Welcome to the July issue of HOC, in which we cover the vital issues of keeping up with the vast stacks of reading you’re expected to plough through in order to remain current, and the business of making an effective presentation. To those topics we add that generally underestimated – and poorly understood – element of communication: listening. And Clare Gurton weighs in with some strong stuff on assertiveness.

We’ll have an equally strong line-up for our August issue, including preparing for talks and killing your nerves, the pros and cons of e-publishing and dealing with the media.

“There is only one rule for being a good talker.
Learn to listen.”
Christopher Morley, American writer.

HOC is now available for print in pdf format – free

Becoming accustomed to public speaking

by David Woods

While the majority of speakers and panellists at the recent ISPOR meeting made professional and even compelling presentations, some of the offerings were characterised by mumbling – or rambling – delivery, and indecipherable graphics.

If you’re about to face an audience and would prefer not to be in that minority, here are some tips to help you avoid anaesthetising your listeners.

• First of all, effective public speakers aren’t born, they’re made. They’re made by practice, complete knowledge of their subject, and the ability to put it across logically, clearly, succinctly, and with evident interest and enthusiasm. Monotonous speech – however dramatic its content – will turn listening into listlessness.
• Speak naturally, clearly, and with the help of notes, and develop your theme logically. A strong start is important since it’s vital to show your listeners during the first minute – when you can be sure that you have their attention – that you are not another rambling bore.
• After developing two or three major points as the core of your discussion, wrap it all up neatly with some clear conclusions: in other words, tell them what you're going to tell them; tell them; then tell them what you’ve told them.
• Don’t try to pack too much information into your talk; it confuses the audience and does you out of an opportunity to deal with the subject again from another angle – and to accept a further honorarium.
• Avoid mannerisms, repetition, and catch phrases. Pruritus ani may be the theme of your talk but scratching yourself there (or anywhere else) will be as irritating and distracting to the audience as it seems to be to the afflicted speaker.
• Misuse of words, and such horrors as “in solo practice on my own” and “per diem a day,” both heard at recent meetings, indicate lack of preparation and polish and can annoy even the least discerning.
• Answer questions – however silly they may appear to be – with interest, and briefly. Question time isn’t an excuse for another full-fledged presentation.
• Finally, end your speech when you have promised to. The speaker who says “and in conclusion” more than twice may find that his audience has taken him at his word and gone home.

Following these guidelines will guarantee you a live audience and, at the end of your talk, a better-informed one. Moreover, you will have done something to narrow the information gap, and will probably be asked to speak again before long.

Properly used, illustrations serve to pep up a sagging audience and to refocus attention. They should be relevant, readable, of high quality and pictorial. We’ll tell you about visual presentations in the next issue of HOC.

“The time comes when you must make sure that what you say is said with accuracy, clarity, brevity, and grace.”
Edward J. Huth, MD, Editor Emeritus, Annals of Internal Medicine.

Let’s hear it for sound listening skills

By David Woods

Of the principal elements in communication – reading, speaking, writing and listening – listening is learned first, is used most through life, and is taught least through all the years of schooling. In his book How to Speak, How to Listen, Mortimer Adler says that it is utterly amazing how people generally assume that the ability to listen well is a natural gift requiring no training. “Deficiencies in listening and the ensuing failures in communication,” says Adler, “are a major source of wasted time, ineffective operation, and miscarried plans and decisions.”

Among the reasons that people either don’t listen or don’t really catch what’s being said are:

• impatience, a low threshold for boredom, and irritation when speakers don't provide a “lead paragraph” – a clear focal point – or when they engage in the sort of self-indulgent long-windedness that Benjamin Disraeli described as “tracing the steam engine always back to the kettle”
• paying more attention to a speaker’s mannerisms while allowing one’s mind to wander
• overreacting to certain words or phrases that arouse adverse emotional responses, or
• just daydreaming.

Listening, Adler believes, requires penetrating through the words to the thoughts that lie behind them. It calls for sifting what's important from what isn’t; it requires perceiving as early as possible the focus of what is being said.
It could be argued that if people spoke more logically, grammatically and colourfully than most of us do, listening would be easier. But that's rather like saying that astronomy would be more rewarding if there were never any clouds.

Philadelphia Inquirer columnist Lona O’Connor lists three types of listening:

• Supportive: making speakers comfortable enough to say what’s on their mind
• Active: asking questions and advancing the conversation
• Analytical: figuring out what the information means and what to do about it.

Can you improve your listening skills? Your future could depend on it. This is especially true for healthcare professionals who, by turning an intentionally deaf ear to what’s being said or by failing to detect nuance, may place their careers in jeopardy. It's estimated that more than half of all malpractice litigation has its origins in garbled communication and misunderstanding.

Let’s hear it!

It’s not what you say, but how you say it

by Clare Gurton

Being assertive is crucial for success in work; in meetings, giving presentations or talks and on paper. It really is not what you say, but how you say it that counts.

