Systematic Effective Instruction 3: Adapting Instruction for Varied Audiences and Formats


Systematic Effective Instruction 3

Adapting Instruction for Varied Audiences and Formats

Margaret M. Plack, PT, DPT, EdD and Maryanne Driscoll, PhD


After reading this chapter, the reader will be prepared to:

  • Define the non-negotiable elements of systematic effective instruction.
  • Apply the non-negotiable elements to a variety of presentation formats.
  • Use the non-negotiable elements to problem solve a variety of common instructional mistakes.
  • Identify additional variables that influence instructional design.
  • Adapt presentations to meet the demands of various formats and time frames.


What do you think of when you think about “Teaching and Learning in Physical Therapy”? Consider the following:

  • Who do physical therapists teach?
  • What do physical therapists teach?
  • Where do physical therapists teach?
  • When do physical therapists teach?
  • How do physical therapists teach?
  • Why do physical therapists teach?

In the introductory chapter, we asked you to “Stop and Reflect” on what you think of when you think about “Teaching and Learning in Physical Therapy.” From there, we explored what the learner brings to the learning situation and the characteristics of our learners, we examined the reflective process and discussed how to facilitate critical thinking on the part of our learners (students and patients), we described the structure and function of the brain and the implications of current brain research on teaching and learning, and we presented a systematic approach to designing effective teaching-learning situations.

By now, you recognize the complexity of your role as an educator. You know that teaching is much more than simply telling your patients or audience what is important and expecting that they will learn it and remember it, or relying on the old mantra “show one, do one, teach one.” Teaching requires a systematic and comprehensive approach to understanding your learners, focusing their attention, presenting materials in a manner that meets their needs, and continually reinforcing the learning so that they can achieve behavior change and/or knowledge retention. Teaching requires deliberate design and planning. By now, you also recognize just how much teaching is an integral part of being a health care practitioner and how each teaching-learning situation is unique.

In the previous chapters, we presented the principles behind effective teaching, whether in the classroom or clinical setting. However, as noted in previous chapters, each teaching-learning situation is unique, and, as health care professionals, we engage in a great variety of teaching activities. For example, you may be asked to present at a community fair or a national meeting, you may want to present your scientific findings in a poster or platform presentation format, you may be invited to do a workshop that lasts 3 hours or a continuing education course that lasts 3 days, you may be called upon to participate in a panel discussion, or you may be asked to teach in a doctor of physical therapy (DPT) classroom or laboratory. These presentations can span across the clinic, hospital, classroom, laboratory, conference room, or community setting. How can you use the principles discussed in the previous chapters to prepare for the variety of teaching-learning situations that you may be expected to engage in physical therapy practice?

This chapter is designed to build on the principles of systematic effective instruction presented in Chapters 5 and 6 as you think about how you might adapt your presentation to meet the demands of different presentation formats and different audiences. Which components of the principles of systematic effective instruction are non-negotiable and which ones can be modified or deleted depending on the situation? What else must you consider in trying to meet the demands of the requested presentation format? What will you do if you arrive and find that your audience is much more knowledgeable than you anticipated or the room set-up is not what you had planned? What will you do if your presentation is taking much longer than you had planned? Will you be ready? To begin this chapter, we would like you to take some time to ponder the scenarios presented in the following sections.


MJ is presenting at a national conference for the first time. She is eager to share her recently developed curriculum on strategies to communicate effectively with challenging patients. She is speaking to an audience of experienced academicians and clinicians. Out of respect for her audience’s expertise, she decides that it is important to provide solid background information, including the history of and an evidence-based rationale for the curriculum. She prepared 120 PowerPoint slides for the 30-minute presentation.

The presentation does not go well. People look distracted and no one participates when given the opportunity to ask questions. Because of the time constraints, MJ has to rush through some of the curricular components. The written evaluations are awful; they reveal a dissatisfaction with what was presented.

Reflective Questions

  1. What do you think went wrong?
  2. What might have been the expectations of the audience members?
  3. How might the presenter’s goals have differed from the audience’s goals?
  4. What might have helped this situation?


Being a reflective practitioner, MJ stops to reflect on her presentation and on the feedback she received from the participants. Fortunately, she is given another opportunity to present her curriculum at a different national conference. She is given a 45-minute time frame. This time, she decides that she wants to draw on the expertise of the audience and engage them more in her presentation. Rather than a PowerPoint presentation, she decides to plan a less-structured, more conversational approach to her presentation. MJ wants the audience members to feel valued and like an integral part of the workshop, so she decides to begin the presentation with introductions. She asks participants to walk to a central microphone and introduce themselves to the rest of the audience, one at a time, by telling their names, where they work, and why they are there. After approximately half of the 50-member audience completes this activity, MJ is upset to realize that more than 20 minutes have elapsed and they are not finished yet! There would be no time for the small group tasks and barely any time to go over the handouts.

Reflective Questions

  1. What do you think went wrong?
  2. What could the presenter have done differently?
  3. How could the goal of the presenter to have participants feel valued been accomplished in a different, more timely way?
  4. How might she have engaged the audience differently?
  5. How might she have better managed to incorporate the expertise of the participants?

