Publishing in professional journals and presenting at conferences have long been the traditional methods of disseminating the results of research and quality improvement projects to clinical nurses. In contrast to what oral presentations, such as lectures and panel discussions, can communicate, the amount of information posters can convey is limited by poster size as well as by conference attendees’ priorities and attitudes about poster sessions. Attendees are unlikely to value poster sessions as highly as they do featured oral presentations. When creating poster presentations, nurses need to be aware of design principles that improve visual impact in order to attract viewers’ attention and maximize content dissemination.
Although there's no shortage of published articles on how to create a “winning poster,” almost all the articles examined for this study were opinion pieces, not based on evidence.1-14 And in giving their recommendations, several authors cited previously published articles that appeared in the 1980s and 1990s, long before the development of current digital design and printing technology.
An extensive review of the literature on poster presentations found only two evidence-based articles, but neither provided evidence to support poster design guidelines.15, 16 The first examined academic nurses’ experience of developing and presenting a poster at a nursing conference, but didn't offer insights into poster attributes that appealed to viewers.15 The second, an observational study conducted at a medical conference, found that few physician attendees went to the poster sessions.16 The researchers were unable to say what attributes made a poster presentation memorable because, in a follow-up survey, too few respondents were able to recall the posters they viewed.
Despite the numerous how-to articles available in the literature, there is little research evidence on the characteristics that influence viewers’ decisions to read a particular poster or interact with a particular poster presenter. Therefore, nurses need empirical evidence to guide poster development and enhance their ability to share important practice information with their peers at nursing conferences.
The purpose of this study was to identify poster attributes that would improve the chance that conference attendees would read a poster. Specifically, I wanted to explore the aesthetic and content-specific variables that would influence a nurse's decision to read a poster at a nursing research conference poster session.
Design. A mixed-methods, descriptive exploratory study employing paper survey methodology was used to identify nursing conference attendees’ perceptions of poster presentation as a knowledge dissemination method. Nurses were asked to rate the importance of poster variables on an 11-point scale, from 0 (not at all important) to 10 (very important), according to how much each variable influenced their decision to read a poster at the conference.
Protection of human subjects. The study was approved by the Cleveland Clinic institutional review board, and careful attention was paid to the methods of survey distribution and data collection to ensure respondents’ anonymity and confidentiality. No personal information was collected that permitted identification of any of the respondents; all quantitative data were reported in the aggregate; and direct quotes were never attributed to a specific responder.
Sample and setting. Using a convenience sampling method, a total of 180 nurses attending a local two-day nursing research conference were invited to participate in the study by way of an announcement made at the start of each conference day. In this announcement, I explained the study and its purpose and asked attendees to participate by viewing the posters, completing the survey, and returning it to a sealed box; administrative staff monitored the box for the duration of the conference.
The attendees were primarily clinical nurses (n = 86; 48%) or advanced practice registered nurses (APRNs; n = 47; 26%). However, attendees also included nurse managers, educators, and academic researchers (n = 47; 26%).
Survey. I developed the survey questions using a two-stage Delphi method. In the first stage, I reviewed the literature to identify the variables that were thought to be important in designing an effective poster presentation; then I incorporated these variables into an initial set of questions. A group of four clinical nurse specialists who had experience as poster presenters reviewed these questions and gave their feedback. I used their responses in refining the survey, adding several new questions and removing others. This same group then reviewed the survey again, and their suggestions were incorporated into the final version. The final content validity index of the survey ranged from 0.75 to 0.95 per item and was 0.86 for the entire survey (minus the demographic data questions).
The survey was arranged in three sections. The first asked for basic demographic and education information. The second comprised five subsections with a total of 25 items that asked respondents to identify and rate the importance of variables that influenced their decision to read a poster. Finally, the last section contained two pairs of open-ended questions that asked respondents how they decided which posters to examine more closely and read in depth (“When walking through a poster session, how do you select the posters you will take a closer look at? What is most important to you?” and “How do you select the posters to read completely? What is most important to that decision?”).
Data analysis. Descriptive statistics and measures of central tendencies were used to describe the sample and the specific aesthetic and content-related variables. Qualitative data obtained from answers to the open-ended questions were initially organized by the frequency with which respondents identified specific variables, and then examined for patterns and themes. The qualitative data were useful in clarifying the context of the quantitative responses; therefore, both qualitative and quantitative findings are reported together to facilitate a better understanding of the data.
Demographics. A total of 96 participants returned the surveys, for a 53% response rate. The majority of respondents were female (98%), from 22 to 74 years of age (mean age, 50 [SD, 10]), and had between one and 51 years of nursing experience (mean years, 25 [SD, 12]). More than half had experience as a principal investigator or coinvestigator (n = 53; 55%), or a poster presenter (n = 56; 58%), or both. Twenty-eight percent of respondents were clinical nurses; the remainder included APRNs (22%), nurse educators (16%), and nurse managers (14%). See Table 1.
