On Shaping a Talk

On Shaping a Talk

“Those managerial egos were pleasantly piqued. What helped was the opening gambit: a detailed metric analysis of Rambo films.”

Background to London, 2008, An insiders account, by Dr. Diana A. Taylor.

“In devising and shaping a conference talk under such circumstances is, therefore, no different to the core aim of medical writing itself: devising, shaping and delivering information for the intended–and assumed–audience/s.”

“We are all fated to be on someone else’s list. Some are known, most unknown, many unwelcome, and a few much appreciated. One of the former for me is the one kept in a database by colleagues at the Institute of International Research, owned since 2006 by Informa UK.

The list confirms that I can be called upon to speak at conferences on subjects directly or tangentially associated with my core work activity–medical writing, a subject on which I have been happy to lead IIR workshops across Europe since 2002.While the advantages of the arrangement can be obvious, each invitation comes with its own bundle of logistic and, often stimulating, professional demands.

As experience has uncomfortably shown, for example, the invitation usually comes during the very final stages of the conference planning; a point where the general story is in plain view, the participant numbers are looking healthy and fine-tuning is now the order of the day and night. So my requested talk must be quickly formulated, abstracted, and a PowerPoint delivered at very short notice to Informa HQ in London.

This means intensive preparatory homework on the particular conference–its agenda, its location, stated and assumed subject range, the profile of its organisers, its likely participants and, crucially, those speakers who are already listed. So, yes, lots of Zooming, Xinging and Googling.

Despite the tight learning curve, one advantage at this point is that since 90% of the schedule and speakers is fixed, I can quickly determine the scope and allowable content overlap of my proposed talk, how and where does my particular account fit into the conference narrative. Knowing in advance when my talk is precisely scheduled is of course additionally invaluable in this respect. (According to Patrick H. Winston [1], the ideal slot is 11.00 am). The irony here is that the last called can often be amongst the first to speak, as happened for the informa conference on Comprehensive user testing of the patient information leaflet in Sofia, Bulgaria, 11-12 September 2006 (www.ibc-lifesci.com/readability).

On this occasion I ensured that my talk became a generalist overview–lordly pitched to anticipate and help establish the subject and thematic scope of those that were to follow. In devising and shaping a conference talk under such circumstances is, therefore, no different to the core aim of medical writing itself: devising, shaping and delivering information for the intended–and assumed–audience/s.

What militates against the building panic is that I have certain creative and pedagogic luxuries in my approach, as the conference has been virtually sold. In 2003, for example, I was called upon to hold forth in Munich on best practices in the creation of SOPs for clinical drug development, that uncomfortable procedural ‘tool’ that emerged in the wake of severe middle-management downsizing in the 1980s.

On that occasion the emphasis was on how knowledge workers can best meet the demands of the operational management procedures as grounded on SOPs with the smart economy that rests on professional expertise, workplace learning, response and innovation?

So, my name on the Informa UK list can implicate me on a journey that often compels me–despite my better judgement–to quickly learn, articulate and hold forth with authority upon a topic that is embedded in my daily work as a medical writer, but which is not always so explicitly coupled to the drafting of a clinical study report or the preparation of a subject information for obtaining informed consent from a prospective trial participant.

Such was the case in late 2007 when, meeting urgent Christmas and New Year deadlines at work (PAREXEL, Berlin) I was asked to hold forth for the 5th Annual conference on Clinical trial performance metrics in London, as scheduled for February 20th-21st 2008:-

“The 5th Annual Clinical Trial Performance Metrics conference is the leading European event assembling senior industry decision-makers to discuss their key experiences in measuring and enhancing clinical trial performance and productivity. Attending this event will provide you with first-hand experience of success and failures in the set-up and implementation of metrics and benchmarking systems to enable you to improve the quality of your own metrics systems… At 11.30 on Thursday 21 February, Diana Taylor, Medical Writer and Trainer of PAREXEL will give the following presentation: `Involving metrics early in a new employee’s work: risks and benefits`:-

• The dual nature: metrics and performance – balancing the odds
• Individual metrics for the individual employee?
• Life with metrics for medical writers at a CRO: an example”

The Preparation
Metrics? Not the most appealing of subjects. But for a veteran of my own seminars on ‘Professional working practices for the SOP–Challenging times for the smart knowledge worker’ for the Pharmaceutical Training Institute (PTI) and as fueled with recent discussions at the Medical Writing SIAC at the DIA, I was willing to give it a try. My initial wariness was quickly confirmed when I blinked the drafted conference flier, whose tantalisingly headed slug line promised ‘using metrics to improve performance and productivity’.

