Spring

 
10  

Presentation  Prowess  Design  Documentation  

Patricia  Rand  
This  document  describes  the  design  process  and  decisions  that  were  used  to  
create  a  presentation  about  Congestive  Heart  Failure  using  the  Pecha  Kucha  
technique.  

I T   6 7 1 0   C r e a t i v e   D e s i g n   f o r   I n s t r u c t i o n a l   M a t e r i a l s  
Overview
This presentation is intended as an adjunct to the EMT and
Paramedic cardiology curriculum. The purpose of the
presentation is to teach the audience about the etiology,
symptoms and treatment of Congestive Heart Failure (CHF).
CHF is a complicated disease whose symptoms mimic many
other disease processes. With a prevalence of 1 in 56, CHF
is not an uncommon disease. Patients with CHF are likely to
activate the 911 system during times of disease
exacerbation. Exacerbation of CHF is a true, life-threatening
emergency. When an ambulance is called to assist a CHF
patient, correct diagnosis and treatment are imperative to
the survival of the patient.
The original presentation consisted of numerous PowerPoint
slides that were text-dense with very few photographs.
Following the presentation, students expressed confusion
over the subject matter and scored poorly on test questions
related to CHF.

Audience
Audience members consist of students in the EMT and
Paramedic programs at Aims Community College. The
demographics are typically 19 to 30 year olds in the EMT
class and 25 to 40 year olds in the Paramedic Program.
There are slightly more males to females. Students have all
undergone pre-assessment testing showing a reading level
of at least 80 on the Accuplacer test. This translates into
roughly freshmen level English. Paramedic students also
undergo pre-assessment testing to show baseline knowledge
in electrocardiography (EKG interpretation), basic algebra
and EMT principles. Additionally, Paramedic students have
completed two semesters of Anatomy and Physiology.

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Using Abela’s classification of personality types, the
audience is composed primarily of extraverts, intuitors,
feelers and judgers. The implications for these personality
types include the need for discussion, presentation of the
“big picture”, the implications for each stakeholder and
upfront conclusions (Abela 2008, p.21). Since the
presentation is designed for the classroom (either face to
face or online) discussion could easily follow the
presentation. The narration of the story gives the audience
the big picture at the beginning of the presentation and
provides clear conclusions at the end.

Learning Objectives
1. Following the presentation, students will be able to
recite the etiology of CHF.
2. Following the presentation, students will be able to
identify the symptoms of CHF exacerbation.
3. Following the presentation, students will be able to
correctly treat CHF exacerbation.

Problem/Solution
Typically, EMT and Paramedic students struggle with
recalling the etiology, symptoms and treatment algorhythms
of CHF. Previously, this curriculum was taught using the
stereotypical PowerPoint presentation full of endless bullet
points and mundane lists of information. The slides (and
presentation) were very text and fact dense and the overall
presentation was very long. This presentation will present
the information in an entirely different format in the form of
a story. The story-telling format enables understanding and
memory and according to Abela, is probably the method
through which most child and adult learning occurs (2008, p.

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65). Additionally, the revised presentation length is
significantly shorter than the original.

Evidence
Learners usually forget 90 percent of what they learn in a
class within 30 days (Medina 2008, p.100). However, when
photographs are added to the presentation, recall in greatly
increased (Medina 2008, p. 233). Additionally, presentation
of material in the form of a story appears to enable
understanding and memory (Abela 2008, p. 65). Medina
explains that emotionally arousing events tend to be better
remembered than neutral events (2008, p. 79). Finally, we
know that most audience members are able to pay attention
in ten-minute segments (Medina 2008, p. 74).

