oral presentations medicine

How To Present a Patient: A Step-To-Step Guide

Last Updated on June 24, 2022 by Laura Turner

Updated and verified by Dr. Lee Burnett on March 19, 2022.

The ability to deliver oral case presentations is a core skill for any physician. Effective oral case presentations help facilitate information transfer among physicians and are essential to delivering quality patient care. Oral case presentations are also a key component of how medical students and residents are assessed during their training.

At its core, an oral case presentation functions as an argument. It is the presenter’s job to share the pertinent facts of a patient’s case with the other members of the medical care team and establish a clear diagnosis and treatment plan. Thus, the presenter should include details to support the proposed diagnosis, argue against alternative diagnoses, and exclude extraneous information. While this task may seem daunting at first, with practice, it will become easier. That said, if you are unsure if a particular detail is important to your patient’s case, it is probably best to be safe and include it.

Now, let’s go over how to present a case. While I will focus on internal medicine inpatients, the following framework can be applied to patients in any setting with slight modifications.

Oral case presentations are generally made to a medical care team, which can be composed of medical and pharmacy students, residents, pharmacists, medical attendings, and others. As the presenter, you should strive to deliver an interesting presentation that keeps your team members engaged. Here are a few things to keep in mind:

• Be confident: Speak clearly at the loudest volume appropriate to protect patient privacy, vary your tone to emphasize the most important details, and maintain eye contact with members of your team.
• Don’t fidget : Stand up straight and avoid unnecessary, distracting movements.
• Use your notes : You may glance at your notes from time to time while presenting. However, while there is no need to memorize your presentation, there is no better way to lose your team’s attention than to read your notes to them.
• Be honest: Given the importance of presentations in guiding medical care, never guess or report false information to the team. If you are unsure about a particular detail, say so.

The length of your presentation will depend on various factors, including the complexity of your patient, your audience, and your specialty. I have found that new internal medicine inpatients generally take 5-10 minutes to present. Internal medicine clerkship directors seem to agree. In a 2009 survey , they reported a range of 2-20 minutes for the ideal length of student inpatient presentations, with a median of 7 minutes.

While delivering oral case presentations is a core skill for trainees, and there have been attempts to standardize the format , expectations still vary among attending physicians. This can be a frustrating experience for trainees, and I would recommend that you clarify your attending’s expectations at the beginning of each new rotation. However, I have found that these differences are often stylistic, and content expectations are generally quite similar. Thus, developing a familiarity with the core elements of a strong oral case presentation is essential.

How to Present a Patient

You should begin every oral presentation with a brief one-liner that contains the patient’s name, age, relevant past medical history, and chief complaint. Remember that the chief complaint is why the patient sought medical care in his or her own words. An example of an effective opening is as follows: “Ms. X is a 78-year-old female with a past medical history of chronic obstructive pulmonary disease who presents to the hospital after she felt short of breath at home.”

Following the opener, elaborate on why the patient sought medical care. Describe the events that preceded the patient’s presentation in chronological order. A useful mnemonic to use when deciding what to report is OPQRST , which includes: • The Onset of the patient’s symptoms • Any Palliative or Provoking factors that make the symptoms better or worse, respectively • The Quality of his or her symptoms (how he or she describes them) • The Region of the body where the patient is experiencing his or her symptoms and (if the symptom is pain) whether the patient’s pain Radiates to another location or is well-localized • The Severity of the symptoms and any other associated Symptoms • The Time course of the symptoms (how they have changed over time and whether the patient has experienced them before) Additionally, include any other details here that may support your final diagnosis or rule out alternative diagnoses. For example, if you are concerned about a pulmonary embolism and your patient recently completed a long-distance flight, that would be worth mentioning.

The review of systems is sometimes included in the history of present illness, but it may also be separated. Given the potential breadth of the review of systems (a comprehensive list of questions that may be asked can be found here ), when presenting, only report information that is relevant to your patient’s condition.

The past medical history comes next. This should include the following information: • The patient’s medical conditions, including any that were not highlighted in the opener • Any past surgeries the patient has had and when they were performed • The timing of and reasons for past hospitalizations • Any current medications, including dosages and frequency of administration

The next section should detail the patient’s relevant family history. This should include: • Any relevant conditions that run in the patient’s family, with an emphasis on first-degree relatives

After the family history comes the social history. This section should include information about the patient’s: • Living situation • Occupation • Alcohol and tobacco use • Other substance use You may also include relevant details about the patient’s education level, recent travel history, history of animal and occupational exposures, and religious beliefs. For example, it would be worth mentioning that your anemic patient is a Jehovah’s Witness to guide medical decisions regarding blood transfusions.

Once you have finished reporting the patient’s history, you should transition to the physical exam. You should begin by reporting the patient’s vital signs, which includes the patient’s: • Temperature • Heart rate • Blood pressure • Respiratory rate • Oxygen saturation (if the patient is using supplemental oxygen, this should also be reported) Next, you should discuss the findings of your physical exam. At the minimum, this should include: • Your general impressions of the patient, including whether he or she appears “sick” or not • The results of your: • Head and neck exam • Eye exam • Respiratory exam • Cardiac exam • Abdominal exam • Extremity exam • Neurological exam Additional relevant physical examination findings may be included, as well. Quick note: resist the urge to report an exam as being “normal.” Instead, report your findings. For example, for a normal abdominal exam, you could report that “the patient’s abdomen is soft, non-tender, and non-distended, with normoactive bowel sounds.”

This section includes the results of any relevant laboratory testing, imaging, or other diagnostics that were obtained. You do not have to report the results of every test that was ordered. Before presenting, consider which results will further support your proposed diagnosis and exclude alternatives.

The emergency department (ED) course is classically reported towards the end of the presentation. However, different attendings may prefer to hear the ED course earlier, usually following the history of present illness. When unsure, report the ED course after the results of diagnostic testing. Be sure to include initial ED vital signs and any administered treatments.

You should conclude your presentation with the assessment and plan. This is the most important part of your presentation and allows you to show your team how much you really know. You should include: • A brief summary (1-2 lines) of the patient, the reason for admission, and your likely diagnosis. This should also include information regarding the patient’s clinical stability. While it can be similar to your opener, it should not be identical. An example could be: “Ms. X is a 78-year-old female with a past medical history of chronic obstructive pulmonary disease who presents with shortness of breath in the setting of an upper respiratory tract infection who is now stable on two liters of supplemental oxygen delivered via nasal cannula. Her symptoms are thought to be secondary to an acute exacerbation of chronic obstructive pulmonary disease.” • A differential diagnosis . For students, this should consist of 3-5 potential diagnoses. You should explain why you think each diagnosis is or is not the final diagnosis. Be sure to rule out potentially life-threatening conditions (unless you think your patient has one). For our fictional patient, Ms. X, for example, you could explain why you think she does not have a pulmonary embolism or acute coronary syndrome. For more advanced trainees, the differential can be more limited in scope. • Your plan . On regular inpatient floors, this should include a list of the patient’s medical problems, ordered by acuity, followed by your proposed plan for each. After going through each active medical problem, be sure to mention your choice for the patient’s diet and deep vein thrombosis prophylaxis, the patient’s stated code status, and the patient’s disposition (whether you think they need to remain in the hospital). In intensive care units, you can organize the patient’s medical problems by organ system to ensure that no stone is left unturned (if there are no active issues for an organ system, you may say so).

Presenting Patients Who Have Been in the Hospital for Multiple Days

After the initial presentation, subsequent presentations can be delivered via SOAP note format as follows:

• The  Subjective  section includes details about any significant overnight events and any new complaints the patient has.
• In the  Objective  section, report your physical exam (focus on any changes since you last examined the patient) and any significant new laboratory, imaging, or other diagnostic results.
• The  Assessment  and  Plan  are typically delivered as above. For the initial patient complaint, you do not have to restate your differential diagnosis if the diagnosis is known. For new complaints, however, you should create another differential and argue for or against each diagnosis. Be sure to update your plan every day.