In the first scenario, MJ was excited about her topic and wanted to convey as much information as possible in a 30-minute time frame, so she designed a highly structured and extensive PowerPoint presentation, taking care to ensure that all of the information she planned to present was included. Given the expertise of the audience, MJ also wanted to make sure that she appeared credible, so she spent a great deal of time making sure that the audience recognized the steps she took in creating the curriculum and how it was based in evidence and grounded in theory. The problem is, however, that she spent so much time on the background information that she had to rush through the curricular design, which is what the audience really wanted to hear. To her credit, MJ reflected on her presentation and the feedback she received. Given another opportunity, she did reframe her presentation. So, what went wrong with her second presentation? This time, she wanted to be sure that she fully understood who was in her audience and what each hoped to take from her presentation; however, getting to know a large audience one by one is time consuming and may be boring for many of the participants. Again, she used so much time getting to know her audience that she ended up rushing through the content that was relevant and meaningful to her participants.

In the third scenario, TR was excited to have been asked back to her alma mater to share her expertise. She was anxious to do an excellent job and wanted to provide the students with as much information as she could because she knew that she had not received this information when she was in school. The problem here was twofold: (1) the more expertise you have on a topic, the harder it is to know what is need to know vs nice to know; and (2), again, TR did not stop to gauge the expertise—or lack of expertise in this case—of her audience. Giving too much information, without allowing any time to process that information, can be overwhelming to an audience. The end result might be that students shut down and disengage altogether from the learning situation.

Each of the scenarios described above would have benefitted from a plan B, a modified plan of action that would allow the presenter to make a few changes based on direct observations and information obtained from, and about, the audience early on (ie, an on-the-spot needs assessment). In the first scenario, had MJ included an on-the-spot needs assessment she would have realized how knowledgeable the audience was, could have omitted much of the background rationale and theory, and could have spent more time on discussing the curriculum itself. For those in the audience with less knowledge, she may have provided handouts and used a few minutes in small groups, during which time audience members with greater expertise may have been able to answer the questions of the more novice participants. This same solution may have also benefited in the second scenario and would likely have taken much less time to accomplish than individual introductions. The small group activity would have enabled participants to both introduce themselves and share their expertise with their group members, and would have provided background information for the novice audience members. In TR’s case, a discussion with a member of the faculty who is familiar with the students’ level of knowledge and the expectations of an entry-level practitioner may have helped her to determine what to include and exclude from her presentation. In addition, sequencing her presentation in a way to provide sufficient processing time would have engaged the learners and enabled them to ask questions along the way.

How do you know what to consider when planning a modification to your original plan? As a novice presenter, you may be overwhelmed by the idea of planning more than one way to conduct your presentation. Start with simple modifications, such as differentiating between background or basic information and more advanced information. Then, if you discover through a few questions at the beginning that your audience participants are more knowledgeable or experienced than you expected, you can skip over the extra background information and make the extra information available for audience members who are less familiar. As described in Chapter 5, active learning strategies can also help everyone to learn more effectively. You can design an activity in which participants discuss (review) basic information to be sure that everyone is at the same level. In this way, those with expertise can share their knowledge with novice participants, and the novice participants will have enough information for you to be able to move through your presentation without having to first review all of the basic information needed. These active learning strategies can be as brief as a few seconds or much longer, and the duration of each activity can be modified to meet the needs of the group. In general, we recommend planning at least 2 activities of different lengths for even brief presentations of 30-minute duration. If time is going by more quickly than you anticipated, you can eliminate or spend less time on one activity.

In all 3 scenarios a solid needs assessment, refined learning objectives, and some active learning strategies could have enhanced the presentations greatly. Each of the scenarios presented is different and required specific design considerations; however, in any presentation, there are still some non-negotiables to consider.


In each of the 3 preceding scenarios, there was a well-intentioned presenter who experienced disappointing results. In this chapter, we consider a variety of different presentational formats that require different design considerations. To optimize your teaching, regardless of the instructional situation, we consider certain components of systematic effective instruction to be non-negotiable. The components or elements of systematic effective instruction were presented in detail in Chapter 5. Figure 7-1 summarizes those elements that are considered to be non-negotiable.

Let us consider the non-negotiables as they apply to the opening scenario. In attempting to ensure credibility of her presentation, MJ used 120 slides to convey as much as possible about her model for teaching communication. There was a mismatch between her goals and the audience’s expectations. In this instance, the presenter could have done a quick on-the-spot needs assessment and asked participants if they were clinicians or academicians and if they had encountered challenging patients with whom it was difficult to communicate. The presenter might have asked the participants to think about any questions or concerns they hoped would be addressed during the workshop. Once the participants had spent 30 to 60 seconds thinking about their questions/concerns, they could have turned to a person nearby to exchange their questions/concerns. Lastly, the presenter could have asked for questions/concerns from the larger group and written these on a flip chart or digital white board to be put on hold or revisited during or at the end of the session. Within 2 to 3 minutes, the presenter could have learned something about the audience’s expectations and could have clarified the extent to which the planned presentation would address their concerns. Audience members also would have learned quickly whether to stay in this workshop session or to leave and find another session more appropriate for them.