One of the four key claims for participants was to ‘gain real experience and data to successfully implement and apply metrics systems’. As if that wasn’t enough, according to the flier’s headline tag, I was to be one of ‘the leading metrics experts at Europe’s only clinical performance event’. And my fellow speakers? The first day list gives the reader a good idea of the challenge: it included David Davies (Futura Medical Development Limited), Jossy Matute (Planning and Metrics Manager Europe, Eli Lilly & Co), Mary O’Mahony (Principal Investigator, National Institute of Economic and Social Research), Detlef Geiges (Director Clinical Support, AstraZeneca). The keynote address was to be from John Bennett–Senior Director, Portfolio Management, Pfizer. Speakers from Genentech (David Polakovs) and Roche (Michael Britt) were also included. Speaking on ‘Monitoring and managing patient recruitment with metrics’ was Dave Zuckerman (President, Customized Improvement Strategies), and Tom Gibb (Senior Partner, Result Planning Limited) shared his thirty years experience to the subject of ‘Applying a planning language from software engineering metrics to clinical trials performance metrics’. A quick Google search on these names revealed extensive CVs of the founding CEOs of companies that, since the 1980s, had become the leading ‘drivers’ in this very field. Such, then, was the substance and standing of my fellow speakers.

However, despite each speaker’s industry prominence–and the obvious importance and weight of their separate talks–it was clear from the draft flier that the conference narrative as a whole was already deep in content overlap. Which, I guessed, why I was called.However, before succumbing to the welcoming temptations of the PowerPoint (the deadline was late January), I thought it wise to second-guess the profile of the paying participants and who would most likely want to undertake a cold, wet, mid-week jaunt to London for GBP 1408.83. Like it or not, these would likely to be middle managers and similar to the gender profile of the speakers–12 men, 5 women, including me.

As it happened, this proved an accurate assumption (little did I know at the time, but I was engaging in a form of heuristic metrics already, intuiting, that is, the likely outcome of an event based on certain limited but relevant data!). And then there was the uncomfortable hard graft–some back-to-basics assurances: what exactly is a ‘metric’? I quickly sidebared the informa programme and, starting simple, reached for the Collins English Dictionary that revealed intriguing definitions: ‘Maths: denoting or relating to a set of containing pairs of points for each of which a non-negative real number p (x,y) (the distance) can be defined, satisfying specific conditions.’

Even though, a PhD in Nuclear Physics (which I am) might be challenged by such questionable help, especially when combined with a secondary definition that lingers on the same page: ‘Prosody. The art of using poetic metre.’

`Metrics’, it seemed, sat happily poised somewhere between the worlds of hard science and the literary arts. Which, depending on one’s predilections, could either be a problem or an opportunity.

In preparing my talk, I chose it should be the latter. As usual when plunged into such a sharp learning curve, the apparently new quickly becomes the recognisably familiar. In my research on the use of metrics in the pharmaceutical industry (most applicable in project management), I began to see its use in all aspects of everyday private and business life: decisions/hunches in the global economy surfs the incoming ticker tape of changing stocks and shares (finance metrics); we are accustomed to film industry reports that focus on box office metrics; car drivers compute their chances of surviving a cold storm on the basis of mixed metrics–the cost and availability of petrol, the time of travel, the time of year, the gradient of a hill; while (most) smokers do their very best to ignore those metrics that predicate their chances of long-term survival–and as written, no doubt, by medical writers.

From the Age of Enlightenment, then, welcome to the Age of Calculation, the urge for change, adventure, and profit, but at little or no risk.

The Presentation Challenge.
But how applicable is this to the daily work of a medical writer? That was the question, which I was suddenly invited to answer. What motivated, or should I say ‘drove’ my own critical thinking on the subject, was the written assumption from one speaker that metrics could ‘drive not only performance but also behaviour and change towards a more efficient and better standardized organisation’. Metrics, then, designed to change whose behaviour? No doubt, the employees.