Anecdotes
The entire presentation is an anecdote in that it is told in the
form of a story. The presentation introduces two different
patients who have CHF. Specific, personal information about
patients is given in order to draw the viewer into their story.
Design decisions related to anecdotes include the following:
1. Facts about congestive heart failure are replaced with a
story about two people with the disease. As Terrance
McNally said, “Facts alone cannot counter what people
believe. The most powerful tool for convincing people is a
story”. (McNally, 2010). Abela further emphasizes the
choice of using storytelling by explaining that stories enable
understanding and memory (Abela, p. 65).
2. The story that is presented is intentionally designed to
play on the emotions of the audience and thus capture their
attention. This choice is supported by Abela who explains

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that since humans are both rational and emotional beings,
both of these faculties need to be engaged in order to hold
their attention (Abela, p. 63). McCloud also suggests the
importance of capturing the audience’s attention. He states,
“When creating something that will be presented to an
audience, take into consideration the things that will grab
their attention”. (2006, p. 35). Furthermore, Medina claims
that people do not pay attention to boring things. He states,
“The more attention the brain pays to a given stimulus, the
more elaborately the information will be encoded and
retained.” (2008, p.74).

The
presentation
utilizes a
story and
images that
are designed
to play on the
emotions of
the viewer.

3. The narration of the story is provided in a casual,

conversational tone. The use of this style is known as the
Personalization Principle and is shown to enhance learning.
(Clark and Mayer, 2008). This is an extremely unorthodox
delivery method in the field of medicine, as presenters
usually follow the dreaded text-laden PowerPoint style.
According to Medina, presentation using novel stimuli that is
unusual and unexpected is a powerful method for harnessing
attention from the audience (2008, p. 76).
Format

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Design decisions related to format include the following:
1. The presentation follows the Pecha Kucha format of 20
slides with 20 seconds of narration per slide. As Abela
explains, constraining the length of a presentation can
enhance the impact by packing information into a smaller
package (2008, p. 226). McCloud (2006, p.12) emphasizes
this practice when he describes communicating in the most
direct and efficient manner. As mentioned above, the
shorter length is ideal as it falls within the 10-minute time
frame that most people are able to pay attention (Medina
2008, p.74).
2. The presentation is narrated with the inclusion of pictures
and photographs that are relevant to the information being
discussed. This follows the Multimedia Principle, which
states that people learn better from words and pictures than
from words alone (Mayer, 2001). In fact, studies show that
when tested 72 hours after a presentation, people call recall
about 10% of information presented orally. That figure
increases to approximately 65% when pictures are added to
the oral presentation (Medina 2008, p.324).
3. In order to focus solely on the learning objectives, only
the most critical pieces of information about CHF are
included in the presentation. Students actually learn better
when extraneous material is excluded rather than included
(Medina, 2008 p.210). Heath and Heath emphasize the
importance of “finding the core of the idea” in order to
create a message that will be memorable (2008, p. 27).
The key pieces of information are then repeated throughout
the presentation to enhance memory as suggested by
Medina (2008, p. 123).

Sequencing

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Design decisions related to sequencing are as follows:
The sequence of events in the story was determined using
the SCoRE method as described by Abela (2008, pp. 75-79).
Situation: Two likeable characters, Rose and Oscar are
introduced.
Complication: Both suffer from a life-threatening illness.
Oscar is so sick that he may die any minute.
Resolution: Rose is treated with prescription medications to
manage her illness. Oscar is treated urgently with CPAP and
transported to the Emergency Room by ambulance.
Example: Graphic representations of each patient including
their face, symptoms, disease process and treatment are
provided.

