Presentations in Medicine & Science

There are four things you must consider before you do your oral presentation

• Message
• Audience
• Purpose
• Occasion (setting and circumstances)

What do you want the presentation to do?

• Present a new patient to your preceptor: The amount of detail will be determined by your preceptor. It is also likely to reflect your development and experience, with less detail being required as you progress.
• Present your patient at working or teaching rounds: The amount of detail will be determined by the customs of the group. The focus of the presentation will be influenced by the learning objectives of working responsibilities of the group.
• Request a consultant’s advice on a clinical problem: The presentation will be focused on the clinical question being posed to the consultant.
• Persuade others about a diagnosis and plan: A shorter presentation which highlights the pertinent positives and negatives that are germane to the diagnosis and/or plan being suggested.
• Enlist cooperation required for patient care: A short presentation focusing on the impact your audience can have in addressing the patient’s issues.

Preparation:

1. Patient evaluation: history, physical examination, review of tests, studies, procedures, and consultants’ recommendations.
2. Selected reading: reference texts; to build a foundational understanding.
3. Literature search: for further elucidation of any key references from selected reading, and to bring your understanding up to date, since reference text information is typically three to seven years old.
4. Write-up: for oral presentation, just succinct notes to serve as a reminder or reference, since you’re not going to be reading your presentation.

Knowledge

Be prepared to answer questions about the following:

• Etiology
• Pathophysiology
• Diagnosis
• Complications
• Differential diagnosis
• Course of conditions
• Treatment
• Diagnostic tests
• Medications

Tools / Databases:

1. Ovid
2. Pub Med
3. Essential Evidence Plus
4. MD Consult

Chief Complaint (CC)

The opening statement should give an overview of the patient, age, sex, reason for visit and the duration of the complaint. Give marital status, race, or occupation if relevant.  If your patient has a history of a major medical problem that bears strongly on the understanding of the present illness, include it. 

• For ongoing care, give a one sentence recap of the history.

History of Present Illness (HPI)

This will be very similar to your written HPI. Present the most important problem first. If there is more than one problem, treat each separately. Present the information chronologically. over one system before going onto the next. Characterize the chief complaint – quality, severity, location, duration, progression, and include pertinent negatives. Items from the ROS that are unrelated to the present problem may be mentioned in passing unless you are doing a very formal presentation. When you do your first patient presentation you may be expected to go into detail. 

• For ongoing care, present any new complaints.

Review of Systems (ROS)

Most of the ROS is incorporated at the end of the HPI. Items that are unrelated to the present problem may be briefly mentioned. 

• For ongoing care, present only if there are new complaints.

Past Medical History (PMH)

Discuss other past medical history that bears directly on the current medical problem.

• For ongoing care, have the information available to respond to questions.

Past Surgical History

Provide names of procedures, approximate dates, indications, any relevant findings or complications, and pathology reports, if applicable. 

• For ongoing care, have the information available to respond to questions.

Allergies/Medications

Present all current medications along with dosage, route and frequency. For the follow-up presentation just give any changes in medication. 

• For ongoing care, note any changes.

Smoking and Alcohol (and any other substance abuse)

Note frequency and duration.

• For ongoing care, have the information available to respond to questions.

Social/Work History

Home, environment, work status and sexual history.

• For ongoing care, have the information available to respond to questions.

Family History

Note particular family history of genetically based diseases.

• For ongoing care, have the information available to respond to questions.

Physical Exam/Labs/Other Tests

Include all significant abnormal findings and any normal findings that contribute to the diagnosis. Give a brief, general description of the patient including physical appearance. Then describe vital signs touching on each major system. Try to find out in advance how thorough you      need to be for your presentation. There are times when you will be expected to give more detail      on each physical finding, labs and other test results.

• For ongoing care, mention only further positive findings and relevant negative findings.

Assessment and Plan

Give a summary of the important aspects of the history, physical exam and formulate the differential diagnosis. Make sure to read up on the patient’s case by doing a search of the literature.

1. Include only the most essential facts; but be ready to answer ANY questions about all aspects of your patient.
2. Keep your presentation lively.
3. Do not read the presentation!
4. Expect your listeners to ask questions.
5. Follow the order of the written case report.
6. Keep in mind the limitation of your listeners.
7. Beware of jumping back and forth between descriptions of separate problems.
8. Use the presentation to build your case.
9. Your reasoning process should help the listener consider a differential diagnosis.
10. Present the patient as well as the illness.