Oral Presentations on Clerkships

The oral presentation of patients on rounds is an integral skill for medical students to develop. You are communicating how the patient’s current symptoms, past medical problems, exam findings, and lab results play together into a coherent story. You could be the smartest medical student in the hospital, but if you can’t effectively communicate this information to team members, it is no help. It isn’t a natural skill, but here are five tips to employ in your oral presentations.

Perfect Practice Makes Perfect

The best way to improve a skill is to practice it. When you have a new patient to present, ask your resident or classmate if you can practice your presentation in front of them first. A dry run will help knock out some of the nerves and allows you to make adjustments before rounds. If you admit someone late in the day or overnight and know you’ll have to present the full H&P the following morning, go home and practice. Stand in front of the mirror and give the full oral presentation as if it were real. I get nervous speaking in front of any crowd more than three, so home practice was essential for me. Practice runs will double your reps and accelerate your skill development.

Use the Same Template Every Time

In the pre-clinical years, medical schools generally teach you basic clinical skills, including a basic format for presentation.  These include the full H&P format for new patients or SOAP (Subjective, Objective, Assessment, Plan) structure for existing patients. Utilize this format every single time! If you don’t feel like you have a good template, ask your residents. You will hear attendings and residents stray quite far from the basic format, but they are seasoned and have earned this right through professional competency. As a student, you are still mastering fundamentals. Cutting corners will lead to forgotten information, unorganized presentation, awkward pauses when (not if) you lose your place, and confused team members. Sticking to the basic format with every presentation will imprint consistency and build a strong muscle memory for presenting.

“Oral presentations are an essential tool for medical student success.”

Dr. Alan Gambril, Contributor, Med Student Edge

Write Everything Down!

There is simply too much data to sift through and interpret to remember on the fly. Write it down (or print it out) and have it on hand during rounds. You don’t necessarily always have to report every single solitary data point, but you do need to have it available if someone on the team asks. This will become more important as your presentation skills develop and you begin to summarize/synthesize data rather than simply reporting values. Make sure you are organized and know where everything is located on the page. Having it on paper does no good if you spend half your presentation shuffling papers to find what you’re looking for.

Ask About Attending or Service Specifics

Every attending has different preferences. When you are working with a new attending, make sure to ask the attending or team what his/her particular preferences are. Some will want thorough, detailed presentations with a formal one-liner, each lab value stated, and impression with problem-by-problem plan. Others prefer a more concise approach with only pertinent lab values and updates on changes. There’s no right or wrong way, just different styles. If you are with an attending you’re unsure about, opt for the more formal and detailed approach. Better to show you have the information and cut it down, than appear unprepared or too informal. Different units in the hospital also have their own unique specifics. Again, ask the team when you start what you need to include. Sometimes it is a simple data point that is difficult to find in the electronic health record. But you won’t know unless you ask.

Ask for Feedback

Asking for feedback is key for improvement in your performance. It can be awkward, but if you don’t ask, you won’t know how you can improve. After rounds, you might ask your attending or team, “Is there anything I need to change about my presentation format?”. Sometimes attendings will rotate weekly, so you are better off asking for feedback on your formatting of the presentation on day one so you can adjust for the rest of the short week. Follow up with them at the end of the week and/or right before the attending rotates off to assess how you performed.

Oral presentations are an essential tool for medical student success. It is not an easy skill to master. But with practice, using consistent templates, writing everything down, and asking the right questions you can quickly look like a seasoned pro!

Have you perfected the oral presentation for rounding? What areas do you think you need improvement? Comment below.

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Alan Gambril, MD
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