1. The sequence of the story is intentionally designed to

create tension. Abela explains that creation of tension and
then resolution keeps the audience engaged (2008, pp.75-
87). McCloud also bestows the benefits of tension in the
creation of a compelling story (2006, pp 9-10).
2. The order of the presentation is designed to create a
comparison between two different patients with CHF. Tufte
(2006, p. 127) describes the use of comparisons when he
states, “Visual displays, if they are to assist thinking, should
show comparisons”.
3. The narration of the presentation begins by telling the
listener about each patient and then adding more details of
their condition. Medina suggests starting with the “big
picture” and then adding more details (2008). However, the
presentation does not add too many details. As Duarte
states, “too much data…is very distracting and in general a
bad thing” (2008, p. 74).
Graphics

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Design decisions related to graphics are as follows:
1. Photographs, which clearly demonstrate patient
symptoms, medications and disease pathophysiology, are
used. McCloud (2006, p. 37) emphasizes that thoughtful
choice of images is necessary to create clarity in the story.
Photographs that strictly served ornamental purposes are
avoided. Duarte (2008, p. 259) encourages designers to
avoid making “pretty talking points” and to instead display
information that makes complex information clear.

The original
presentation
contained text
heavy
information.
The student was
left to visualize
what the
symptoms look
like.

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 The new
presentation
utilizes
photographs to
teach the
student what the
symptom looks
like.

2. Photographs and text are used together to improve

recognition and recall of the material. As explained by
Reynolds (2007), pictures are remembered better than
words, especially during casual exposure. This is known as
the “Picture Superiority Effect”. As explained by Medina
(2008, p. 210), presentations using words and pictures lead
to deeper learning than presentations using words alone.

The use of
graphics and
text together
enhances recall
and learning.

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3. The majority of the presentation is delivered with the use
of photographs instead of bulleted lists. Medina explains
that the more visual the input is, the more likely the
information will be recognized and recalled (2008, p. 233).
This format allows the content to be processed quickly.
Duarte (2008, p.140) suggests using content that can be
processed within three seconds.

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Text
Design decisions related to text are as follows:
1. The presentation contains very little text. According to
Medina, less text and more pictures lead to better
comprehension (2008, p.238). The majority of the
information presented is in the form of the spoken word.
The narration was specifically designed to avoid reading the
written text on the slides. Duarte cautions against reciting
the exact information on the slides (2008, p. 221).

Very little text

is used. Text is
positioned
closed to the
object it refers
to. Word count
is kept low

2. Following the design principle of proximity (Williams,

2004), corresponding text and images are placed near each
other. Mayer (2001) showed that effectiveness of the
presentation increases when this principle is followed.
Duarte also advises placing text close to relevant graphics
(2008, p.133).
3. The content of the text is intentionally kept brief and to
the point. Heath and Heath (2007, p. 46) describe this as
creating a message that is simple and compact. Duarte
(2008, p. 144) also suggests keeping word count to a
minimum.

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Layout
Design decisions related to layout are as follows:
1. Slides are designed with a simple black background and
minimal photographs and text on each slide to create an
obvious point. Ample use of “white space” or in this case,
black space was used (Duarte, p. 106). This layout ensures
maximum readability and passes the “squint test” as
explained by Duarte (2008, p.111). Abela describes
creating a “central message” on each slide (2009, p. 109).

A maximum
amount of
white space
(in this case
black space)
is utilized.
The graphic is
arranged such
that it is the
dominant
feature with
minimal
information.

2. In order to enhance recall of the material, slides are

arranged such that graphic images are the most dominant
feature. Previous studies show that people were able to
remember more than 2500 pictures with 90% accuracy even
with exposures as short as 10 seconds. Accuracy rates a
year later still hovered around 63% (Medina 2008, p.233).
Duarte also describes the importance of placing content
purposefully on the slide (2008, p. 104).

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3. Slides are designed with minimal information or graphics
on each slide. Duarte (2008, p. 190) recommends dividing
content on multiple slides when there is an abundance of
information. Garr Reynolds (2008) also echoes the virtue of
simplicity in a presentation.

