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INTRODUCTION

  • Principles of the Oral Presentation

  • New Patient Presentation on Rounds

  • Follow-up Patient Note and Presentation on Rounds

  • Handovers (Hand-offs)

  • Handovers: The Essential Elements

Original chapter by Steven A. Haist, MD, MS, and Andrew R. Hoellein, MD

PRINCIPLES OF THE ORAL PRESENTATION

An essential skill as a medical student and as an intern or resident is being able to provide a concise and organized oral presentation of your patients. Likely outcomes for those who master this essential skill include more efficient rounds and higher ratings on your clerkship evaluations from your attending, residents, and fellows. The one caveat is that the expectations of what information to present and how long you have to present each patient will vary from institution to institution, from service to service, and from attending to attending. On the first day of a new rotation you should inquire about your responsibilities on rounds, including the preferred format of the oral presentation and the maximum length of the presentations, both for the initial presentation and on subsequent days. Additionally, the site of rounds, such as bedside versus a conference room, may influence the amount of time allotted for your presentation. Occasionally, teams will meet in a conference room to review the patients. This may occur before the team goes to the bedside, or the team may not go back to the bedside with the attending if the attending has already seen the patients or if the attending will see the patients in the afternoon after morning clinic.

What you want to avoid is a disorganized presentation that takes 15 or more minutes and is confusing to those who do not know the patient (and, maybe, even to those who do know the patient). The best way to avoid this, especially early on, is to write out the key findings of the history, physical examination, and laboratory data and practice the presentation. Be sure to time yourself!

Obviously, new patient presentations will take more time compared to subsequent hospital days unless the patient after admission has a major complication and/or becomes gravely ill. The various formats for the written

presentations in Chapter 7 provide you with outlines for your oral presentations on surgical and nonsurgical services, including obstetrics. For the patient in the write-up in Chapter 6, below is the information that could be presented on rounds after admission. It is written out as it would be verbalized on rounds. The time of day and format for patient presentations can vary based on the nature of the service (medical vs. surgical vs. psychiatric, for example). This example is typical for medicine services. The new patient presentation as a general rule should be about 3 minutes and not be more than 4 minutes (this may vary for the reasons outlined earlier). Remember, the resident and possibly the attending ...

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