“Its all about the audience” is a nice sentiment, but only half true”
― Dan Roam, author of “Show and Tell” book

show-tell bookPublic speaking and presentation building skills are critical aspects of medical education and academic careers. Despite how important it is to develop these skills, many educators often “wing it” or copy the same boring format they have seen in the past. Show and Tell: How Everybody Can Make Extraordinary Presentations by Dan Roam is a worthy investment for anyone seeking to improve their public speaking skills. And this concise book stands out among the plethora of books available in this genre; not only is it refreshingly simplified, but it is also uniquely visually appealing.


As physicians we are accustomed to the many difficult conversations within the clinical setting. This may be telling a family that they have lost a loved one or that the cancer in remission has returned. We have learned over the years to develop our own delivery and conversation style. And yet, when preparing for a public presentation, the overwhelming majority of us feel uncomfortable and incredibly nervous. Dan Roam seeks to help presenters of all levels master the art of an amazing presentation using the skills he teaches in “Show and Tell.” Through a series of stick figures and real life analysis of presentations, he shows us how to build a phenomenal presentation and to capture our audience using three fundamental rules:  

  1. Tell the truth and the heart will follow
  2. Tell it with a story and the understanding will follow
  3. Tell the story with pictures and the mind will follow

1) Tell the truth and the heart will follow.

“What makes an extraordinary presentation? One that changes people. What makes people change? The truth.”

He discusses the “pyramid of truth” – the different types of truth: factual, intellectual, and emotional. By forming truths into 3 categories: your idea, your identity and what you want to portray and finally who your audience is, you can better pull together your ideas and unite the goals for your presentation.

2) Tell it with a story and the understanding will follow.

“The change we want our audience to experience will determine which storyline we choose”

Roam discusses at length the need for a clear storyline, as the backbone to your presentation. At the core of every presentation is one of four storylines. A “report” storyline will deliver the facts. An “explanation” will teach new insights or abilities. The “pitch” is for recommending solutions, and the “drama” is to inspire a new belief, for example TED talks. Each type of story line has its own unique goals and composite, however they all have two things in common – they all have a beginning and an end, and secondly, the endpoint of the storyline should be set up to teach or “trigger” change in our audience. By knowing how far and how high we want to take our audience, we can truly start to build the presentation.

3) Tell the story with pictures and the mind will follow.

“If we do have something interesting to look at, our minds can stay focused forever”

Dan describes the 6 primary “visual pathways” through which our eyes monitor the world. He states that in order to illustrate any story, we only need 6 pictures to show anything: portraits showing our players and objects, charts to show quantity, maps to show location and overlap, a timeline to show sequence, a flowchart to show cause and effect, and finally an equation to show the moral of the story. By combining a few of these simple pictures we can bring the storyline to life.


The final chapters in the book touch on how to alleviate the fear of presenting and how to conduct yourself on stage. The ideas in the book are straightforward and break down storytelling into the most essential elements, giving us the skills of a great presenter.

  • By telling the truth we can connect with our audience, become passionate and find self-confidence
  • By telling it with a story we make complex concepts clear, we make ideas unforgettable, and we take our audience to a new level
  • By telling the story with pictures our audience will see exactly what we mean, we captivate their mind and we banish boredom

Clinical Applications

1) Tips for Lecture Based Education

Utilizing different storylines and truths for the variety of audiences we present to can guide how we build our lectures. For example, when lecturing to interns and junior residents a factual truth through a “report” type presentation may be the best approach. When your audience is the experienced physician, they may require a “pitch” or a “drama” storyline to change their practice. By understanding our audience and the goals we have set for each group we can create change more effectively in our audience.

2) Tips for Bedside Teaching

Using the truth to teach residents and medical students is of utmost importance. There is no faster way to lose your learners trust then to lie. Also, your learners do not want to be told what to do but want their ideas corroborated. When teaching, allowing learners to think something that you are teaching them is their idea will allow for the most effective passage of information.

About the Author

Dan Roam is the founder and president of Digital Roam Inc., a management-consulting firm that uses visual thinking to solve complex problems for such clients as Google, Boeing, eBay, Microsoft, Wal-Mart, Wells Fargo, and the United States Senate. Along with Show and Tell, Roam is the the author of the international bestseller The Back of the Napkin, the most popular visual-thinking business book of all time.

Discussion Questions

  • Think of the last time you have sat in an amazing presentation – what specifically was it about the presentation that was so engaging?
  • Has this book changed how you approach making a presentation?
  • What are challenges in incorporating the ideas that Dan Roam suggests in clinical presentations?
  • What are some ways we can translate the fundamentals of presenting to bedside teaching?
Fareen Zaver, MD

Fareen Zaver, MD

Chief Operating Officer, Chief Resident Incubator 2017-18
Lead Editor/Co-Founder of ALiEM Approved Instructional Resources - Professional (AIR-Pro)
Champion, 2016-17 ALiEM Chief Resident Incubator
Board Member, 2016-17 ALiEM Wellness Think Tank
Deputy Head - Education and Clinical Assistant Professor for Emergency Medicine
University of Calgary Emergency Department
Fareen Zaver, MD


@UCalgaryEM Clinical Educator, interests in transition to practice, gender equity, #FOAMed @ALiEMteam & @WeAreCanadiEM #Meded #genderequity
Shana Ross, DO MSc

Shana Ross, DO MSc

Assistant Residency Program Director
Assistant Professor
Department of Emergency Medicine
University of Illinois-Chicago