Measurement
Students will be assess for comprehension using the
following questions:
List two causes of CHF Two correct=10 pts
One correct=5 pts
Describe the pathophysiology Both correct=10 pts
of the two causes you listed One correct=5 pts
Describe four signs and Four correct=10 pts
symptoms that are Three correct=7 pts
associated with CHF Two correct= 5 pts
One correct=3 pts
Describe the prehospital Treatment is correct and
treatment of a patient with description is thoroughly
exacerbation of CHF explains the mechanism=10
symptoms and the pts
mechanism behind this Only treatment is listed
treatment without adequate explanation
of mechanism=5 pts

Points Possible 40 pts

Passing 30-40 pts

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Peer Review Results
Peer reviewers were asked to address five questions. The
following table lists each question and the reason the
question was asked. Results and planned changes are also
included.
Question Reason for Results Planned
Question Change
Please reflect on Did the Reviewer #1-“I No change (the
how much you presentation learned a lot, I audience has
knew about
congestive heart
teach would pre-requisite
failure before the something? recommend a knowledge of
presentation vs. Were the handout of terms)
after the learning terms for people
presentation. objectives met? who are not
familiar with
them”
Reviewer #2-“I
didn’t know
much about
CHF before the
presentation,
now I know the
causes”

Please describe One of the Reviewer #1-“I No change-this

how you felt about strategies of felt bad for the was the
the two characters
in the presentation.
this two characters” intended
presentation is Reviewer #2- outcome
to elicit “Your heart
emotions in the goes out for the
audience. characters”
Explain what you Which aspects Reviewer #1- No change
feel were the two of the “The characters
most effective
aspects of the
presentation and the
presentation and should be kept? graphics”
why. Is there Reviewer #2-
anything that could “Your
make them MORE explanation and
effective?
the characters,
also the
graphics”

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Explain what you Which aspects Reviewer #1-“I No change-this
feel were the two of the connected with was the
least effective
aspects of the
presentation the characters intended
presentation and should be too much” outcome
why. How would changed? Reviewer #2-“Is
you change them? there going to The audience
be some already knows
documentation the terms
that defines the
terms?”
How did the idea of Is the story- Reviewer #1-“It No change-this
presenting a telling format was easy to sit was the
difficult subject in
the form of a story
effective for the through and pay intended
(verses a bulleted subject matter? attention” outcome
list of causes, Reviewer #2-
symptoms and “Adding the
treatments) affect stories of Ruth
the depth of
learning of the
and Oscar made
subject? it seem more
like a
documentary
then a ppt”

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Resources
Abela, A. (2008). Advanced presentations by design:
Creating communications that drives action. San
Francisco, CA: Pfeiffer.
Clark, R. and Mayer, R. (2008). eLearning and the Science
of Instruction: Proven Guidelines for Consumers and
Designers of Multimedia Learning. San Francisco, CO:
Pfeiffer.
Duarte, N. (2008). slide:ology: The art and science of
creating great presentations. Sebastopol, CA: O’Reilly
Media, Inc.
Heath, C. and Heath, D. (2008). Made to Stick. Why Some
Ideas Survive and Others Die. New York, NY: Random
House.
Mayer, Richard E. (2003, April). The promise of multimedia
learning: using the same instructional design methods
across different media, Learning and Instruction, Volume
13, Issue 2, April 2003, Pages 125-139
Mayer, R. E. (2001). Multimedia learning. Cambridge,
England: Cambridge University Press.
Medina, J. (2008). Brain Rules: 12 principles for surviving
and thriving at work, home, and school. Seattle, WA:
Pear Press.
McNally, Terrance. “Corporate Storytelling.” Conference on
World Affairs. University of Colorado. Boulder, CO.
April, 2010.

16
Reynolds, G. (2007, April 30). Presentation Zen. Retrieved
from
http://www.presentationzen.com/presentionzen/2007/04
/the_picture_sup.html.
Tufte, E. R. (2006). Beautiful Evidence. Cheshire, CT:
Graphics Press, LLC.
Williams, R. (2004). The non-designer’s design book.
Berkeley, CA: Peachpit Press.