Presenting Patients in Different Specialties

Before you present a patient, consider your audience. Every specialty presents patients differently. In general, surgical and OB/GYN presentations tend to be much quicker (2-3 minutes), while pediatric and family medicine presentations tend to be similar in length to internal medicine presentations. Tailor your presentations accordingly.

Presenting Patients in Outpatient Settings

Outpatients may be presented similarly to inpatients. Your presentation’s focus, however, should align with your outpatient clinic’s specialty. For example, if you are working at a cardiology clinic, your presentation should be focused on your patient’s cardiac complaints.

If your patient is returning for a follow-up visit and does not have a stated chief complaint, you should say so. You may replace the history of present illness with any relevant interval history since his or her last visit.

And that’s it! Delivering oral case presentations is challenging at first, so remember to practice. In time, you will become proficient in this essential medical skill. Good luck!

Kunal Sindhu, MD, is an assistant professor in the Department of Radiation Oncology at the Icahn School of Medicine at Mount Sinai and New York Proton Center. Dr. Sindhu specializes in treating cancers of the head, neck, and central nervous system.

2 thoughts on “How To Present a Patient: A Step-To-Step Guide”

To clarify, it should take 5-10 minutes to present (just one) new internal medicine inpatient? Or if the student had 4 patients to work up, it should take 10 minutes to present all 4 patients to the preceptor?

Good question. That’s per case, but with time you’ll become faster.

Comments are closed.

• - Google Chrome

Intended for healthcare professionals

• My email alerts
• BMA member login
• Username * Password * Forgot your log in details? Need to activate BMA Member Log In Log in via OpenAthens Log in via your institution

Search form

• Advanced search
• Search responses
• Search blogs
• How to prepare and...

How to prepare and deliver an effective oral presentation

• Related content
• Peer review
• Lucia Hartigan , registrar 1 ,
• Fionnuala Mone , fellow in maternal fetal medicine 1 ,
• Mary Higgins , consultant obstetrician 2
• 1 National Maternity Hospital, Dublin, Ireland
• 2 National Maternity Hospital, Dublin; Obstetrics and Gynaecology, Medicine and Medical Sciences, University College Dublin
• luciahartigan{at}hotmail.com

The success of an oral presentation lies in the speaker’s ability to transmit information to the audience. Lucia Hartigan and colleagues describe what they have learnt about delivering an effective scientific oral presentation from their own experiences, and their mistakes

The objective of an oral presentation is to portray large amounts of often complex information in a clear, bite sized fashion. Although some of the success lies in the content, the rest lies in the speaker’s skills in transmitting the information to the audience. 1

Preparation

It is important to be as well prepared as possible. Look at the venue in person, and find out the time allowed for your presentation and for questions, and the size of the audience and their backgrounds, which will allow the presentation to be pitched at the appropriate level.

See what the ambience and temperature are like and check that the format of your presentation is compatible with the available computer. This is particularly important when embedding videos. Before you begin, look at the video on stand-by and make sure the lights are dimmed and the speakers are functioning.

For visual aids, Microsoft PowerPoint or Apple Mac Keynote programmes are usual, although Prezi is increasing in popularity. Save the presentation on a USB stick, with email or cloud storage backup to avoid last minute disasters.

When preparing the presentation, start with an opening slide containing the title of the study, your name, and the date. Begin by addressing and thanking the audience and the organisation that has invited you to speak. Typically, the format includes background, study aims, methodology, results, strengths and weaknesses of the study, and conclusions.

If the study takes a lecturing format, consider including “any questions?” on a slide before you conclude, which will allow the audience to remember the take home messages. Ideally, the audience should remember three of the main points from the presentation. 2

Have a maximum of four short points per slide. If you can display something as a diagram, video, or a graph, use this instead of text and talk around it.

Animation is available in both Microsoft PowerPoint and the Apple Mac Keynote programme, and its use in presentations has been demonstrated to assist in the retention and recall of facts. 3 Do not overuse it, though, as it could make you appear unprofessional. If you show a video or diagram don’t just sit back—use a laser pointer to explain what is happening.

Rehearse your presentation in front of at least one person. Request feedback and amend accordingly. If possible, practise in the venue itself so things will not be unfamiliar on the day. If you appear comfortable, the audience will feel comfortable. Ask colleagues and seniors what questions they would ask and prepare responses to these questions.

It is important to dress appropriately, stand up straight, and project your voice towards the back of the room. Practise using a microphone, or any other presentation aids, in advance. If you don’t have your own presenting style, think of the style of inspirational scientific speakers you have seen and imitate it.

Try to present slides at the rate of around one slide a minute. If you talk too much, you will lose your audience’s attention. The slides or videos should be an adjunct to your presentation, so do not hide behind them, and be proud of the work you are presenting. You should avoid reading the wording on the slides, but instead talk around the content on them.

Maintain eye contact with the audience and remember to smile and pause after each comment, giving your nerves time to settle. Speak slowly and concisely, highlighting key points.

Do not assume that the audience is completely familiar with the topic you are passionate about, but don’t patronise them either. Use every presentation as an opportunity to teach, even your seniors. The information you are presenting may be new to them, but it is always important to know your audience’s background. You can then ensure you do not patronise world experts.

To maintain the audience’s attention, vary the tone and inflection of your voice. If appropriate, use humour, though you should run any comments or jokes past others beforehand and make sure they are culturally appropriate. Check every now and again that the audience is following and offer them the opportunity to ask questions.

Finishing up is the most important part, as this is when you send your take home message with the audience. Slow down, even though time is important at this stage. Conclude with the three key points from the study and leave the slide up for a further few seconds. Do not ramble on. Give the audience a chance to digest the presentation. Conclude by acknowledging those who assisted you in the study, and thank the audience and organisation. If you are presenting in North America, it is usual practice to conclude with an image of the team. If you wish to show references, insert a text box on the appropriate slide with the primary author, year, and paper, although this is not always required.

Answering questions can often feel like the most daunting part, but don’t look upon this as negative. Assume that the audience has listened and is interested in your research. Listen carefully, and if you are unsure about what someone is saying, ask for the question to be rephrased. Thank the audience member for asking the question and keep responses brief and concise. If you are unsure of the answer you can say that the questioner has raised an interesting point that you will have to investigate further. Have someone in the audience who will write down the questions for you, and remember that this is effectively free peer review.

Be proud of your achievements and try to do justice to the work that you and the rest of your group have done. You deserve to be up on that stage, so show off what you have achieved.

Competing interests: We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: None.

• ↵ Rovira A, Auger C, Naidich TP. How to prepare an oral presentation and a conference. Radiologica 2013 ; 55 (suppl 1): 2 -7S. OpenUrl
• ↵ Bourne PE. Ten simple rules for making good oral presentations. PLos Comput Biol 2007 ; 3 : e77 . OpenUrl PubMed
• ↵ Naqvi SH, Mobasher F, Afzal MA, Umair M, Kohli AN, Bukhari MH. Effectiveness of teaching methods in a medical institute: perceptions of medical students to teaching aids. J Pak Med Assoc 2013 ; 63 : 859 -64. OpenUrl

Tools for the Patient Presentation

The formal patient presentation.

• Posing the Clinical Question
• Searching the Medical Literature for EBM

Sources & Further Reading

First Aid for the Wards

Lingard L, Haber RJ.  Teaching and learning communications in medicine: a rhetorical approach .  Academic Medicine. 74(5):507-510 1999 May.

Lingard L, Haber RJ.  What do we mean by "relevance"? A clinical and rhetorical definition with implications for teaching and learning the case-presentation format . Academic Medicine. 74(10):S124-S127.