As can be noted in the PowerPoint presentation(http://healthywords.edublogs.org), I made my own claims to ‘using metrics to improve performance and productivity’. The opening gambit that would agree with audience assumptions was to accept the familiar time, budget, and quality rubric and yet emphasise its importance in the early recruitment not of patients–but medical writers, and, beyond that, managers. My critical position was to alert managers (of whom there would be many in the room) of their responsibility in recruiting–and retaining–their best ‘knowledge and communication workers’ and on which their profits are ultimately dependent.

To support my aim, opening slides reminded the audience of their own historical context–back to the early development of scientific management principles of Frederick Winslow Taylor and highlighting then the importance he attached to the selection, training, and development of workers–and, crucially, the need, as well, for qualified management. With this principle fixed, focus then turned to the recruitment, training, and retaining of medical writers. It was about this point in the talk (bait and switch) that the first laughs were recorded on the Taylor MetriCom–with the employment of recently plundered quotes that ‘What corporate America can’t build: a sentence’ and ‘Even C.E.O.’s need writing help…They’re in denial, and who’s going to argue with the boss?’ [2]

With managerial egos hopefully piqued, the talk then angled towards a core question:

How to determine what makes a good medical writer? and as headed by a warning that ‘we cannot assume that someone who writes well will be a great medical writer’. Familiar performance metrics in this regard were quickly listed: the quality of the application document, technical skills, industry knowledge (laws), language skills, interpersonal competences, ability to learn.My critical questions at this point came thick and fast: “So, you tested the candidate for technical skills. What else would you like to test? How do you test if a candidate can see the big picture of a document, tell a story? Can the candidate understand what the data are saying, can he/she tell a credible story? In other words, how do you measure the thinking skills of a candidate? What metrics do you apply here? Their time needed to write a full-integrated report? Or their time to implement comments from reviewers?”

How these are accessed accurately and effectively by a CRO, never mind a line manager is the question.

As shared now with the conference attendees, the timing of the talk coincided with current DIA discussions designing metrics or tests for the assessment of medical writers–and this across the whole life cycle of that writer, an industry development that only transpired through my preparatory research.

Frederick Taylor’s time and motion tests were in his day readily applicable to hunks of manhood carrying their heavy loads of coal from A to B.

However, the same thinking that pursued ‘optimal performance’ then, still assumes the ability to penetrate into the effectiveness of employee cognitive thinking skills–while they are in operation and in a way that, magically with more ‘data’, is designed to improve on their current performance, ‘towards a more efficient and better standardized organisation’, as one of the colleagues would have it.

Pharma is, after all, a leading example of the ‘knowledge economy’, and the medical writer, understandably, is at its own coalface.

As the reader might gather, my talk emerged as a critical liturgy on the scorecard mentality that seems to characterise managerial ‘thinking’ and, dare we say it, ‘planning’ that now pervades the pharmaceutical industry [3] and which was ‘driven’ and championed by my fellow speakers.

Reflections: ‘Late afternoon is also bad…Never speak after dinner’. [1]
As it happened, I was unable to avoid two of Patrick H. Winston’s main warnings. As expected, by the mid-afternoon of the second day the participants were understandably fatigued with the repetitive churn of metrics terminologies. So, as hoped, my own critical account that was scheduled for this time played its part in sharpening the cognitive daze.

Those managerial egos were pleasantly piqued. What helped was the opening gambit: a detailed metric analysis of Rambo films.

None was expecting an outline of how metrics could be employed in the analysis of sex and violence in the movies of Mr. Stallone.

According to my own finely tuned bias-free scorecard, immediate feedback from the predominantly male audience was generally positive and welcoming, including, as it did, an immediate offer to participate in a London ‘Think Tank’.

On another list, then”.

Feedback from the London 2008 conference:
“Very well structured, talented speakers and positive brainstorming on a complex topic.” (Merck Serono International SA, 2008 delegate)
“Heightened my awareness of the need to define metrics and other measures to improve the quality and performance of our clinical studies.” (Cordis Clinical Research Europe, 2008 delegate)
“Interesting opportunity to gather case studies and learnings from other companies on performance metrics.” (F Hoffmann-La Roche AG, 2008 delegate)