diploma in Medical
Informatics that I completed a few years ago. One of the modules was
on presentations. I had always been interested in this, but was stimulated
to learn more and stumbled across a tutorial written by Julie
Terberg about
.PNG files. I wrote to her and asked her if she wanted to write
a book. After some hesitation, she finally agreed.
The book teaches PowerPoint from the very basics to a quite advanced
level, aimed specifically at healthcare workers -- not just doctors.
We have tried use my own experience of the problems that doctors have
come to me with. Indeed the catalyst for writing came when a colleague
couldn't get a 120 Mbyte talk to run on a very old laptop at a major
meeting. He had no USB ports and only a floppy drive! I compressed
all his images, extracted them to a folder, moved them in batches
to another computer and got him up and running with a minute to spare.
He dedicated his talk to me!
The book has been good to me. I have recently been asked to teach PowerPoint
in Dubai, and in Beijing!
How do you source medical visuals? Are any sources better than others -- what are your favorites?
Terry:
This is a complex issue. We have to consider patient confidentiality
and copyright issues, so you cannot use just any image. We take very
specific consent from patients, even if we are only using their
radiology films. I have just written a very lengthy policy for our
hospital on the use of medical images. The images remain the property
of the hospital, because they are part of the patient record (not surprisingly, there is a whole chapter in the book dedicated to this!).
I like images with an immediate appeal that tell a story. Many of
these can be downloaded and used safely from the net. Flickr is a
great source, but you need to check permissions for use. Medical
journals will often release copyright for teaching use. Some
textbooks will have a CD with good images that can be used for teaching.
I try to take most of my own images of patients.
Geetesh:
Can you share some trivia? Anything about an unconventional use of
PowerPoint, or a humorous incident, or just something that you want
to share with Indezine readers?
Terry:
Many people feel that presenting was much simpler in the days of 35mm
slides. They have short memories! A good friend presenting at an
international meeting recalls that a manic projector suddenly erupted
and belched my slides in the air one after the other! Many of us
have suffered from the helpful chap at the back of the room who
turned the carousel of slides upside down to fix the latch at the
bottom -- but who always seem to forget to put the top on, so that
your entire talk was distributed around the floor!
I gave a talk on PowerPoint in Prague a few years ago. The chairman
had invited a government minister to the meeting and (as they do) he
decided to speak even though he was not on the programme. He had
never seen PowerPoint used. In fact he rattled on for far too long
and...well I had recently bought a digital camera that also took mpeg
movies (they were very new). Imagine his surprise when he appeared in
my PowerPoint talk in a movie a few minutes later.