The Oral Presentation (A Practical Guide to Clinical Medicine, UCSD School of Medicine)  http://meded.ucsd.edu/clinicalmed/oral.htm

"Classically, the formal oral presentation is given in 7 minutes or less. Although it follows the same format as a written report, it is not simply regurgitation. A great presentation requires style as much as substance; your delivery must be succinct and smooth. No time should be wasted on superfluous information; one can read about such matters later in your admit note. Ideally, your presentation should be formulated so that your audience can anticipate your assessment and plan; that is, each piece of information should clue the listener into your thinking process and your most likely diagnosis."  [ Le, et al, p. 15 ]

Types of Patient Presentations

New Patient

New patients get the traditional H&P with assessment and plan.  Give the chief complaint and a brief and pertinent HPI.  Next give important PMH, PSH, etc.  The ROS is often left out, as anything important was in the HPI.  The PE is reviewed.  Only give pertinent positives and negatives.  The assessment and plan should include what you think is wrong and, briefly, why.  Then, state what you plan to do for the patient, including labs.  Be sure to know why things are being done: you will be asked.

The follow-up presentation differs from the presentation of a new patient.  It is an abridged presentation, perhaps referencing major patient issues that have been previously presented, but focusing on new information about these issues and/or what has changed. Give the patient’s name, age, date of admission, briefly review the present illness, physical examination and admitting diagnosis.  Then report any new finding, laboratory tests, diagnostic procedures and changes in medications.

The attending physician will ask the patient’s permission to have the medical student present their case.  After making the proper introductions the attending will let the patient know they may offer input or ask questions at any point.  When presenting at bedside the student should try to involve the patient.

Preparing for the Presentation

There are four things you must consider before you do your oral presentation

• Occasion (setting and circumstances)

Ask yourself what do you want the presentation to do

• Present a new patient to your preceptor : the amount of detail will be determined by your preceptor.  It is also likely to reflect your development and experience, with less detail being required as you progress.
• Present your patient at working or teaching rounds : the amount of detail will be determined by the customs of the group. The focus of the presentation will be influenced by the learning objectives of working responsibilities of the group.
• Request a consultant’s advice on a clinical problem : the presentation will be focused on the clinical question being posed to the consultant.
• Persuade others about a diagnosis and plan : a shorter presentation which highlights the pertinent positives and negatives that are germane to the diagnosis and/or plan being suggested.
• Enlist cooperation required for patient care : a short presentation focusing on the impact your audience can have in addressing the patient’s issues.

Preparation

• Patient evaluation : history, physical examination, review of tests, studies, procedures, and consultants’ recommendations.
• Selected reading : reference texts; to build a foundational understanding.
• Literature search : for further elucidation of any key references from selected reading, and to bring your understanding up to date, since reference text information is typically three to seven years old.
• Write-up : for oral presentation, just succinct notes to serve as a reminder or reference, since you’re not going to be reading your presentation.

Knowledge (Be prepared to answer questions about the following)

• Pathophysiology
• Complications
• Differential diagnosis
• Course of conditions
• Diagnostic tests
• Medications
• Essential Evidence Plus

Template for Oral Presentations

Chief Complaint (CC)

The opening statement should give an overview of the patient, age, sex, reason for visit and the duration of the complaint. Give marital status, race, or occupation if relevant.  If your patient has a history of a major medical problem that bears strongly on the understanding of the present illness, include it.  For ongoing care, give a one sentence recap of the history.

History of Present Illness (HPI)

This will be very similar to your written HPI. Present the most important problem first. If there is more than one problem, treat each separately. Present the information chronologically.  Cover one system before going onto the next. Characterize the chief complaint – quality, severity, location, duration, progression, and include pertinent negatives. Items from the ROS that are unrelated to the present problem may be mentioned in passing unless you are doing a very formal presentation. When you do your first patient presentation you may be expected to go into detail.  For ongoing care, present any new complaints.

Review of Systems (ROS)

Most of the ROS is incorporated at the end of the HPI. Items that are unrelated to the present problem may be briefly mentioned.  For ongoing care, present only if new complaints.  

Past Medical History (PMH)

Discuss other past medical history that bears directly on the current medical problem.  For ongoing care, have the information available to respond to questions.

Past Surgical History

Provide names of procedures, approximate dates, indications, any relevant findings or complications, and pathology reports, if applicable.  For ongoing care, have the information available to respond to questions.

Allergies/Medications

Present all current medications along with dosage, route and frequency. For the follow-up presentation just give any changes in medication.  For ongoing care, note any changes.

Smoking and Alcohol (and any other substance abuse)

Note frequency and duration. For ongoing care, have the information available to respond to questions.

Social/Work History

Home, environment, work status and sexual history.  For ongoing care, have the information available to respond to questions.

Family History Note particular family history of genetically based diseases.  For ongoing care, have the information available to respond to questions.

Physical Exam/Labs/Other Tests

Include all significant abnormal findings and any normal findings that contribute to the diagnosis. Give a brief, general description of the patient including physical appearance. Then describe vital signs touching on each major system. Try to find out in advance how thorough you need to be for your presentation. There are times when you will be expected to give more detail on each physical finding, labs and other test results.  For ongoing care, mention only further positive findings and relevant negative findings.

Assessment and Plan

Give a summary of the important aspects of the history, physical exam and formulate the differential diagnosis. Make sure to read up on the patient’s case by doing a search of the literature. 

• Include only the most essential facts; but be ready to answer ANY questions about all aspects of your patient.
• Keep your presentation lively.
• Do not read the presentation!
• Expect your listeners to ask questions.
• Follow the order of the written case report.
• Keep in mind the limitation of your listeners.
• Beware of jumping back and forth between descriptions of separate problems.
• Use the presentation to build your case.
• Your reasoning process should help the listener consider a differential diagnosis.
• Present the patient as well as the illness .
• << Previous: Home
• Next: Posing the Clinical Question >>
• Last Updated: Jul 19, 2023 10:52 AM
• URL: https://rowanmed.libguides.com/tools

• Subscribe to journal Subscribe
• Get new issue alerts Get alerts

Secondary Logo

Journal logo.

Colleague's E-mail is Invalid

Your message has been successfully sent to your colleague.

Save my selection

Evaluating Oral Case Presentations Using a Checklist

How do senior student-evaluators compare with faculty.

Kakar, Seema P. MD; Catalanotti, Jillian S. MD, MPH; Flory, Andrea L. MD; Simmens, Samuel J. PhD; Lewis, Karen L. PhD; Mintz, Matthew L. MD; Haywood, Yolanda C. MD; Blatt, Benjamin C. MD

Dr. Kakar is assistant professor, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Dr. Catalanotti is assistant professor, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Dr. Flory is assistant professor, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Dr. Simmens is research professor, Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC.

Dr. Lewis is director of administration, Clinical Learning and Simulation Skills (CLASS) Center, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Dr. Mintz is associate professor, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Dr. Haywood is assistant dean for student and curricular affairs, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Dr. Blatt is professor, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Funding/Support: None.

Other disclosures: None.

Ethical approval: This study was approved by the institutional review board of The George Washington University.

Previous presentations: The abstract of an earlier version of this article was presented at the May 2011 Northeastern Group on Educational Affairs meeting, Washington, DC, and at the November 2011 Research in Medical Education Conference, Denver, Colorado.

Correspondence should be addressed to Dr. Kakar, Department of Medicine, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave., NW, Washington, DC 20037; e-mail: [email protected] .

Purpose 

Previous studies have shown student-evaluators to be reliable assessors of some clinical skills, but this model has not been studied for oral case presentations (OCPs). The purpose of this study was to examine the validity of student-evaluators in assessing OCP by comparing them with faculty.

Method 

In 2010, the authors developed a dichotomous checklist. They trained 30 fourth-year medical students (student-evaluators) to use it to assess 170 second-year medical students’ OCPs in real time during a year-end objective structured clinical examination. Ten faculty physicians then scored videos of a random sample of these OCPs. After discarding items with poor faculty reliability, the authors assessed agreement between faculty and student-evaluators on 18 individual items, total scores, and pass/fail decisions.

Results 

The total score correlation between student-evaluators and faculty was 0.84 ( P < .001) and was somewhat better than the faculty–faculty intraclass correlation ( r = 0.71). Using a 70% pass/fail cutoff, faculty and student-evaluator agreement was 74% (Kappa = 0.46; 95% CI, 0.20–0.72). Overall, student-evaluator scores were more lenient than faculty scores (72% versus 56% pass rates; P = .03).

