26 June 2019

Dr Chris Tiplady, Director of Education at Northumbria Healthcare NHS Foundation Trust, shares his advice on keeping your trainees – or any audience! – invested in their learning.

There are only a couple of things I dread being asked to do when it comes to training. The first is facing a room full of people who don’t want to be there and the second is being asked to do training about training. The latter is the ultimate test of your skills when every word you use, every slide you show and every move you make is watched very critically.

Every so often, I have done teaching or training that just seems to work. Was it me, my planning, the audience, the venue or just the stars aligning? Truthfully, it’s probably a little of each.

But the best answer I have about what good training looks like is this: I know it when I see it. I have learnt tricks from dozens of people over the years, from @ffolliet on Twitter, who’s brilliant with presentation skills, to the creative genius of junior doctor Jonny Guckian. And I’ve made a few up myself to see if they work.

So, if you’re looking to put an extra bit of ‘oomph’ into your next session, here are a few ideas:

Have fun and be creative

I had a huge amount of fun at a sixth former’s event a few years ago. I wanted to explain what doctors did – and my idea took me to work via the local petrol station. There, I bought nearly every type of chocolate bar they had and kept the receipts.

Stepping into the lecture theatre, I asked my audience of sixth formers for a volunteer. Always hard, but someone brave came down. Taking them to one side, I asked them to look in the shopping bag and pick their favourite chocolate bar without showing the audience. Then, I got them to sit down and slipped the bar under a towel, next to them on the table.

I wanted the room to imagine the chocolate bar was the illness our participant had come to us about. Without giving the name of the bar away, he had to answer questions about it (history taking) and another couple of volunteers felt the bar through the towel (examination). Then we came up with a list of possible chocolates (differential diagnosis). I gave the receipt to someone on the front row and told them how much it cost (doing a lab test), which only helped us exclude the cheap Fudge bar (pre-test probability, specificity and sensitivity). Last thing we did was cut a messy piece off (biopsy) and ask the front row to taste it (histopathology).

Through the whole process we discussed who else was involved (multi-disciplinary working) and what the volunteer was experiencing (patient centred care). It all worked because it was lively, interactive and used props that they all recognised. You have to ensure you relate to your audience using stories or examples they already understand. Medicine is full of complexity but there is nearly always a simple concept you can start with and build on.  

Set the scene and look after them

It’s probably cheating to involve chocolate with all your training, but looking after everyone’s basic needs is important. This is what American psychologist Maslow described in his ‘hierarchy of needs’: make sure your audience is warm, comfortable, happy, safe and welcome. As the trainer it is your job to ensure those things: to set the scene, the tone and the environment which allows your trainees to learn. You have to read your audience, however big or small it is. You should be the one they ask if the thermostat needs adjusting.

You also should be able to read the emotions in the room. It is so easy to upset, alienate or ignore people without you even noticing. So put every one of your senses into play and watch reactions, body language and energy levels. Importantly, if something isn’t working, be prepared to change what you are doing or how you are doing it.

Know your audience

It was easy to predict sixth formers’ level of knowledge – and to anticipate that they would interact with chocolate. But the worst thing you can do is underrate your audience.

My advice is to always look at the participant list in detail. Know what grade of staff you are teaching, where they come from and what they want from you. This is usually straightforward in small group teaching, but as your audience gets larger, you need to be able to pitch something to everyone or they will just turn off. A good teacher always sets out some learning objectives. Going to the effort of describing what you want your audience to learn, even if it just to yourself, is the first step in planning a good session.

Don’t be frightened to make fun of yourself

I have heard so many trainers and speakers tell me they feel like actors when they train. Many trainers, like me, are surprisingly quite introverted, but somehow, when planted in front of an audience or a teaching group, they open up. I find it easier speaking to an audience than making small talk at the parent/teacher night.

Personally, injecting a little humour and humility into my training has helped me manage feelings of discomfort or nervousness. People are there to learn from you, to listen to you and to be inspired by you – showing you have a fun side makes you approachable and they are far more likely to ask you questions. It is OK to use humour appropriately, as long as you never undermine or demean anyone (apart from yourself – a bit of light self-deprecation is fine).

I saw humour used brilliantly once, in a talk about how our appearance affects what we say. The trainer started in a white coat with pens in the pocket, removed that to show a sharp three piece suit, took the jacket off, then the tie, rolled the sleeves up and unbuttoned the top two buttons and then sat on a backwards chair. Every change of clothes came with a different impact.

I even tried this once wearing a fake tattoo sleeve, which was fun. I wanted to test if my audience was aware of unconscious bias: would they think differently of my message because of the way I looked? It was a useful tool for discussing emotional intelligence and how to manage difficult situations, since being aware of how you instinctively react is extremely important.

Steal the tricks

Everyone has someone who they remember as being inspiring, what was it they did and how did they do it? I watch brilliant TED talks to see how they do it, I am envious of the relaxed style of many TED speakers, the genius of their language and the logic of their arguments. You will know you have got it right as you start to feel comfortable and you get asked back to do the same talk again.

Get feedback

Reflecting on your own teaching and training is vital. After a session, write down what went well so you can adapt and improve – after all, everyone starts somewhere. Use feedback forms at the end of your sessions, email your students the next day or just plain ask them how it went. You may have to go on courses or read a book to fill the gaps in your current approach, but don’t worry, these are skills like any other that take time to learn and perfect.

Have a plan… and back-up plan

Work out what you want your learners to know at the end of your training – then work backwards, to think how they may best learn using you, your resources or what you can access on the day. This is the basics of lesson planning – I recommend getting further training on this if teaching becomes a big part of your role. Your students will benefit, you will feel more comfortable and it makes doing the session a second time really easy.

Aside from having a clear, timed plan for what you’re presenting, consider the practical resources you need too.  I am getting old but in those early days, you brought acetates as back up for slides. Neither of those would work now if your PowerPoint went down. So don’t rely on PowerPoint – in fact do everything you can not to rely on PowerPoint.

Don’t dump on your slides

When it comes to the visual bit of your training, any slides should be an aid to sharing your content; they should not be the content. There have been so many occasions when colleagues have told me that the best training they did was when the projector was broken, forcing them to be creative and innovative.

Avoid reading from slides at all costs: your audience will stop listening to you because you are not adding anything. Consider creative ways you could utilise visuals in your talk – strong diagrams, useful videos or props that will help your audience remember key bits of information. Memes have taken off on the internet and we should all learn something from them – a relevant image with a small amount of text will make a bigger impact than a page of data copied and pasted from a journal.   


At the end of the day, training should be fun to do and never a chore – after all, if you are bored, imagine what your learners are going through! If you do feel it’s a chore, ask yourself why. Are you the right person for this training? Have you been constrained by a boring curriculum? Or maybe it’s been a while since you refreshed things? Small changes like the ones I mention here can make a big difference – both for you, your audience and ultimately your patients.