Here are some tips to help you develop assertive language:

• Use familiar language
  Use formal conversational or written language
  Avoid obscure language
  Avoid jargon unless you are certain the readers will understand it
• Use concise language
  Remember that wordy expressions can hide major points
  Be concise: pare sentences as much as possible without losing the
  meaning
  Instead of general and vague phrases, be specific
• Use correct language
  Be accurate; accuracy requires correct word usage
  Use moderation; avoid over-generalisations
  Correct grammar, punctuation and spelling is imperative. Errors create negative impressions and cause you to lose credibility
• Use persuasive language
  Strong verbs – use direct action-oriented verbs and verb phrases
  Assertive phrasing – eliminate deferential words and phrases
• Use constructive language
  Take a positive approach; avoid language that invites negative
  responses

Assertive body language is also crucial in meetings or when giving presentations. This will help to centre you and to ensure your audience connects with what you are saying. There are several elements involved in assertive body language:

• Your voice. You may be considered non-assertive if your voice is weak, hesitant, soft, or wavering, while a tense, loud, shaky, or demanding voice will demonstrate aggression. Aim for an assertive voice: firm, relaxed, well modulated.
• Your eyes. Non-assertive eyes may be averted or downcast, while aggressive eyes can be narrowed, cold, or staring. Keep your eyes open, frank, and direct.
• Your posture. Non-assertive posture is often stooped, while an aggressive person may stand stiff, with hands on hips and feet apart. Assertive posture is erect, relaxed, well balanced.
• Your hands. Non-assertive hands are fidgety, fluttery, or clammy, while someone who is showing aggression might keep fists clenched and make abrupt gestures or point a lot. An assertive person will use relaxed appropriate hand movements.

How to turn that mountain of “must” reading into a manageable molehill

by David Woods

Are there means by which the busy professional can keep up to date by reading? Well, speed-reading may be one solution but this is rather like bolting a good meal in five minutes – probably just as much nourishment, but not very enjoyable. In any case, it’s not the mindless devouring of words that counts so much as remembering what you’ve read. Here are some more palatable approaches, if reading is to be more than simply a chore.

• Pre-sort the mountain of reading material that may be threatening to avalanche your desk, and turn it into a manageable molehill. For a month’s reading, that might include a dozen or more journals, several general magazines, and perhaps five or six books. Plan ahead, noting those items that will be of interest, and unashamedly leaning on the comments and suggestions of critics and reviewers with established credibility.
• Make full use of abstracts and contents pages in your journals, or circle promising headlines. No paper or magazine can expect to print material that will involve all of its readers all of the time, but nearly all of them make it as easy as possible for readers to pick out what information they need.
• Try to decide in advance what you want to be informed about and where you can find that information. A process, in other words, of discernment and discipline.
  – Discipline in reading consists of allotting realistic amounts of time to it.
  – Discernment is sifting information; knowing what not to read. In other words, as one writer puts it: “The art of reading is to skip judiciously.”

After that, reading becomes constant assessment: is the message coming through? Is the material interesting? Is it enjoyable? These are factors that are not always easy to discern since education, which taught us how to read, has not always taught us how to judge what is worth reading and persevering with. Some of that may hinge on a bit of ruthlessness: don’t hesitate to discard what is clearly neither helpful nor crystal clear.

“The man of science appears to be the only man who has something to say,
just now – and the only man who does not know how to say it.”
J.M. Barrie, playwright and journalist

Effective communication

As a matter of fact, at the end of the day, it’s a foregone conclusion...

by Clare Gurton

It’s easy to poke fun at street lingo; words such as “like”, “yeah”, “y’know” are completely over-used in most sentences. Yet we all have our favourite phrases, words or clichés that we repeat too often and don’t even notice.

If you use these in a presentation, or worse still, a piece of written text, you are almost guaranteed to turn off the audience.

Some will get fixated on the phrase and start to count how many times you use it, while others will stop listening because it irritates them.

If you are not sure if you have a phrase or word that fits into this category ask your closest friends – they are bound to know. Then make sure you concentrate on ridding the offending words from your vocabulary.

As Oliver Wendell Holmes, Sr., the famous American physician and writer, wrote in his essay titled Scholastic and Bedside Teaching: “I would never use a long word... where a short one would answer the purpose. I know there are professors in this country who ‘ligate’ arteries. Other surgeons only tie them, and it stops the bleeding just as well.” Here are a few more words and phrases to avoid:

• multiple for many
• interface for talk
• time frame, or period of time, for time
• great majority for most
• ongoing for continuing
• demonstrated for showed
• enhances for increases
• minimises for decreases
• optimal for best
• prior to for before
• following for after
• quantify for measure
• input, impact and dialogue – used as verbs

From Edith Schwager's book Medical English Usage and Abusage (Greenwood Publishing Group/Oryx Press).

Another packed issue, including dealing with the media, preparing for talks and killing your nerves, and the pros and cons of e-publishing.