Findings. Two major themes emerged from the qualitative analysis: poster-viewing decisions were based first on aesthetics and then on relevance. Aesthetic characteristics included the poster's visual appeal, color, organization, and layout; but it also included content, such as tables, pictures, or other design elements, including graphs and other figures. Relevance was specific to each respondent; what was personally or professionally relevant to one nurse was not relevant to another. Respondents determined each poster's relevance primarily by reading its title; typically, if the poster's title seemed relevant, the nurse would then scan the purpose statement and conclusion and decide whether to read through the entire poster and/or interact with the presenter, if available. One additional finding that emerged from the qualitative data analysis was that content affected not only relevance but also aesthetic appeal. Sixty percent (n = 58) of respondents stated that they typically viewed and read fewer than 50% of posters at a conference; only 4% (n = 4) reported that they read all. (Note: Some participants did not respond to all survey items; therefore, some percentages are based on n = 95, as indicated where relevant below.)
Aesthetics. Among the poster variables, each of which was rated on an 11-point scale, nurses considered visual appeal the most important (mean score, 8.4 [SD, 1.4]) in deciding whether to read a poster. This quantitative finding was congruent with the qualitative findings. For example, as one respondent wrote,
“Until I took this survey I had not been aware of how important visual appeal was to me. Some posters just attract you from across the room. They seem to speak to you. I notice that I was drawn to posters that were easy on the eye; or at least “my eye.” Sometimes it was color or maybe layout or an interesting picture; it was different things, hard to put my finger on it.”
Color. When asked what aesthetic characteristics attracted them to a poster, most nurses (n = 76; 79%) said they preferred a white or light background with a black or dark font. After white, respondents were drawn to light blue (n = 32; 33%) and medium blue (n = 31; 32%) backgrounds. Respondents reported being least drawn to neon (n = 48; 50%) and dark colors (n = 26; 27%). According to one respondent,
“Some backgrounds are harder on the eyes than others, especially the dark ones. I also noticed that if they were all one color, they seemed boring. Some contrast is needed… but not too much. One poster had a dozen different colors. I did not like that.”
Layout and visual impact. Overwhelmingly, respondents reported a preference for a symmetrical three-column poster layout (n = 77; 80%) over nonsymmetrical and four-column formats. Font size affected the overall visual appeal of a poster, and respondents highly rated font size as a factor in deciding whether to read a poster (mean score, 8.10 [SD, 1.6]). Text that was too large or too small could contribute to a respondent's decision not to read a poster. Respondents reported that ease of reading (defined as the right amount of content in a font large enough to read from three feet away) was highly important in deciding whether to read a poster (mean score, 8.87 [SD, 1.6]). Quantitative data revealed that respondents also identified graphic elements as adding visual appeal and considered them important (mean score, 8.13 [SD, 1.73]), but the qualitative responses indicated that this was true only if the graphic elements were easy to understand and clearly relevant to the poster's topic. For example, one respondent wrote:
“Some posters just looked confusing… too much of everything… really little print and way too much text. I was afraid I would not understand it… so I stayed away.”
More than half of respondents (n = 52; 54%) reported that the inclusion of tables in a poster affected their decision about whether to read it; posters that included tables with an abundance of statistics were rated as less visually appealing than those without tables. However, the inclusion of statistical tables was not as important to the decision to read a poster (mean score, 6.86 [SD, 2.2]) as was overall visual appeal and the inclusion of pictures and graphs.
Content. Respondents rated ease of understanding as the most important content attribute in poster presentations (mean score, 8.93 [SD, 1.4]). In response to the open-ended questions, respondents said they thought posters that looked like they contained “too much” information wouldn't be easy to understand, so they tended to avoid them. Respondents also reported that not only was too much text or content packed into a small poster visually unappealing, it made them want to avoid reading the poster, even if the content was relevant. For example, one respondent wrote:
“The posters I was not attracted to seemed to have some things in common; first, they did not look professional or they had too much content squeezed into a small space.”
Respondents also reported that they preferred not to see or found distracting several common poster elements, including scatterplots (n = 77; 80%), box plots (n = 66; 69%), correlation matrix tables (n = 65; 68%), large statistical tables (n = 56; 58%), and references (n = 56; 58%). Responses to the open-ended questions indicated that nurses thought these elements cluttered the poster, lessening its visual appeal, and were not relevant to the viewer. Some respondents reported that they stayed away from posters that contained too many tables or figures. Two respondents wrote the following:
“A poster filled with lots of tables seems too technical and I tend to avoid it. “
“There are many posters available to view, but I find many of these to be irrelevant to clinical practice, or at least to my clinical practice. Sometimes they are just too theoretical or filled with statistical jumble. I want information that I can actually use.”
Relevance. Eighty-six percent (n = 83) of respondents reported that they browse the posters on display until something “catches my eye.” Thus, viewers’ initial decision to view a poster is influenced by aesthetic factors, such as color, font size, layout, and graphics (n = 74; 77%), and once they get close to the poster, they read the title to decide whether to continue reading (n = 87; 91%).