17
Appendix A

Presentation Prowess
Abela Worksheets
Patricia Rand

Worksheet A.1a. Audience Personality Type

Audience Personality Type

EMT and Paramedic students. Students The audience is primarily

are all adult learners composed of:

1. Extraverts
2. Intuitors
3. Feelers
4. Judgers

Worksheet A.1b. Audience Personality Implications

Instructional Product (presentation or job aid) Implications

Personality Implications
Extraverts Schedule time for questions and
discussion
Intuitors Provide and overview upfront
Feelers State implications for each stakeholder
Judgers Present conclusions up front

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 Worksheet A.2. From-To Think-Do Matrix

From
Think 1. I don’t remember the
causes of CHF
2. I don’t remember the
symptoms of CHF
3. I don’t remember the
treatment of acute CHF
Do 1. Inability to recognize
CHF in a patient
2. Inability to properly treat
acute CHF in a patient
To
1. I can remember the causes of CHF
2. I can remember the symptoms of
CHF
3. I can remember the treatment for
acute CHF
1. Ability to recognize the symptoms of
CHF
2. Ability to properly treat acute CHF

Worksheet A.3. Audience Problem

Learning Needs:
1. The audience has difficulty remembering the etiology of CHF.
2. The audience has difficulty recognizing the symptoms of CHF.
3. The audience has difficulty recalling the treatment algorhythm of CHF.

Instructional Goals:
1. The audience will remember the etiology of CHF.
2. The audience will recognize the symptoms of CHF.
3. The audience will recall the treatment algorhythm of CHF.

Worksheet A.4. Spectrum of Solution Contributions

Recognize Help define Help solve Help solve

Helps to define part of the
there is a the problem the solution the whole
problem space problem problem

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 Worksheet A.5. Solution Evaluation

Option 1 Option 2 Option 3

Do Nothing Conduct post Conduct
Evaluation class assessment simulated patient
Criteria scenarios
Learners Learners will list Learners will ask
will recall the common pertinent
the ___ causes of CHF questions about
etiology of the patient’s past
CHF medical history
related to CHF
symptoms
Learners Learners will list Learners will
will the common correctly
recognize symptoms of CHF diagnose a
(and recite) ____ patient with CHF
the after conducting a
symptoms physical exam
of CHF
Learners Learners will list Learners will
will recite the treatments of correctly treat a
the ____ CHF patient with CHF
treatment after properly
algorhythm diagnosing them
for CHF

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Worksheet A.6. List of Evidence

1. Storytelling-example patients will be personalized with names,

photos
2. Causes, symptoms and treatment of CHF will be presented in a
story format
3. Photographs of physical assessment findings (symptoms of CHF)
will be included

Worksheet A.7 Stakeholder Analysis

Who will be Students Instructors Patients

impacted by
the success or
failure of this
instructional
product?
What is their Students must Instructors Patients do not
role in the watch the must have a direct roll.
success or presentation understand the
failure of this then apply what curriculum
instructional they have themselves so
product? learned to real that learning
life and can be properly
simulation assessed.
patients.
How will they Students will Instructors will Patients will
be impacted if understand the be able to receive prompt
the etiology, move on to and correct care
instructional symptoms and more advanced resulting in
product is a treatment of curricula since treatment of their
success (i.e., CHF resulting in the students condition
learners the ability to will already
achieve correctly understand the
learning diagnose and basic
objectives)? treat patients information

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 with CHF. about CHF
How will they Students will Instructors will Patients will not
be impacted if not understand have to spend receive prompt
the the etiology, more time and/or correct
instructional symptoms and covering the care resulting in
product is a treatment of information exacerbation of
failure (i.e., CHF resulting in about basic their condition
learners do the inability to
not achieve correctly
learning diagnose and
objectives)? treat patients
with CHF

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Appendix B
Presentation Prowess Checklist

Please complete this checklist, and submit it with your final Presentation
Prowess project.