Conclusions 

Senior student-evaluators were able to reliably assess second-year medical students’ OCP skills. The results support the use of student-evaluators for peer assessment of OCPs in low-stakes settings, but evidence of leniency compared with faculty assessment suggests caution in using student-evaluators in high-stakes settings. Extending peer assessment to OCPs provides a practical approach for low-resource evaluation of this essential skill.

Full Text Access for Subscribers:

Individual subscribers.

Institutional Users

Not a subscriber.

You can read the full text of this article if you:

• + Favorites
• View in Gallery

Readers Of this Article Also Read

Health systems science in medical education: unifying the components to..., new educator roles for health systems science: implications of new physician..., advancing competency-based medical education: a charter for clinician–educators, entrustment decision making in clinical training, amending miller’s pyramid to include professional identity formation.

How to Prepare and Give a Scholarly Oral Presentation

• First Online: 01 January 2020

Cite this chapter

• Cheryl Gore-Felton 2  

1277 Accesses

Building an academic reputation is one of the most important functions of an academic faculty member, and one of the best ways to build a reputation is by giving scholarly presentations, particularly those that are oral presentations. Earning the reputation of someone who can give an excellent talk often results in invitations to give keynote addresses at regional and national conferences, which increases a faculty member’s visibility along with their area of research. Given the importance of oral presentations, it is surprising that few graduate or medical programs provide courses on how to give a talk. This is unfortunate because there are skills that can be learned and strategies that can be used to improve the ability to give an interesting, well-received oral presentation. To that end, the aim of this chapter is to provide faculty with best practices and tips on preparing and giving an academic oral presentation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save.

• Get 10 units per month
• Download Article/Chapter or Ebook
• 1 Unit = 1 Article or 1 Chapter
• Cancel anytime
• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Strategies for the Preparation and Delivery of Oral Presentation

Graduate Students and Learning How to Get Published

Pashler H, McDaniel M, Rohrer D, Bjork R. Learning styles: concepts and evidence. Psychol Sci Public Interest. 2009;9:105–19.

Article   Google Scholar  

Newsam JM. Out in front: making your mark with a scientific presentation. USA: First Printing; 2019.

Google Scholar  

Ericsson AK, Krampe RT, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100:363–406.

Seaward BL. Managing stress: principles and strategies for health and well-being. 7th ed. Jones & Bartlett Learning, LLC: Burlington; 2012.

Krantz WB. Presenting an effective and dynamic technical paper: a guidebook for novice and experienced speakers in a multicultural world. Philadelphia: Elsevier; 2017.

Download references

Author information

Authors and affiliations.

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

Cheryl Gore-Felton

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Cheryl Gore-Felton .

Editor information

Editors and affiliations.

Laura Weiss Roberts

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Gore-Felton, C. (2020). How to Prepare and Give a Scholarly Oral Presentation. In: Roberts, L. (eds) Roberts Academic Medicine Handbook. Springer, Cham. https://doi.org/10.1007/978-3-030-31957-1_42

Download citation

DOI : https://doi.org/10.1007/978-3-030-31957-1_42

Published : 01 January 2020

Publisher Name : Springer, Cham

Print ISBN : 978-3-030-31956-4

Online ISBN : 978-3-030-31957-1

eBook Packages : Medicine Medicine (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

Posters & Oral Presentations

Good scientific research involves a sound methodology and a novel idea that can be tested simply and repeatedly to give valid, trustworthy results. However, even the most clinically significant research is useless if it is not communicated successfully. Scientific ideas are novel, sometimes simple in theory, but most always complex in technique. These attributes of research make it necessary to use all available means of presentation. The most common media for scientists to communicate with the general public is primary journal articles. However, posters and oral presentations are also affective because they allow scientists to be in direct contact with their audience. This provides both parties an opportunity to ask pertinent questions to add clarity to the work being presented.

A poster is an exciting way for scientists to present their research. It, just as a primary research article, includes all aspects of the scientific method. A title that is brief, but specific, an abstract, an introduction, material and methods, results, and a conclusion are some headings that can appear on a poster. Also, references and acknowledgments are sometimes are included. A poster is different from a written manuscript or an oral presentation because it is mostly graphical. As such, it is important to design a poster that is visually pleasing by focusing on charts, graphs, and pictures and minimizing lengthy introductions and discussions. Highlighting all significant information with the use of bullets is essential because if further explanation is needed the audience will simply ask for it.

Oral presentations are yet another avenue for scientists to share their findings with the world. Although it can be challenging to present years of works within fifteen minutes, oral presentations can be a rewarding experience because you are the only one front of an audience whose attention you know have. Of course this emphasizes the need to speak clearly and concisely with choice words that engross the audience. Again, just as with written manuscript and posters the format of oral presentations can also vary, but essentially it must include logical, easy-to-understand events that are presented in a matter with respect to the scientific method.

Electronic Resources

Poster Presentation http://www.ncsu.edu/project/posters

This is an excellent site that covers all aspects of a poster presentation from creating a poster to presenting one. It also provides several examples with critiques for each sample. Lastly, it has a quick reference page with helpful tips for delivering a successful poster presentation.

Oral Presentation http://www.kumc.edu/SAH/OTEd/jradel/Preparing_talks/103.html

This site is cited by the NIH and is quite useful when designing an oral presentation. It addresses all aspects of a scientific talk from planning and preparing to practicing and presenting. It is brief and easy to follow with helpful tips on how to prepare for the question/answer session.

Document Resources  

Scientific Poster: Tips, Significance, Design, Templates and Presentation

This document provides tips and temples for designing a poster presentation. It also discusses the significance of a poster presentation and includes a section that gives advice on how to present successfully.

Oral Presentations: Tips, Significance, Design, Guidelines & Presentation

This document provides tips and guidelines for designing an oral presentation. It also discusses the significance of an oral presentation and includes a section that gives advice on how to present successfully.

Inpatient Medicine

• Organization: Health care in teaching hospitals is very hierarchical. At the top of the pyramid is the attending physician, a staff doctor who has ultimate responsibility for the patient. Beneath them is the supervising resident, a physician in the advanced stages of their training. They supervise the interns, doctors in their first year out of medical school who are generally the worker bees of the service. Fourth year students (referred to as Sub or Acting Interns) may also be members of the team. This is their opportunity to work with an increased degree of autonomy in order to prepare them for their future role as doctors. Some teams have additional layers of residents or fellows (physicians participating in advanced post-residency training), depending on the complexity and volume of work to be done.
• Role of the Student: The third year student occupies a variably placed position on the team. Clinical education is based on the concept that students learn through a process of observation and controlled participation in patient care. Their ability to function and contribute will depend on the scope of their general experience as well as specific knowledge in any one field. During the beginning of the year and/or early in a particular rotation, students will be less functional then towards the end. Furthermore, the very nature of some rotations (e.g. surgery) will pose obvious limits on the degree to which the student may actually participate. In addition, the student has a somewhat distinct position from the other team members in that their purpose is not merely to get work done. Nor, for obvious reasons, do they function with speed or efficiency, traits which frequently define the work of the other team members.
• Ask the head of your team (both resident and attending physician) for a precise description of your responsibilities. How many patients will you follow? Will you be writing admission H&Ps, daily notes, presenting at attending or work rounds, etc? Who will be reviewing your work?
• What are your expectations for the rotation? What are the most important things that you want to learn or experience? Even if these are no different then the other students (e.g. observe operations on a surgical service, practice putting in I.V.s, etc.), keep a mental list for yourself that you can refer to periodically. If you have unusual expectations that you feel can be reasonably met within the scope of the rotation, discuss them with your supervising physicians.
• With whom will you be working? One or several of the interns or with the resident directly? Make sure that you know how to contact them and that they know how to find you. It helps to confirm even the most obvious details as non-communication of what others feel is implicitly understood information can become the substrate for conflict.
• Offer feedback to your teachers. Let them know what works and what does not. Similarly, solicit input on your own performance. Don't leave this for the end of the rotation as by then you'll have lost the opportunity to incorporate suggestions and experiment with new approaches.
• Determine the weekly schedule of events. Are there student conferences or other commitments that will make you unavailable to the team? When and where are work rounds, radiology rounds, attending rounds, etc.? If you're on a surgical rotation, when will you be expected to be in the operating room?
• Identify when you are expected to be on call and what your exact responsibilities will be on those days. Will you be sleeping in the hospital? Who is responsible for informing you about new admissions? Should you see these patients with the rest of the team or interview them separately? If there are specific days that you need off, let your team members know at the start of the rotation.
• Realize that education is a two-way street. Students can and should contribute to the learning process. This is of particular value on fast paced rotations, when time constraints prevent other team members from being able to pursue this information on their own.
• Address conflicts or areas of dissatisfaction early in the rotation. Frequently, these are simply the result of miscommunication and can be easily remedied. More complex issues should be taken up either directly with the person(s) involved or, if you are uncomfortable with this approach, via the attending physician or course director. Don't let problems fester!
• Take each rotation seriously and try to learn as much as possible while you're there. A casual or cavalier attitude is rapidly transmitted to those with whom you work. Any lack of interest on your part will almost certainly lead to less enthusiasm and effort from your teachers. The resulting clinical experience is destined to be less fulfilling and interesting. Try to adopt the attitude that you are truly a practitioner in the field of medicine to which you've been assigned. The resulting experience will be more enjoyable, the teaching superior, and you may occasionally identify a previously undiscovered area of interest or aptitude.

