title: Continuing Medical Education Speakers with High Evaluation Scores Use more Image-based Slides.
abstract: BACKGROUND
  Although continuing medical education (CME) presentations are common across health professions, it is unknown whether slide design is independently associated with audience evaluations of the speaker. Based on the conceptual framework of Mayer's theory of multimedia learning, this study aimed to determine whether image use and text density in presentation slides are associated with overall speaker evaluations.
  
  
  METHODS
  This retrospective analysis of six sequential CME conferences (two annual emergency medicine conferences over a three-year period) used a mixed linear regression model to assess whether post-conference speaker evaluations were associated with image fraction (percentage of image-based slides per presentation) and text density (number of words per slide).
  
  
  RESULTS
  A total of 105 unique lectures were given by 49 faculty members, and 1,222 evaluations (70.1% response rate) were available for analysis. On average, 47.4% (SD=25.36) of slides had at least one educationally-relevant image (image fraction). Image fraction significantly predicted overall higher evaluation scores [F(1, 100.676)=6.158, p=0.015] in the mixed linear regression model. The mean (SD) text density was 25.61 (8.14) words/slide but was not a significant predictor [F(1, 86.293)=0.55, p=0.815]. Of note, the individual speaker [χ2(1)=2.952, p=0.003] and speaker seniority [F(3, 59.713)=4.083, p=0.011] significantly predicted higher scores.
  
  
  CONCLUSIONS
  This is the first published study to date assessing the linkage between slide design and CME speaker evaluations by an audience of practicing clinicians. The incorporation of images was associated with higher evaluation scores, in alignment with Mayer's theory of multimedia learning. Contrary to this theory, however, text density showed no significant association, suggesting that these scores may be multifactorial. Professional development efforts should focus on teaching best practices in both slide design and presentation skills.
authors.affiliation: Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Ian
authors.initials: I
authors.lastname: Ferguson
authors.affiliation: Stanford University, Department of Anesthesia, Division of Critical Care, Stanford, California.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Phillips
authors.affiliation: University of California, San Francisco, Department of Emergency Medicine, San Francisco, California.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lin
mesh_terms: D003226:Congresses as Topic; D003626:Data Display / Q000706:statistics & numerical data*; D004502:Education, Medical, Continuing / Q000592:standards*; D005069:Evaluation Studies as Topic; D006801:Humans; D016014:Linear Models; D012107:Research Design / Q000592:standards*; D012189:Retrospective Studies; D014481:United States