Asking audience members to reflect on questions and concerns that they hope will be addressed and responding to these expectations can serve both as a needs assessment and a motivational hook. It will help focus the participants’ attention to the topic of the presentation. Personal connections to relevant concerns also help establish context for the workshop material. In describing the purpose of the workshop, the presenter has the opportunity to present the specific learning objectives of the session as well.


Figure 7-1. The non-negotiables of systematic effective instruction.

Assuming that this, in fact, was not a workshop, but rather it was a presentation about a recently developed program for improving communication, it would be important to consider ways to engage the audience (active learning) as much as possible and to boost the content in a meaningful way. The presenter might have shown video clips of students engaged in clinic-based role plays before they learned the new techniques. These video clips could have been followed by an opportunity for audience members to speak with participants nearby to critique the student-patient role-play scenarios. Several comments about the student performance from the audience could have been shared in the large group. This brief discussion could have been followed by a brief lecturette (lasting 10 minutes) about the new communication training program. Following this lecturette, a second video clip showing students using the new communication techniques could have been presented. Once again, audience members could have commented on the student role plays, with instructions to compare and contrast the different communication approaches they had observed (lasting 2 to 3 minutes). Based on observations and comments from the audience, the instructor could have reviewed the key points of the new communication training program and highlighted the different outcomes observed in the role plays. This 2– to 3–minute encapsulation could have served as a summary of the presentation. This interactive presentation could have been done within the same 30-minute time frame originally allotted for the lecture plus PowerPoint presentation. The adapted version contains all of the components necessary for effective instruction and is much more likely to engage learners.


Consider the 2 teaching scenarios presented earlier: (1) the less-structured, more conversational conference presentation on the communication curriculum and (2) the guest lecture on lymphedema.

Reflective Questions

  1. Using the non-negotiable components of systematic effective instruction, what suggestions would you have for these 2 presenters?
  2. What objectives might be appropriate for these 2 presentations?
  3. How might your suggestions differ in view of the different time frames (45 minutes vs 2 hours?)
  4. How might these 2 presentations compare with any presentations you have done?


  • Good teaching requires good planning.
  • Good planning requires having a plan B and being prepared to adapt to the needs of your audience and the constraints of your environment.
  • Good planning means including the non-negotiables of systematic effective instruction as follows:

    • Completing a needs assessment either beforehand or on the spot.
    • Incorporating motivational hooks to grab your audience’s attention.
    • Developing well-written learning objectives to guide your presentation.
    • Utilizing content boosters, such as active learning strategies, to maintain your audience’s attention and to enable the participants to process the information you are presenting.
    • Summarizing the major points to reinforce retention.


Although we emphasize the importance of incorporating certain components of effective instruction regardless of the teaching-learning situation, these are not the only variables to be considered when designing your instruction. Additional variables appear in Table 7-1. Creating optimal teaching-learning experiences requires you to consider both the non-negotiable components of effective instruction and the unique characteristics of your situation. These unique characteristics or variables may include, but may not be limited to, the audience, time frame, format, room set-up, and equipment available, and context.


The people who comprise your audience definitely influence your instructional plan. As discussed in detail in Chapter 1, the participants may have different expectations of your presentation, depending on their level of experience, current knowledge of the topic, cultures, generational differences, learning styles, and purpose for using the content that you are presenting. What about participants of different ages or literacy levels? For example, if you are presenting information on the benefits of aerobic conditioning to a high school health class vs a group of senior citizens at the local community center, you will likely need somewhat different pacing (ie, ratio of content and process), content boosters, and active learning strategies. Even in a setting where you assume a more homogeneous audience in terms of education and experience, such as when you present at a conference of professional peers, it is important to consider the specific audience in your session. Are these participants clinicians, academicians, or a combination of the 2? Are they expecting a lecture or a workshop format? How familiar are they with your topic? More often than not, you should expect a fair amount of diversity in your audience.

The key is to make the presentation as relevant as possible for the audience. If you discover that most of the group is familiar with the key background information needed in your presentation but a handful are not, you may provide less of the background information you had prepared and frame it as “review for many of you and new information for some of you.” Clearly stating that you are aware of, and accommodate for, these differences in baseline knowledge indicates that you recognize and value the characteristics of this specific audience.


Imagine that you have been invited to give a 40-minute presentation on the topic of aerobic conditioning to the following 2 groups in your community: 25 adolescents in a high school health class and 15 senior citizens at a local community center.

Reflective Questions

  1. How does the composition of your audience influence your expectations of their participation?
  2. How will your selection of content boosters differ? What boosters might you select for each group?
  3. How might your pacing (ratio of content and process) differ?

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May 30, 2017 | Posted by in NURSING | Comments Off on Systematic Effective Instruction 3: Adapting Instruction for Varied Audiences and Formats

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