Specific Suggestions for Making the Most of Inpatient Rotations

Pre-Rounding: Work rounds occur each morning and are the time when the team sees each patient, discusses their course, and decides on the diagnostic and therapeutic plan of the day. In order to be maximally efficient, it falls to the students and interns to gather relevant clinical data. This process is referred to as pre-rounding and should incorporate the following:

• Review the flow chart that is kept for each patient. This sheet is a record of their vital signs as well as fluids taken in or excreted (referred to as Is and Os, for Ins and Outs) over a twenty-four hour period.
• Be aware of major events that have occurred over the past day. Were any studies performed? Were there major changes in clinical status? Of course, access to this information is predicated on your having been actively involved in the patient's care (i.e. you need to make it a priority to stay informed about the patient's clinical activity). If things are happening that you are not made aware of, mention this to the interns and residents so that they can help you become an active participant in the patient care process.
• If your team was not on call, try to speak with the person who was responsible for caring for the patient overnight. Alternatively, it may be easier to check with your intern as they have, in all likelihood, obtained some sort of sign out from the covering person.
• Check the chart to see if any notes were written about specific overnight events (or by consulting physicians who may have stopped by late on the previous day). Also, take a look in the order section for things initiated over night. You may then be able to piece together what happened during your absence. If, for example, new antibiotics were given, then someone must have discovered a previously unrecognized infection.
• Speak with the nurse who was covering the patients overnight and/or the one who has taken over in the AM.
• Query the patient about any overnight events. You will need to perform a focused exam each morning, which is a prime opportunity to ask if anything has happened.
• Leave yourself plenty of time to pre-round. Early in the year, this can require up to 30 minutes per patient. You may need to arrive quite early, depending on your experience, as well as patient volume and complexity. However, providing yourself with a realistic time cushion will generate much less anxiety and allow you to be as complete and accurate as possible.
• Have instant access to each patient's relevant past history, medications and baseline labs.
• Be aware of in-house medications and daily lab results.
• Maintain a list of things that need to be done for each patient.

The following system allows you to keep all relevant information on 5x8 index cards. This method has several advantages:

• It's readily portable. The cards fit nicely into standard lab coat pockets and are available on most hospital floors.
• As opposed to clip-boards (which are frequently misplaced), these cards leave your hands free to perform tasks (e.g. physical examinations, compressions during CPR, etc.).
• It makes relevant data readily available and allows you to keep an organized list of things that need to be done.
• It's easily standardized and understandable by others.
• This system can be learned and used by students and then carried over and applied during later careers as house officers and attending physicians.

A few things to remember:

• Over time you will develop a short-hand that allows you to make best use of the card space available. You can also adjust the format any way you wish.
• The information included on the back (PMH, PSH, HPI, PE, etc.) is in very brief form. It should only include the critical highlights. More detailed points can be found in the chart.
• If a patient is hospitalized for a very long period of time, additional cards can be stapled on top of the original.
• The data presented should be factual. Old events that were described in earlier notes should not be repeated. The daily note is not meant to be a recapitulation of the H&P.
• The impression and plan generally reflects the thoughts of the entire team. That is, don't use the note as a format for expressing ideas that differ wildly from everyone else. If you don't understand, or even disagree with, the dominant view, talk to your team members and try to gain insight into their thought process. Independent reasoning is certainly encouraged. However, avoid using the note as a means of battling with (or inflaming) your colleagues. This is, unfortunately, a common problem for many "higher level" providers, leading to energy and time wasting "chart wars."
• Don't take hours (or more then 10 minutes, for that matter) to write a note. The length of the note will depend to a large extent on your experience, understanding of the case and the complexity of the patient's illness. However, there is generally WAY TOO MUCH attention paid to this process. Many, many other endeavors are of greater value, to both the patient and yourself. Remember, compared with all of the other aspects of patient care, the note is a minor end unto itself. After all, those most interested in the note are you and your team members. Thus, the exquisite detail found in many of these masterpieces is for the benefit of physicians who are already well aware of the patient and their course! In the event that some point is unclear, the reader can always find you to discuss the matter further.
• Certain services have very particular styles, emphasizing aspects that are important to the care that they provide. General Surgery teams, for example, tend to highlight fluid status, wound care, and IV access issues, areas that are critical to their patient population. Furthermore, these notes are very brief. The surgeon's time is spent elsewhere (e.g. the Operating Room) and by necessity they cannot spend exorbitant amounts of time charting. Realize that being succinct is not equivalent to being incomplete nor does it imply sub-optimal care. To my knowledge, no one has shown that the length of the note correlates with the quality of care delivered. In fact, it occasionally seems that more time and energy is put into notes then actual patient care!

Hospital Day # 3

• S: Patient feeling less short of breath, with decreased cough and sputum production.
• O: Maximum Temperature: 101.5 (yesterday 103)
• Pulse: 80-90
• BP: 110-120/70-80 RR: 20-24 Sat: 95% 2l O2 (yesterday 95% 4l O2)
• I/O: 2.5 L IV, 1 L PO/ UO 2L, BM x 1 Wt 140 lbs (no change from yesterday)

Day # 3 Ceftriaxone, 1g IV BID PE: No jvd Lungs: Crackles and dullness to percussion at R base with egophony; no change c/w yesterday C/V: s1 s2 no s3 s4 m Abd: soft, non-tender Ext: no edema Labs: Sputum and blood cx still negative; otherwise no new data

• IV abx x 1 addl day... then change to po Azithromax
• Hep. lock IV to assess if PO intake adequate
• Check sat off O2... d/c if under 92%
• Encourage ambulation
• consider discharge in approximately 2 days if continues to improve.

That's a pretty simple note. However, it clearly serves its purpose. More complicated patients with additional issues would require an assessment and plan that dealt with each problem specifically. Notice that I've chosen to highlight objective data so that improvement is clearly demonstrated (e.g. decreased O2 requirement, declining temperature curve) and number ranges are mentioned when discrete points in time might not be representative (e.g. for heart rate and blood pressure). This is based on common sense and is done at the discretion of the writer. In addition, I chose to mention the antibiotic given and duration of therapy to date. In this case, it's an important issue and deserves mention. The patient may be receiving other medications, perhaps for the treatment of several chronic conditions (e.g. hypertension, glaucoma, etc.). As these elements were undoubtedly mentioned elsewhere and are not changing, I've omitted them from the SOAP note. If, however, there was ongoing medication adjustment, as might be the case if Insulin were being used to treat diabetes or extra doses of Lasix provided for heart failure, I would have made special mention of these meds as well.