Name: Patricia Rand

A. Components submitted prior to final project

Completed? Project Element # of

Points
(Y or N) Possible

Memo (less than one page in length) of intent regarding 5

context, content, and anticipated format. Due 4/4.
Y

By the due date, draft presentation is posted for peer 5

review with a list of five questions to guide peer reviewers.
Y Due 4/18.

Two peer reviews completed by due date (2 reviews x 5 10

points per review). Due 4/21.
Y

Total 20

B. Presentation ~ Draft for peer review due 4/25; final version due 4/28

Completed? Project Element # of

Points
(Y or N) Possible

Teaches somebody something (i.e., is instructional, not 5

simply informational).
Y

Pecha Kucha Is either in the format of a (a) pecha kucha (20 5

images/slides, 20 seconds per image/slide), or (b) music
video.

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 Speaks for itself (i.e., does not require a human at a 3
podium to explain the message).
Y

Can be delivered on a big screen in a physical space or via 3

a computer screen.
Y

Total 16

C. Design Document ~ Due 4/28

Completed? Project Element # of

Points
(Y or N) Possible

Sections 1 through 7: Complete, following project 8

directions. Note: There have been consistent issues with a
few of these sections, so please double-check the following:

Audience—Is Abela’s approach to determining

Y audience characteristics referenced? Is it clear how
the audience characteristics influence design
decisions?
Learning Objectives—Are measurable learning
Y objectives listed? Do the learning objectives address
change in the learners—what learners will do
differently as a result of the presentation?
Anecdotes—Are anecdotes shared that influence
Y the story told by the presentation?

Sequencing Section: Following the project directions, 5

design decisions related to sequencing (following Abela’s
S.C.o.R.E. method) are clearly described and supported by
our readings.

Check off completed items:

Y Three creative, significant design decisions

are shared.
Each design decision is supported by at least
Y two unique citations.

24
 Y two unique citations.
Y Application of Abela’s S.C.o.R.E. method is
described.
Y Design decisions are numbered.
Y Location in presentation of where each design
Screen decision is instantiated is provided.
shots

Graphics Section: Following the project directions, design 5

decisions related to graphics are clearly described and
supported by our readings.

Check off completed items:

Y Three creative, significant design decisions

are shared.
Each design decision is supported by at least
Y two unique citations.
Y Design decisions are numbered.
Y Location in presentation of where each design
Screen decision is instantiated is provided.
shots

Text Section: Following the project directions, design 5

decisions related to text are clearly described and
supported by our readings. Note: Text-related design
decisions also include what content is shared via text:
narration, music lyrics, dialogue, and so on.

Check off completed items:

Y Three creative, significant design decisions

are shared.
Each design decision is supported by at least
Y two unique citations.
Y Design decisions are numbered.
Y Location in presentation of where each design
Screen decision is instantiated is provided.
shots

25
Layout Section: Following the project directions, design 5
decisions related to layout are clearly described and
supported by our readings.

Check off completed items:

Y Three creative, significant design decisions are

shared.
Each design decision is supported by at least two
unique citations.
Y Design decisions are numbered.
Location in presentation of where each design
Y decision is instantiated is provided.

Measurement Section: Determinants/measurements of 3

presentation success (in terms of the presentation filling
the instructional need) are clearly described.
Check off completed items:

Y Clear connection to learning objectives is

provided.
Approach to measuring whether the learning
Y objectives have been achieved as a result of the
presentation is described (regardless of whether
measurement is possible).

Results of the Peer Review: Shared, and revisions based 3

on those results are described.

Check off those items completed:

Y Specific results of peer review are provided.

Description of how results for each question
Y were addressed or not addressed is provided.

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 Abela’s Appendix A Worksheets: Completed in advance 5
of building actual slides and included as a Design Document
Y appendix.

Specific Authors are Cited: Abela, Duarte, Reynolds,

Medina, and Vernallis (you are also welcome to cite Tufte,
Y Roam, and McCloud if applicable to your work).

Total 39

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