Case Presentations, A Great Way To Work Your Sympathetics

28 Jul

As a 3rd year, I received an email in my inbox from on of my classmates. Contained inside, was a little glimmer of gold.  It was a very in depth dissection of the oral presentation for a medical student.  I’ll include a link to it at the end, as it is a piece of paper you will want to hold on to very tightly and review before and during rotations!

Little did I know as a 1st and 2nd year that when our clinical skills instructors ask us to volunteer to do case presentations, they really meant, “DO IT, AS THIS MAY BE YOUR LAST CHANCE TO CRASH & BURN IN FRONT OF AS MANY PEOPLE AS YOU CAN AND STILL GET GREAT FEEDBACK.”  This little exercise may be very frightening, especially if you’re not a public speaker, but will be a lifesaver once on rotations.  If this is something that makes you nervous then this message is especially for you: sign up & volunteer for every speaking and social engagement you can go to and talk to people! Go to holiday parties, gatherings the school has, conferences, etc.  Volunteer to present cases & do extra presentations in class when the opportunity arises. All of this will help build confidence with public speaking, which will help on rotations and in the end, residency interviews.

I was lucky to have very informal case presentations at first, which later built up to formal, then formal in front of residents and surgeons that are potentially interviewing me to now, residency where I present to attendings every day.  As a third year medical student, I was presenting surgical ICU patients to a group of 20+ physicians (intensivists and trauma surgeons), residents, medical students, nurses and other support staff every AM on ICU rounds.  The morning following a big emergency-life saving surgical procedure, my preceptor, who was on the case with me, didn’t show up to rounds, so guess who got to present? Me! I wasn’t quite prepared for this since I was still a little groggy from the night before and didn’t have all of my story straight yet, but I powered through and came out on top with enough adrenaline at the end to get me through the rest of the day!  Every morning following, I peeled myself out of bed to go read about my ICU patient and interview him and his nurse before rounds start.  I try to learn everything I can about his course throughout the previous day and night and predict the topics that I’ll get pimped on while presenting.  Every day there’s always something that stumps me, but it’s definitely making me a stronger student and my confidence for presenting during ICU rounds has increased immensely.

When you’re interviewing a patient that you will have to present, ask yourself:

  1. What could potentially kill this patient? Have I asked about it/looked for signs/symptoms to rule it out? Ask yourself what your patient would look like if they had a life threatening situation going on, play this “what if” game for MI, Stroke, Tension Pneumothorax, Hemopericardium, DVT/PE, etc.
  2. What do I need to include in my note and presentation to my preceptor for it to be complete and do I have that info yet?
  3. What is my preceptor going to pimp me on? One of my anatomy professors always used the “if you stuck a knife in this area, what structures would you cut?” … that’s a great game to play with yourself since on anatomy is a heavy topic that preceptors like to pimp on.

Rotations where you are given the chance to dictate charts were always daunting to me but make sure to never turn that opportunity down. It will push you to have to remember the order and terminology used in your H&P or SOAP so you can state your findings on the fly.  You can later go back and figure out what’s not reflex for you yet.  This is also a great way to get good at doing oral presentations by memory, or at least practicing for them since you never know when you’ll get asked a question about the patient’s history and you won’t have your H&P on you… like during a delivery or surgery and your attending wants to know what allergies the patient has.

For the presentations, read the document linked below, but in general, know your audience.  Always be ready with a 1 liner sentence that sums up the chief complaint/problem for every patient you have seen, and always be listening intently on rounds, trying to guess what questions the presenter may pimp you on, since you never know when your time to shine will present itself!

https://www.dropbox.com/s/sqpnaqoa1z772lv/The%20Oral%20Presentation.pdf

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