Presenting During Work Rounds: The formal, complete oral presentation is discussed elsewhere. Work rounds are, of course, for work. Regardless of the service, time constraints demand that presentations be succinct yet thorough. An average presentation should take no more then a few minutes. The following is a sample presentation for a patient on the General Surgery service:

"Mr. Smith is post operative day #2 from his appendenctomy, day #3 of 7 of Ampicillin, Gentamycin and Flagyl. Events over the past 24 hours include: CXR performed as part of a fever evaluation; no pulmonary pathology identified Passing of flatus. Decreased abdominal pain. Patient appeared comfortable, without specific complaints Vital Signs: T Max 102.5 yesterday, 100 over past 8 hours Heart Rate 80s to 90s, Blood Pressure 120s-140s over 70s Respiratory Rate in low 20s, Sat'ing at 95% on Room Air Weight 150 pounds, down 1 pound from yesterday; still up 5 pounds from pre-op Is and Os: 2L IV NS at rate of 100/hour. Additional 500 ccs IVF from antibiotics. Still NPO. Urine Output total 2 L, approximately 50 cc/h. Lungs: Clear Heart: regular rate and rhythm without murmurs Abdomen: hypoactive bowel sounds now present; slightly distended; wound without erythema or discharge; minimal pain at incision site Labs: This morning's Chem 7 and CBC pending; Yetsterday BUN and Creat 11 and .8, which are consistent with baseline; White count 16, down from 20 the previous day. Intra-operative cultures still negative; blood and urine cultures from day of admission and yesterday negative. (Team may or may not take this opportunity to enter the patient's room for group interview and exam) Assessment and Plan: G.I. (gastrointestinal): Patient S/P appendectomy. Had prolonged ileus associated with significant peri-appendiceal inflammation. Now with apparent recovery of gut function as evidenced by flatus, bowel sounds. Plan: Advance to sips of clear liquids this A.M... If tolerated, will allow full clears this afternoon and then hep. lock IV as appears to be euvolemic. Encourage ambulation around floor

Plan: Continue current antibiotics for additional 24 hours. If remains well, change to oral ciprofloxin and flagyl to complete 7 day course. Follow up on cultures. Ambulation and incentive spirometry may help if atelectasis contributing.

Plan: D/C Foley

Plan: Expect patient may be ready for discharge in 2 days

• Every service has a different style. Some may see every patient as a group and discuss the assessment and plan after the exam. Others prefer to hear the entire presentation (including the A and P) prior to seeing the patient, with appropriate adjustments made after the visit. The only way to learn the particulars is to ask.
• Oral presentations do not precisely follow the SOAP format. In the above example I've opted to include an "events" section along with the Subjective comments. Patients presented for the first time will generally be done in a more inclusive fashion, covering enough background information so that the course to date as well as the assessment and plan are understandable to all team members.
• Accurate presentations require that the presenter be intimately aware of all the details related to a patient's course. Pre-rounding and record keeping (see above) are thus vital. You'll also find it necessary to read critical data from your portable record keeping system.
• You may find it helpful, particularly early in your careers, to take a few minutes before rounds to practice your presentations.
• The number of sub-categories mentioned in the assessment and plan will vary with the complexity of the patient's illness. Patients with many issues will require detailed discussions. The major categories include: Neurological, Cardiac, Pulmonary, gatrointestinal, Renal, Hematologic, Infectious Disease, Endocrine/Metabolic, Access (i.e. tubes, lines, and drains), and Disposition. If there are no issues related to a particular area, it is not mentioned in the discussion. At times, there will be clinical problems that bridge several areas. For example, pneumonia is both a Pulmonary and an ID issue. In such settings, the presenter uses their judgment and discusses the problem under a single heading in order to avoid redundancy. In very complex cases, these major headings can be exploded into sub- categories so that important issues are not missed. For example, a patient may have CHF, Hypertension and Atrial Fibrillation. These are all Cardiac issues, which may or may not be related. As each requires specific therapy, listing them separately allows for maximum clarity.
• It will take some time before you become comfortable presenting as this process requires rather advanced organizational skills. In addition, you are likely to feel quite exposed during this process. Try not to be intimidated or discouraged. Ask for feedback frequently.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• BMC Med Educ
• PMC10210329

Comparing oral case presentation formats on internal medicine inpatient rounds: a survey study

Brendan appold.

1 University of Michigan Medical School, Ann Arbor, MI USA

Sanjay Saint

2 VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105 USA

Ashwin Gupta

Associated data.

The data that support the findings of this study are available from the corresponding author, AG, upon reasonable request.

Oral case presentations – structured verbal reports of clinical cases – are fundamental to patient care and learner education. Despite their continued importance in a modernized medical landscape, their structure has remained largely unchanged since the 1960s, based on the traditional Subjective, Objective, Assessment, Plan (SOAP) format developed for medical records. We developed a problem-based alternative known as Events, Assessment, Plan (EAP) to understand the perceived efficacy of EAP compared to SOAP among learners.

We surveyed (Qualtrics, via email) all third- and fourth-year medical students and internal medicine residents at a large, academic, tertiary care hospital and associated Veterans Affairs medical center. The primary outcome was trainee preference in oral case presentation format. The secondary outcome was comparing EAP and SOAP on 10 functionality domains assessed via a 5-point Likert scale. We used descriptive statistics (proportion and mean) to describe the results.

The response rate was 21% (118/563). Of the 59 respondents with exposure to both the EAP and SOAP formats, 69% ( n  = 41) preferred the EAP format as compared to 19% ( n  = 11) who preferred SOAP ( p  < 0.001). EAP outperformed SOAP in 8 out of 10 of the domains assessed, including advancing patient care, learning from patients, and time efficiency.

Conclusions

Our findings suggest that trainees prefer the EAP format over SOAP and that EAP may facilitate clearer and more efficient communication on rounds, which in turn may enhance patient care and learner education. A broader, multi-center study of the EAP oral case presentation will help to better understand preferences, outcomes, and barriers to implementation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12909-023-04292-3.

Excellent inter-physician communication is fundamental to both providing high-quality patient care and promoting learner education [ 1 ], and has been recognized as an important educational goal by the Clerkship Directors in Internal Medicine, the Association of American Medical Colleges, and the Accreditation Council for Graduate Medical Education [ 2 ]. Oral case presentations, structured verbal reports of clinical cases [ 3 ], have been referred to as the “currency with which clinicians communicate” [ 4 ]. Oral case presentations are a key element of experiential learning in clinical medicine, requiring learners to synthesize, assess, and convey pertinent patient information and to formulate care plans. Furthermore, oral case presentations allow supervising clinicians to identify gaps in knowledge or clinical reasoning and enable team members to learn from one another. Despite modernization in much of medicine, oral case presentation formats have remained largely unchanged, based on the traditional Subjective, Objective, Assessment, Plan (SOAP) format developed by Dr. Lawrence Weed in his Problem Oriented Medical Record in 1968 [ 5 ].

Given that the goals of a medical record are different than those of oral case presentations, it should not be assumed that they should share the same format. While Dr. Weed sought to make the medical record as “complete as possible,” [ 6 ] internal medicine education leaders have expressed desire for oral case presentations that are succinct, with an emphasis on select relevant details [ 2 ]. Using a common SOAP format between the medical record and oral case presentations risks conflating the distinct goals for each of these communication methods. Indeed, in studying how learners gain oral case presentation skills, Haber and Lingard [ 7 ] found differences in understanding of the fundamental purpose of oral case presentations between medical students and experienced physicians. While students believed the purpose of oral case presentations was to organize the large amount of data they collected about their patients, experienced physicians saw oral case presentations as a method of telling a story to make an argument for a particular conclusion [ 7 ].

