Your medicine attending probably only sees you on rounds. That means that his evaluation of you is based solely on the few minutes you spend presenting patients each morning (and possibly your written notes). Don’t let this opportunity go to waste – with a little effort, you can be a rock star!
Communication in medicine is an art, and it’s one that medical personnel stink at: studies suggest that poor communication is the most common root cause of medical error. As a medical student, remember that your clinical years are intended to teach you the fundamentals of practical medicine and how to function effectively as part of a team. Do yourself a favor now and focus on your communication skills, beginning with your presentations. If you need a model or aren’t convinced this is worth the effort, evaluate your residents: senior residents who can give brief, fluent presentations that highlight key information get more done and have fewer patients crump.
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- Be brief: Five minutes is the absolute limit, and three minutes is better. Nobody (not even your fellow student) wants to listen to your ten-minute monologue, and long presentations make rounds take forever. Don’t try to anticipate and answer every question, and don’t compress your presentation by talking faster! Keep in mind that your attending works from a 30,000-foot perspective, so his information needs are very different from your intern’s.
- Follow standard structure: Deviating from the standard presentation structure (CC, then HPI, then PMH/PSH…) confuses your listeners. If portions aren’t relevant to your patient’s hospitalization, eliminate them entirely.
- Fight word bloat: Transitions between sections of your presentation are awkward and unnecessary (especially the dreaded “in terms of”) – just pause for a second and move into the next topic. While speaking and while writing, take care to avoid wordy constructions and phrases that lack an agreed-upon meaning. In particular, avoid saying “The patient describes X and may have felt a little Y, but doesn’t think that he had too much Z.” Instead, say “The patient had X and Y but not Z.”
- Focus on the assessment and plan: Though usually the least emphasized part of the presentation in physical diagnosis courses, this is where the money is. As a student, this is where you show off your knowledge (well, your ability to filter out irrelevancies is also a measure of your clinical acumen) and demonstrate that you want to own this patient’s care. As a clinician, this is the section of the presentation that keeps everyone on the same page and directs the day’s activity. Again, remember to focus on the big picture – your attending doesn’t care about the minutiae.
I’m the first person to admit that I break these guidelines often, but at least I feel bad about it. Incisive presentations are a mark of incisive thought; since I aspire to the latter, I cultivate the former.