numero rivista e pagine: HSR Proceedings in Intensive Care and Cardiovascular Anesthesia 2011; 3(4): 271-272
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Too-many-bullets spoil the broth (slightly modified English proverb)

Authors: M. John*

Head of Medical Humanities International MD Program, Professor of Biomedical Communication Skills, Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy

Corresponding author: * Corresponding author:
Prof. Michael John
UniversitÓ Vita-Salute San Raffaele
Via Olgettina, 48 - 20132 Milan, Italy

E-mail: michael.john@hsr.it

Hands up if you have ever seen a presentation where the slides were jam-packed with writing. Everybody has their hands up, I imagine. Presenters sadly feel the need to bombard the poor audience with slides that look like the opening chapter of Anna Karenina, meaning that they are full of words.
Lots of words. Sometimes these words will be written in complete sentences and these complete sentences will, in turn, make up paragraphs. This mass of words is often badly organized, making it not only irritating and frustrating to look at but also impossible to follow.
Slides need to be big, clear and uncluttered. If they are cluttered then they automatically become unclear and this will undoubtedly lead to a communications breakdown. So, those extensively written slides, where every word you need to pronounce, and not just the all-important key terminology, is written, will become dangerous boomerangs. Indeed, the audience is not there to listen to a bedtime story and certainly does not need you to read a list of complete sentences or, worse still, a long paragraph to them.
Be conservative, therefore, with your writing. Save your bullets. Ideally, you should never have more than four bullet points per slide and each point should be written, wherever possible, on one line to simplify and speed up reading. Bullet points are preferable to complete sentences as you only need to write in key terminology. You can then use this terminology as a launching pad for your story. You can avoid the problems caused by unnecessary words (at least in their written form) such as articles and certain prepositions. Having complete sentences is limiting, as you will no doubt read your data verbatim and this will make your presentations mechanical and boring, as well as patronizing and dull.
As bullet points should not be complete sentences but merely a list of key words and numbers, you will naturally not be needing punctuation of any kind. Indeed, how can you punctuate something that is not a sentence? It would be illogical and silly. The only punctuation you might need will be a question mark. Certainly not an exclamation mark. Stay away from that, please. Do not think you are stressing something’s importance by sticking an exclamation mark (sometimes two or three exclamation marks!!!) at the end of a bullet point. Exclamation marks are not elegant. You can give added stress to your words by varying the tone of your voice, which is not only more elegant but far more effective.
Another thing to avoid is semi colons and illogical grammar use (Figure 1).



Figure 1

I think the slides speak for themselves.


Look at the following example.
The introduction of anesthesia meant:

  • no pain for patients
  • easier work for surgeons 
  • longer surgical interventions 
  • the chance to work more slowly

In the example above we can see how the bullet points are a continuation of the initial statement.
They can be read and understood individually, or as a list of ideas. Although they do make up a complete sentence(s) no punctuation should be used between bullets and no final full stop is needed after the word slowly.
So, don’t fall into the trap. Keep your slides big, clear and uncluttered and save your bullets.


Questions from the readers

1- How should I use the laser pointer properly?
First of all, remember you have it in your hand. Use it to draw the audience’s attention to key terminology or to focus upon images. Do not move the laser around the screen excessively. Keep it on target. Do not over use the laser either. This would defeat the object of trying to draw attention to the key points. If used sparingly and correctly the laser pointer can be your most important ally during a presentation.

2- How can I improve my timing during presentations?
Timing is fundamental. It is the most important single aspect of presenting. You should NEVER exceed your allocated time. Practice makes perfect, so the more you practice the presentation the better the timing will be. Remember however that your time during practice could be reduced during the actual presentation in front of the audience because of the adrenalin factor. Indeed, nerves tend to make us do things more quickly. However, keep cool and remember to practice. Good improvisers are professionals of the highest level, and pros practice until they get everything just right.

3- What happens if someone asks me a question that I cannot answer?
Then just tell them you don’t know the answer. Nobody knows everything. You might not have sufficient data, or you might not wish to deal with this matter in this particular context as your knowledge is insufficient on this specific point. However, always be sure that you know how to answer questions on the data presented in your slides. Not knowing the answer in this case would be rather embarrassing, don’t you agree?


This is the twelfth of a series of articles on this topic. Send any questions to michael.john@hsr.it who will answer them as part of this column.