From PowerPoint to PechaKucha

Marc J. Kahn, MD, MBA
Dean of the University of Nevada, Las Vegas School of Medicine; Member of the oversight working group and former Co-Director for the ASH Medical Educators Institute (MEI)

How often have you sat in the audience of a presentation at a medical conference and heard the speaker apologetically mumble, “Sorry, this is a busy slide …” How many times have you strained your eyes to read paragraphs of red text on a blue background? How many times have you squirmed in your chair as someone chose to spend his or her allotted time reading verbatim from slides?

For anyone who attends educational events with any regularity, these are all common scenarios – the unfortunate side effects of a reliance on PowerPoint presentations. Slideshows are the norm for medical presentations, but there is another way – a shorter, more engaging, and more fun way: PechaKucha.

“PechaKucha” is the Japanese term for “chitchat.” As the name suggests, this presentation style is fast-paced: 20 slides appear on screen for 20 seconds each. The slides automatically advance after the allotted 20 seconds, so the time constraint forces speakers to get to the point. The slides also are light on text, with most presenters opting for images only. So, an entire talk takes 6 minutes and 40 seconds, followed by a question-and-answer period with the audience. Several talks, potentially covering a massive amount of information, can be given in a relatively small block of time.

With a PechaKucha-style presentation, you’ll have tons of practice, you’ll never have to apologize for a busy slide, and you’re only up on stage for 6 minutes and 40 seconds. It goes quickly.

This presentation style was devised in 2003 for a meeting of Tokyo architects. The meeting organizers, realizing that architects could talk forever on any topic, devised the PechaKucha format to streamline presentations into concise, engaging experiences for the audience – and the presenter.

Within a couple of years, PechaKucha gained traction in several different professional settings. At the inaugural trainee-focused ASH-a-Palooza preceding the 2018 American Society of Hematology Annual Meeting, organizers included PechaKucha–style “Blood Drops,” talks in which experts spoke for 5 minutes using 20 slides that advanced automatically. I also have chaired PechaKucha sessions at the American College of Physicians annual meeting, where it has turned into a spectator sport – complete with a gong to subtly remind speakers when their time is up.

Practice Makes PechaKucha Perfect

Audience members love the PechaKucha format because it is undeniably fun to see if presenters can give a great presentation within such tight parameters. Speakers seem to enjoy the format because those same tight parameters force them to hone their presentation skills and think about what really matters.

Typically, when we prepare for an hour-long talk, we open PowerPoint and map out around 60 slides, following the standard rule of “one slide per minute.” We write down our talking points and fill out our slide templates, and that’s it. Most of us don’t practice them – why would we, when we have so much information on our slides?

So, how do you start a PechaKucha presentation? First, figure out what you want to say. The time constraint requires speakers to pare down their talking points. What information do you want to communicate? How can you do that with 20 slides that are only visible for 20 seconds each? If you can’t cover your topic in 6 minutes and 40 seconds, then you need to rethink and revise accordingly.

Next, storyboard your slides. Unlike the traditional presentation style in which the slides can supplant your lecture, the slides in a PechaKucha presentation are on the screen to enrich your presentation. Each slide contains little text in favor of images. Any text that you do include should be contained in a succinct bulleted list that keeps you on track.

When selecting images, you want to pick something that you could not adequately describe with text – a graph, a pathology image, a blood smear, etc. For example, my Blood Drop talk at ASH-a-Palooza covered the value of getting a degree in addition to your MD. When I spoke about MD/MBAs, I didn’t have a detailed description outlining the path to an MBA on the slide; I had an image of a graduate.

Next is the third step: Practice, practice, and practice. Repeat as necessary. The key to a successful PechaKucha presentation is rehearsing it until your timing is impeccable. If you go under your 20 seconds on a slide, there’s an uncomfortable silence; if you go over, you’re forced to play catch up.

Chitchat in the Classroom

The PowerPoint presentation is second nature for most of us. Leaving it behind for a new format can be daunting, but the style is ideal for the evolving medical education landscape. In my experience, students love it. Let’s face it: most students don’t attend classes anyway – and I don’t blame them. Why go to class if the only reason is to listen to a professor talk at you? Why attend a session at a medical meeting if the only reason is to listen to a researcher read from a slide?

From an educational perspective, PechaKucha is a way of taking what might be a mundane PowerPoint presentation and making it user friendly. The concept is a shift from lecturing at an audience for an hour to facilitating a conversation so that they engage with the information. For many of today’s learners with short attention spans, it makes sense.

For example, if I am planning a medical school class about acute leukemia, I would consider putting together a PechaKucha presentation on that topic, recording it, and making it available to students to watch before the next class. Hopefully, by the time they come to class, they have already spent the 6 minutes and 40 seconds viewing the presentation and have a base knowledge of leukemia physiology, so we can spend our class time discussing what they learned and they can ask follow-up questions. This enables a more informed, interactive conversation – rather than spending that time lecturing at them.

Grand rounds are another perfect opportunity to introduce the PechaKucha presentation style. Instead of one lecturer, invite five or six people to present a series of short talks. At Tulane University, we are planning to implement PechaKucha–style grand rounds this semester.

Senior faculty might be initially resistant to this novel concept, but we’ve found that everyone eventually comes around to the idea. They practice – alone and in front of people – and they realize that they can do it. They set their computer to advance slides automatically, they practice their timing, they say, “Hmm, this slide doesn’t work like I thought,” and they replace it.

I have found that it’s easy to get people to buy into the concept when they see it in action. So, to overcome people’s fears, focus on the advantages: You’ll have tons of practice, you’ll never have to apologize for a busy slide, and, although it might seem terrifying at first, in the end, you’re only up on stage for 6 minutes and 40 seconds. It goes quickly.

Coming Soon to a Meeting Near You?

The PechaKucha format is used to convey all types of information; there’s no reason that it can’t be used to present oral abstracts at a medical meeting. The relatively rapid-fire format of oral abstract sessions – 15 minutes to present data, plus a question-and-answer session – lends itself to the lightning-talk format. Again, the time-limited PechaKucha style forces speakers to focus on the most important information in their talks, so it is a phenomenal format for oral abstracts.

Also, consider your audience: At a medical conference, you’re pretty much talking with clinicians who have the requisite knowledge to understand your data. We tend to add introduction and background slides to our PowerPoint presentations – which often are the slides with the most text – but odds are that your audience already knows enough to follow your talk.

In a way, PechaKucha also forces the audience to pay attention. We have all seen it at today’s medical meetings: As soon as a slide goes up, so do audience members’ phones and tablets as they take photos that they will refer to later. To me, that means they’re not listening to what the speaker is actually saying. With the PechaKucha format, audience members are looking and listening more intently to the speaker. First, because they want to see if you can do it, and second, because it’s much easier to hold someone’s attention for 6 minutes and 40 seconds than it is to hold it for an hour. With PechaKucha, less is more: Less talking and more learning.

Examples from Dr. Kahn’s Blood Drop talk at ASH-a-Palooza