In accordance with Dr. Weed’s “problem-oriented approach to data organization,” [ 6 ] but with an eye toward optimizing for oral case presentations, we developed an alternative to SOAP known as the Events, Assessment, Plan (EAP) format. The EAP format is used for patients who are already known to the inpatient team, and may also be utilized for newly admitted patients for whom the attending physician already has context (e.g., via handoff or review of an admission note). As the EAP approach is utilized by a subset of attending physicians at our academic hospital, we sought to understand the perceived effectiveness of the EAP format in comparison to the traditional SOAP format among learners (i.e., medical students and resident physicians).

EAP is a problem-based format used at the discretion of the attending physician. In line with suggested best practices [ 8 ], the EAP structure aims to facilitate transmission of data integrated within the context of clinical problem solving. In this format, significant interval events are discussed first (e.g., a fall, new-onset abdominal pain), followed by a prioritized assessment and plan for each relevant active problem. Subjective and objective findings are integrated into the assessment and plan as relevant to a particular problem. This integration of subjective and objective findings by problem is distinct from SOAP, where subjective and objective findings are presented separately as their own sections, with each section often containing information that is relevant to several problems (Fig.  1 , Additional file 1 : Appendix A).

Overview: comparing EAP to SOAP

Settings and participants

We surveyed third- and fourth-year medical students, and first- through fourth-year internal medicine and internal medicine-pediatrics residents, caring for patients at a large, academic, tertiary care hospital and an affiliated Veterans Affairs medical center. Internal medicine is a 12-week core clerkship for all medical students in their second year, with 8 weeks spent on the inpatient wards. All student participants had completed their internal medicine clerkship rotation at the time of the survey. We did not conduct a sample size calculation at the outset of this study.

Data collection methods and processes

An anonymous, electronic survey (Qualtrics, Provo, UT) was created to assess student and resident experience with and preference between EAP and SOAP oral case presentation formats during inpatient internal medicine rounds (Additional file 2 : Appendix B). Ten domains were assessed via 5-point Likert scale (1 [strongly disagree] to 5 [strongly agree]), including the ability of the format to incorporate the patient’s subjective experience, the extent to which the format encouraged distillation and integration of information, the extent to which the format focused on the assessment and plan, the format’s ability to help trainees learn from their own patients and those of their peers, time efficiency, and ease of use. Duration of exposure to each format was also assessed, as were basic demographic data for the purposes of understanding outcome differences among respondents (e.g., students versus residents). For those who had experienced both formats, preference between formats was recorded as a binary choice. Participants additionally had the opportunity to provide explanation via free text. For participants with experience in both formats, the order of evaluation of EAP and SOAP formats were randomized by participant. For questions comparing EAP and SOAP formats directly, choice order was randomized.

The survey was distributed via official medical school email in October 2021 and was available to be completed for 20 days. Email reminders were distributed approximately one week after distribution and again 48 h prior to survey conclusion.

The primary outcome was trainee preference in oral case presentation format. Secondary outcomes included comparison between EAP and SOAP on content inclusion/focus, data integration, learning, time efficiency, and ease of use.

Statistical analyses

Descriptive statistics were used to describe the results (proportion and mean). For comparative analysis between EAP and SOAP, responses from respondents who had experience with both formats were compared using the Wilcoxon Signed Rank Test to evaluate differences. All statistical analyses were done using SAS V9.4 (SAS Institute, Cary, NC). We considered p  < 0.05 to be statistically significant.

The overall response rate was 21% (118/563). The response rate was 14% ( n  = 62/441) among medical students and 46% ( n  = 56/122) among residents. Respondents were 61% ( n  = 72) female. A total of 98% ( n  = 116) and 52% ( n  = 61) of respondents reported experience with SOAP and EAP formats, respectively. Among medical students, 60% ( n  = 37) reported experience with SOAP only while 39% ( n  = 24) had experience with both formats. Among residents, 36% ( n  = 20) and 63% ( n  = 35) had experience with SOAP only and both formats, respectively (Table ​ (Table1). 1 ). Most students (93%) and residents (96%) reported > 8 weeks of exposure to the SOAP format. Duration of exposure to the EAP format varied (0 to 2 weeks [32% of students, 17% of residents], 2 to 4 weeks [36% of students, 47% of residents], 4 to 8 weeks [16% of students, 25% of residents], and > 8 weeks [16% of students, 11% of residents]).

Quantifying trainees who only experienced SOAP versus those who experienced both formats

Of the 59 respondents with exposure to both the SOAP and EAP formats, 69% ( n  = 41) preferred the EAP format as compared to 19% ( n  = 11) preferring SOAP ( p  < 0.001). The remainder ( n  = 7, 12%) indicated either no preference between formats or indicated another preference. Among residents, 66% ( n  = 23) favored EAP, whereas 20% ( n  = 7) and 14% ( n  = 5) preferred SOAP or had no preference, respectively ( p  < 0.001). Among students, 75% ( n  = 18) favored EAP, whereas 17% ( n  = 4) and 8% ( n  = 2) favored SOAP or had no preference, respectively ( p  < 0.001).

Likert scale ratings for domains assessed by trainees who had experience in either format are shown in Table ​ Table2. 2 . In general, scores for each domain were higher for EAP than SOAP, with the exception of perceived ease of use among students. Among those with experience using both formats, EAP outperformed SOAP most prominently in time efficiency (mean 4.39 vs 2.59, p  < 0.001) and encouragement to: focus on assessment and plan (4.64 vs 3.05, p  < 0.001), distill pertinent information (4.63 vs 3.17, p  < 0.001), and integrate data (4.58 vs 3.31, p  < 0.001) (Table ​ (Table3). 3 ). Respondents also ranked EAP higher in its effectiveness at advancing patient care (4.31 vs 3.71, p  < 0.001), its capacity to convey one’s thinking (4.53 vs 3.95, p  < 0.001), and its ability to facilitate learning from peers (4.10 vs 3.58, p  < 0.001) and one’s own patients (4.24 vs 3.78, p  = 0.003). There were no significant differences in the amount of time allotted for discussing the patient’s subjective experience or in ease of use.

Domain ratings for the EAP and SOAP formats for all respondents with exposure to either format a

a Mean scores to the prompt: “The ‘___’ presentation format…”

(1 = strongly disagree, 2 = disagree, 3 = neither disagree nor agree, 4 = agree, 5 = strongly agree)

EAP vs SOAP head-to-head for all respondents who experienced both formats a

Evaluation of trainee free text responses regarding oral case presentation preference revealed several general themes (Table ​ (Table4). 4 ). First, respondents generally felt that EAP was more time efficient and less repetitive, allowing for additional time to be spent discussing pertinent patient care decisions. Second, several respondents indicated that EAP aligns well with how trainees consider problems naturally (as a single problem in completion). Finally, respondents generally believed that EAP allowed learners to effectively communicate their thinking and demonstrate their knowledge. Those preferring SOAP most often cited format familiarity and the difficulty in switching between formats in describing their preference, though some also believed SOAP was more effective in describing a patient’s current status.

Themes related to format preference

Our single site survey comparing 2 oral case presentation formats revealed a preference among respondents for EAP over SOAP for those medical students and internal medicine residents who had experience with both formats. Furthermore, EAP outperformed SOAP in 8 out of 10 of the functionality domains assessed, including areas such as advancing patient care, learning from patients, and, particularly, time efficiency. Such a constellation of findings implies that EAP may not only be a more effective means to accomplish the key goals of oral case presentations, but it may also provide an opportunity to save time in the process. In line with SOAP’s current de facto status as an oral case presentation format, almost all respondents reported exposure to the SOAP format. Still, indicative of EAP’s growing presence at our academic system, more than one third of medical students and more than one half of residents also reported having experience with the EAP format.