Title and topic. When asked how much the title influenced their decision to view or not view a poster, most respondents rated the title as highly important (mean score, 8.10 [SD, 1.7]). In response to the open-ended questions, nurses said they preferred titles that could be read from at least three feet (n = 87; 91%), were simple and clear (n = 90; 94%), and reported the research findings (n = 74; 77%). Analysis of the qualitative data also found that the topic's personal or professional relevance to the nurse was the most important factor influencing her or his decision to read a poster or interact with the presenter. As two respondents wrote,
“Although the overall appearance and colors on a poster might initially attract me, if the title is not relevant to me or my practice, I will probably not read it.”
“The title tells me if it applies to me… that is how I decide.”
According to the qualitative data, nurses who read the posters were interested in topics that related to their practice. Respondents reported that they selected posters to read because they offered intervention information (n = 86 [N = 95]; 91%) and contained background information they thought would be useful in making patient care decisions (n = 81; 84%). As one respondent wrote,
“The topic must be of interest to me. I am already overwhelmed by the massive amount of information available to me. I just read what is of interest to me and to my practice.”
Poster sections. Most respondents identified the findings as the most important section of the poster (n = 91; 95%); they rated the implications section next in importance (n = 81; 84%), followed by the description of the sample and the setting (n = 72 [N = 95]; 76%). The remaining content items were rated as useful, but not as highly important: design (n = 68 [N = 95]; 72%), measures (n = 62 [N = 95]; 65%), and procedures (n = 62 [N = 95]; 65%).
Additional findings. There were no significant differences between respondents’ preferences regarding aesthetic characteristics, content, and other factors that influenced their decision to read or not read a poster.
When we asked respondents what poster presenters could do to improve knowledge transfer, 55% (n = 53) suggested that the presenter (present or not) should provide business cards, and 68% (n = 65) said they would have liked to have copies of the poster to take home and reread at their leisure. Although the researcher's presence at the poster session was important to many respondents, 30% (n = 29) reported a preference for viewing the posters without having to interact with the presenter.
Nurse researchers need empirical evidence and research to guide poster design and development in ways that improve their ability to share important findings with conference attendees. Most of the articles in the literature on poster design were published before recent technologic advances in digital design and printing. Most are also not based on evidence; rather, they are opinion pieces that cite other, previously published opinion pieces.11, 13, 14 Thus, the importance of this study is that it offers recommendations based on evidence regarding nurses’ perceptions of posters produced with current technology, and the findings are specific to attendees at a nursing conference.
Although these findings supported some of the recommendations of the many opinion articles reviewed, they did not support all. This study identified aesthetic appeal as the primary characteristic that influenced potential viewers’ decision to read a poster. Whereas other authors have suggested the importance of visual appeal, they often differed on how to achieve visual appeal and which characteristics viewers found appealing or unappealing.3, 4, 6, 10 In this study, respondents reported that a poster's symmetry, color, and content all affected its visual appeal.
The perceived relevance to the viewer of a poster's topic and its effect on whether the viewer would continue reading the poster had not been previously addressed in the literature. In this study, the length and font size of the title and whether it contained the study's results were found to influence the viewer's decision about the poster's personal or professional relevance. Respondents reported that they read only the posters they determined were relevant to their practice.
Limitations. The sample for this study was small (N = 96) and clinical nurses, APRNs, and nurse managers predominated; therefore, the findings can be generalized only to this group. Although more than half of the respondents had some experience as a researcher or poster presenter, nurses attending a conference geared specifically to researchers may be interested in different poster characteristics.
The findings of this study help to clarify the conflicting recommendations and suggestions found in the literature and provide some guidance to the nurse who is developing a poster for a conference presentation. A list of suggestions from these findings is provided to assist with poster development (see Suggestions for Creating a Poster That Will Attract an Audience). In addition, a variety of online resources provide detailed information on choices that would-be poster presenters should consider, including digital design software options for creating posters, common poster sizes, and materials used in printing posters (see Online Resources for Nursing Conference Poster Design).
Since relevance had not been previously addressed in the literature, these findings suggest that it's important for the presenter to “know the audience” and to modify the title of the poster to appeal to that audience. As this is likely the first nursing study on this topic, it is clear that much more investigation is needed. It would be interesting to see whether different audiences at different types of conferences respond differently. This study represents a start toward establishing evidence to support design decisions when developing a conference poster presentation. This information may be useful to nurse presenters in disseminating new knowledge to those who are in a position to apply the information to practice.
Online Resources for Nursing Conference Poster Design
There are many technical details to consider when planning a nursing conference poster presentation, including the conference's poster format and size guidelines and the kind of software you're using to design your poster (Microsoft's PowerPoint, for example). And the same software may require different procedures to achieve similar results depending on whether you're running it on an Apple computer or a PC.
The good news? You don't have to redesign the wheel: many online resources provide detailed information on the design process, tailored to the kind of hardware and software you plan to use. Here are a few places to start:
Academy of Medical–Surgical Nurses provides examples of highly ranked poster presentations from its 2015 annual convention free of charge.
University of North Carolina Health Sciences Library provides tips and resources as well as links to a number of other resources on the Web: http://guides.lib.unc.edu/poster_design
University of North Carolina Graduate School has a Poster and Presentation Resources page that offers help with academic poster design.