What do Adolf Hitler, Margaret Thatcher and John F Kennedy have in common? And how can their combined talents possibly benefit the health service? The answers lie in their ability to capture an audience, hold it, and make it believe what they are saying. A course to help people to develop presentation and communication skills similar to these world-class performers - while ignoring their politics - is proving unexpectedly popular with GPs and consultants.

Just why so many doctors should feel the need to polish their images is an indication of the enormous changes in the NHS in the past three years. There has been a shift of power away from hospital consultants in favour of family doctors (particularly those who are fund- holders) and patients. Consultants also have to contend with a new breed of NHS managers who are more interested in budgets and meeting patient 'throughput' targets than the day-to-day problems encountered by their clinical staff. 'They really have no idea, not a clue. We are speaking a different language,' according to one exasperated plastic surgeon.

Competition for jobs is intense too, as the effect of the health-care market begins to bite. Some inner- city hospitals are threatened with closure because they are more expensive to run, and hundreds of doctors face the dole queue. Meanwhile, family doctors are having to learn how to wield their new power effectively in their dealings with consultants, managers and health authority officials.

Then there are the patients, an increasingly demanding bunch who have read the Patient's Charter and know what they are entitled to.

According to Lynn Hodges, founder of Up Front, a company that specialises in teaching presentation skills, these are the factors behind the growing number of doctors seeking help from her team. Many will pay pounds 385 from their own pockets for a one-day course, while others are subsidised by their health authorities, who see it as an investment. Some pharmaceutical companies have started offering the course as a 'perk' for good customers.

There is also a special course, costing pounds 750, to prepare candidates for job interviews. A senior registrar at one London hospital believes that doctors are 'pretty clueless on how to present both themselves and their work, whether at research meetings, job interviews or simply lecturing'.

The day starts on a suitably medical note with a glamorous former actress called Bridget assuring her self-conscious audience that 'presentations are like babies; easy to conceive but hard to deliver'. This is swiftly followed by a reminder that 'Celia Johnson and Mr Howard met briefly on a train. They knew within seconds that it was right. You have four minutes to make an impressionE on someone.'

The class looks unconvinced but the tone iTHER write errors relentlessly upbeat and by mid-morning the well-packaged snippets of common sense and 'luvvie' lore are having an effect. Negativity of any kind is out; the shortcomings of the participants are described as 'baggage' which must be deposited, metaphorically speaking, in a large bin - one of Bridget's props. A bottle of champagne, duly opened and drunk by the class, is another, more acceptable, prop. Bridget drinks from a Toby jug to make the point that the 'fizz and bubble' of a presentation must be right if it is to have impact.

Each participant gives a short videotaped presentation which is then dissected by Bridget and everybody else in the room. Self-consciousness is seen as the biggest minus, along with distracting habits such as fiddling with the hair and using the hands to cover the mouth. Irrelevant facts and complicated statistics muddy some presentations, and the women in the group are much more self-critical than the men.

Having determined the potential of the raw material, Bridget starts work in earnest. She serves up some startling figures: a mere 7 per cent of audience attention is focused on the words that a speaker uses, and 38 per cent on the voice, while 55 per cent is focused on non-verbal communication. Even a simple gesture can have a devastating effect - if a speaker crosses his or her arms, for example, the ability of the audience to retain the message decreases by 40 per cent, according to researchers.

There are exceptions. Archive footage of the Nuremberg rallies reveals that Hitler used to cross and re-cross his arms during speeches, which only emphasises his supreme self-confidence. Bridget says that Baroness Thatcher has similar self- confidence, but her approach is softer, appealing subtly to her audience to agree with her because how could she be wrong?

Kennedy's technique was to use short, sharp bursts. He would jab a forefinger at the air for maximum emphasis on certain points - but in between, his hand movements tended to be nervous and distracting to listeners.

The climax of the day is a final videotaped presentation by each member of the group, in which they put what they have learnt into practice. In nearly every case the transformation in content and style is remarkable. The sloppy performers of the morning session are now polished and confident - and utterly convincing.

(Photograph omitted)

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