While limited data exist that compare alternative oral case presentations to SOAP on inpatient medicine rounds, such alternatives have been previously trialed in other clinical venues. One such format, the multiple mini-SOAP, developed for complex outpatient visits, encourages each problem to be addressed “in its entirety” before presenting subsequent problems, and emphasizes prioritization by problem pertinency [ 9 ]. The creators suggest that this approach encourages more active trainee participation in formulating the assessment and plan for each problem, by helping the trainee to avoid getting lost in an “undifferentiated jumble of problems and possibilities” [ 9 ] that accumulate when multiple problems are presented all at once. On the receiving end, the multiple mini-SOAP enables faculty to assess student understanding of specific clinical problems one at a time and facilitates focused teaching accordingly.

Another approach has been assessed in the emergency department. Specifically, Maddow and colleagues explored assessment-oriented oral case presentations to increase efficiency in communication between residents and faculty at the University of Chicago [ 10 ]. In the assessment-oriented format, instead of being presented in a stylized order, pertinent information was integrated into the analysis. The authors found that assessment-oriented oral case presentations were about 40% faster than traditional presentations without significant differences in case presentation effectiveness.

Prior to our study, the nature of the format for inpatient medicine oral case presentations had thus far escaped scrutiny. This is despite the fact that oral case presentations are time (and therefore resource) intensive, and that they play an integral role in patient care and learner education. Our study demonstrates that learners favor the EAP format, which has the potential to increase both the effectiveness and efficiency of rounding.

Still, it should be noted that a transition to EAP does present challenges. Implementing this problem-based presentation format requires a conscious effort to ensure a continued holistic approach to patient care: active problems should be defined and addressed in accordance with patient preferences, and the patient’s subjective experience should be meaningfully incorporated into the assessment and plan for each problem. During initial implementation, attending physicians and learners must internalize this new format, often through trial and error.

From there, on an ongoing basis, EAP may require more upfront preparation by attending physicians as compared to SOAP. While chart review by attendings in advance of rounding is useful regardless of the format utilized, this practice is especially important for the EAP format, where trainees are empowered to interpret and distill – rather than simply report a complete set of – information. Therefore, the attending physician must be aware of pertinent data prior to rounds to ensure that key information is not neglected. Specifically, attendings should pre-orient themselves with laboratory values, imaging, and other studies completed, and new suggestions from consultants. More extensive pre-work may be required if teams wish to employ the EAP format for newly admitted patients, as attending physicians must also familiarize themselves with a patient’s medical history and their current presentation prior to initial team rounds.

Our findings should be interpreted within the context of specific limitations. First, low response rates may have led to selection bias within our surveyed population. For instance, learners who desired change in the oral case presentation format may have been more motivated to engage with our survey. Second, there could be unmeasured confounding variables that could have skewed our results in favor of the EAP format. For example, attendings who utilized the EAP format may have been more likely to innovate in other ways to create a more positive experience for learners, which may have influenced the scoring of the oral case presentation format. Third, our findings were largely based on subjective experience. Objective measurement (e.g., duration of rounds, patient care outcomes) may lend additional credibility to our findings. Lastly, our study included only a single site, limiting our ability to generalize our findings.

Our study also had several strengths. Our learner participant pool was broad and included all third- and fourth-year medical students and all internal medicine residents at a major academic hospital. Participation was encouraged regardless of the nature of a participant’s prior exposure to different oral case presentation formats. Our survey was anonymous with randomization to mitigate order bias, and we focused our comparison analysis on those who had exposure to both the EAP and SOAP formats. We collected data to compare EAP with SOAP in 2 distinct ways: head-to-head preference and numeric ratings amongst key domains. Both of these methods demonstrated a significant preference for EAP among learners in aggregate, as well as for students and residents analyzed independently.

Our findings suggest a preference for the EAP format over SOAP, and that EAP may facilitate clearer and more efficient communication on rounds. These improvements may in turn enhance patient care and learner education. While our preliminary data are compelling, a broader, multi-center study of the EAP oral case presentation is necessary to better understand preferences, outcomes, and barriers to implementation. Further studies should seek to improve response rates, for the data to represent a larger proportion of trainees. One potential strategy to improve response rates among medical students and residents is to survey them directly at the end of each internal medicine clerkship period or rotation, respectively. Ultimately, EAP may prove to be a much-needed update to the “currency with which clinicians communicate.”

Acknowledgements

The authors would like to thank Jason M. Engle, MPH, who helped edit, prepare, format, and submit this manuscript and supporting files.

Authors’ contributions

Conceptualization: BA SS AG. Data curation: BA DR AG. Formal Analysis: BA SS DR AG. Funding acquisition: SS AG. Investigation: BA SS AG. Methodology: BA SS AG. Project administration: BA SS AG. Resources: SS AG. Software: DR. Supervision: SS AG. Validation: BA SS DR AG. Visualization: BA SS DR AG. Writing – original draft: BA AG. Writing – review & editing: BA SS DR AG. The author(s) read and approved the final manuscript.

Availability of data and materials

Declarations.

All methods were carried out in accordance with relevant guidelines and regulations. The need for ethical approval was waived by the ethics committee/Institutional Review Board of the University of Michigan Medical School. The need for informed consent was waived by the ethics committee/Institutional Review Board of the University of Michigan Medical School.

Not applicable.

Dr. Saint, Mr. Ratz, and Dr. Gupta are employed by the US Department of Veterans Affairs. Dr. Saint reports receiving grants from the Department of Veterans Affairs and personal fees from ISMIE Mutual Insurance Company, Jvion, and Doximity. Dr. Appold, Mr. Ratz, and Dr. Gupta report no conflict of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Main navigation

• Undergraduate Students
• Research and Graduate Students
• Continuing Education
• Alumni and Giving

Faculty Showcases Excellence at JDIQ 2024

• Add to calendar
• Tweet Widget

The Faculty of Dental Medicine and Oral Health Sciences participated in the 2024 Journées dentaires internationales du Québec (JDIQ) from May 24 to 28. The Faculty's booth, represented by the Continuing Dental Education and Student Affairs teams and graduate students, aimed to present our various programs to the dental community.

Among the Faculty members who led classes and workshops were Dr. Samer Abi-Nader, Dr. Julia Cohen-Lévy, Dr. Thomas T. Nguyen, Dr. Taras Konanec, Dr. Véronique Benhamou, and Dr. Sandra Verdon.

Where research is, McGill is: among the nine poster presentations, seven were from our students, highlighting our ongoing research projects, including:

Chetan Shirvankar Development of User-Centered Humanoid Robots for Elderly Primary Care: A Study Protocol Supervisors: Dr Samira Rahimi, Dr Elham Emami

Aia Naksho The effect of radiation therapy on temporomandibular joint and its function.

Tisha Prakash Musculoskeletal Disorders among Dental Workers in Quebec (2005-2019). Supervisors: Dr. Elham Emami, Dr. Sabrina Gravel

Muhammad Talal Khan Exploring Corporate Dentistry- A Scoping Review Supervisors: Dr. Firoozeh Samim, Dr. Elham Emami

Grusha Akade Patients' and Caregivers' Experiences with Home-based Oral Healthcare Services in Quebec: A Qualitative Study. Supervisors: Dr. Pascaline Kengne Talla, Dr. Elham Emami

Mai Atique Genetic Mutations Associated with Inflammatory Response Caused by HPV Integration in Oropharyngeal Squamous Cell Carcinoma. Supervisors: Dr. Belinda Nicolau, Dr. Sabrina Wurbza

The JDIQ 2024 convention provided an opportunity for the Faculty to engage with the dental community, present its programs, and share ongoing research initiatives.

Department and University Information

Dean's office.

• Undergraduate Teaching Clinic

Strathcona Anatomy and Dentistry

• DMD Program
• Advanced Standings
• MSc Non-Thesis
• OMFS Programs
• Pain and Neuroscience
• Mineralized Tissues and Extracellular Matrix Biology
• Biomaterials, Nanobiotechnology and Tissue Engineering
• Population Oral Health
• Student and Staff Clinic
• Community Clinics
• Affiliated Clinics
• Alan Edward Centre for Research on Pain
• Centre for Bone and Periodontal Research
• McGill Institute for Advanced Materials
• Facility for Electron Microscopy Research