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The oral case presentation is a skill central to physician-physician communication and provides a natural venue for the teaching and evaluation of the clinical competency of learners.
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A well-done presentation:
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Advances patient care
Provides an efficient vehicle for collaboration and idea sharing
Highlights areas of uncertainty to further individual or team-directed learning
Promotes self-reflection on gaps in knowledge
Provides space for iterative feedback toward skill refinement
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Within this chapter, we review the core elements of an oral case presentation and provide examples about how to adapt the content to different settings (ie, the context). The structure of presentations varies from service to service (eg, medicine vs surgery), among subspecialties (eg, cardiology vs gynecologic oncology), and between environments (eg, inpatient vs outpatient). Content delivery changes with different audiences (eg, ward attending vs specialty consultant) or with recipients’ familiarity with the patient case (eg, new patient evaluation vs daily update on rounds).
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Before getting into the “how,” it is important to recognize some of the reasons why mastering an oral case presentation can be challenging.
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BLENDING MULTIPLE SKILLS
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The oral case presentation requires that a presenter demonstrate aptitude across a range of clinical skills. At the most basic level, a presenter must accurately gather data, perform an appropriate physical exam, and organize the obtained information into a formed clinical impression.
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These clinical skills span multiple core competencies (Figure 23-1), including the following:
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Patient care (history, physical exam, clinical reasoning, management)
Medical knowledge (applied foundational sciences, therapeutic knowledge, knowledge of diagnostic testing)
Practice-based learning and improvement (evidence-based and informed practice)
Interpersonal and communication skills (patient- and family-centered communication, interprofessional and team communication)
Professionalism (accountability/conscientiousness)
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A single shortcoming in any domain has the potential to alter the end product. An effective oral presentation requires fluid synthesis of building blocks coupled with deliberate practice to produce expert delivery. As learners gain mastery over different clinical skills, the oral case presentation tends to evolve in parallel.
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NEGOTIATING PROFESSIONAL RELATIONSHIPS
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It is important to recognize that while the content and structure of oral case presentations are often explicitly taught, the actual refinement typically occurs via trial and error. Inherent in the mastery of the oral presentation is actively navigating different professional relationships in the practice environment with each recipient possessing their own (sometimes quirky!) presentation preferences (Figure 23-2).
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