Anti Powerpoint Rebellion

Though apparently I'm late on the bandwagon and there's already a group of anti-establishment Luddites that have taken this position, but I'm over PowerPoint. This hit me last night.

I'm not saying PowerPoint doesn't have its uses, like all three of them. As someone that's infatuated with pathology, you need PowerPoint (or some kind of visual projection device) to teach it. Diagrams are also useful, particularly in surgery, where they tend to do procedures that connect stuff to other stuff you wouldn't necessarily expect, and you kind of need a diagram representation of what GI anatomy looks like after you've put in Tivo and a hot tub. Or something. So yeah, if you need something that isn't "words", hooray for PowerPoint.

I was kind of indifferent to PowerPoint for a long time. I laughed when people put in the "funny" slide or the unnecessary slide effect, as you're supposed to, and the really bad PowerPoint presentations stand out as really bad PowerPoint presentations, so I hadn't really chalked them up to the program, but to people's inability to understand the concept of margins, grammar, or choosing colors that don't provoke seizures, and that's valid.

But two things happened yesterday. One, it was conference day, which pretty much means around 7 hours of PowerPoint. Some lecturers are good; some are not. But I realized that the second they dimmed the lights to put up the projections, I had a Pavlovian reaction. I pulled out my Surgical Recall to study.

So essentially, I don't mind PowerPoint because it offers me the opportunity for self-directed study unmolested without the distraction of an engaging or novel lecture. And books tend to be more significantly higher yield, probably because they're not in PowerPoint format. And they're in normal English because the authors presumably have not been doing language gymnastics to avoid direct plagiarism. And I realized the only way to actually pull me OUT of reading my book is to have a lecturer that is either distractingly good or distractingly bad. But most fall under the "okay" line of droning information that is already on their slides with topics they know well, but are no longer capable of presenting in an interesting fashion.

Then I watched one of the really good, extremely knowledgeable residents get the crap pimped out of her on topics that were already later addressed in her presentation, which in fairness, wasn't bad. But you have no flexibility in the direction you're going with PowerPoint because it's already on the slides. And then if the attendings toss you in another direction by ripping you apart with questions, you're still left having to come back to your presentation and plod through slides they may have just explained to make a point, at which point you just kind of stare blankly at the screen, glance at the audience, say "uhhh" and then flip quickly past an hour's work, most of which probably consisted of spacing out the bullets and changing the fonts. Your audience is bored, you've lost your mojo, and more importantly, an hour of your life you will never ever get back.

Everyone thinks about the bad PowerPoint lectures because they're hilarious. But then I thought long and hard about the last GOOD lectures I've had. I've had plenty of perfectly functional decent lectures, including by other students, even when I was forced to pay attention, because text on screen is still text with information, even if it's a wildly inefficient way to get it.

But even this rotation, the GOOD lectures? Half of them were rounding with attendings. The SICU chief who kept vividly maiming our patients when we strayed in the wrong direction: "After spending four hours convincing Anesthesia to actually let you do this procedure, the patient codes on the table. They're resuscitated AGAIN. Systolic pressure is 50". "Uhhh... well, I'd order..." "40." "I'd explore the..." "30." "AHHHHHHH!!!" "Patient begins pouring feces out of the incision site." "AHHHHH!!! Is that a real thing???? Yes?? AHHHHHHHHH!!!"

The lectures with our attending that tells dirty jokes and pimps us... the impromptu question reviews, even when I think they aren't going to be relevant because they're surgical resident question reviews and I haven't studied adrenal anatomy in 8 months. Almost none have used PowerPoint. The ones that do have either been almost exclusively image-oriented or the speaker has barely referenced them and flips through them in the middle of an interesting lecture because a PowerPoint presentation was required or he doesn't have a pen that writes well on the back of his hand. (I'd make one of many easy cracks at Sarah Palin here, but since I totally do that too, I can't.)

And why do the funny effects or that humorous cartoon, or the serene picture of the beach entertain us? Because PowerPoint lectures are so mindnumbing that we need the emotional break from wanting to kill ourselves.

Which finally brings me to my second point. I had to present an excruciating article for surgery today and was up late doing it (because I was late in a lecture and spent a good part of the day listening to an attending bitch and moan about medical students not 'being around' because we're unreasonably 'post 24 hour weekend call' or 'in mandatory conference'). The article was almost exclusively statistical analysis on other statistical values about a topic that wasn't really easy when you stripped it to the original condition, and because I'm not a statistician (nor am I good at arithmetic), I had to Wiki half the terms in the freaking thing.

So I *finally* was able to understand the article, its point, and the original topic it addressed, and interpret the numbers.

But THEN I *still* had the task of taking all the information I had in my head AND the organization and logical follow through, and then turn it into a deadpan samey boring ass PowerPoint presentation despite having no idea which way the attendings would direct it. Plus doing PowerPoints gives me complete mental constipation while I struggle to elaborate on bullet points without reading text off the slide like the listeners are illiterate children rather than board certified freaking surgeons. In addition, the article was virtually incapable of being made interesting by anyone nor to anyone, and the only way you can make it less interesting is by taking all those statistics and copying them onto a PowerPoint slide.

So I kind of rebelled. I put together like 5 slides with the main points on them (particularly since the entire point of the article is summarized neatly in the title and the entire paper is merely justifying why they aren't full of crap) and just talked about it, summarizing the key findings without blasting numbers on a screen at 7 in the morning, and pretty much ignored my own slides. I think I was stuttering a bit because I'd gotten four hours of sleep and was presenting to a group of attendings without the mental crutch, but no one seemed pissed, so who knows.