Overview and General Information about Oral Presentation

  • Daily Presentations During Work Rounds
  • The New Patient Presentation
  • The Holdover Admission Presentation
  • Outpatient Clinic Presentations
  • The structure of presentations varies from service to service (e.g. medicine vs. surgery), amongst subspecialties, and between environments (inpatient vs. outpatient). Applying the correct style to the right setting requires that the presenter seek guidance from the listeners at the outset.
  • Time available for presenting is rather short, which makes the experience more stressful.
  • Individual supervisors (residents, faculty) often have their own (sometimes quirky) preferences regarding presentation styles, adding another layer of variability that the presenter has to manage.
  • Students are evaluated/judged on the way in which they present, with faculty using this as one way of gauging a student’s clinical knowledge.
  • Done well, presentations promote efficient, excellent care. Done poorly, they promote tedium, low morale, and inefficiency.

General Tips:

  • Practice, Practice, Practice! Do this on your own, with colleagues, and/or with anyone who will listen (and offer helpful commentary) before you actually present in front of other clinicians. Speaking "on-the-fly" is difficult, as rapidly organizing and delivering information in a clear and concise fashion is not a naturally occurring skill.
  • Immediately following your presentations, seek feedback from your listeners. Ask for specifics about what was done well and what could have been done better – always with an eye towards gaining information that you can apply to improve your performance the next time.
  • Listen to presentations that are done well – ask yourself, “Why was it good?” Then try to incorporate those elements into your own presentations.
  • Listen to presentations that go poorly – identify the specific things that made it ineffective and avoid those pitfalls when you present.
  • Effective presentations require that you have thought through the case beforehand and understand the rationale for your conclusions and plan. This, in turn, requires that you have a good grasp of physiology, pathology, clinical reasoning and decision-making - pushing you to read, pay attention, and in general acquire more knowledge.
  • Think about the clinical situation in which you are presenting so that you can provide a summary that is consistent with the expectations of your audience. Work rounds, for example, are clearly different from conferences and therefore mandate a different style of presentation.
  • Presentations are the way in which we tell medical stories to one another. When you present, ask yourself if you’ve described the story in an accurate way. Will the listener be able to “see” the patient the same way that you do? Can they come to the correct conclusions? If not, re-calibrate.
  • It's O.K. to use notes, though the oral presentation should not simply be reduced to reading the admission note – rather, it requires appropriate editing/shortening.
  • In general, try to give your presentations on a particular service using the same order and style for each patient, every day. Following a specific format makes it easier for the listener to follow, as they know what’s coming and when they can expect to hear particular information. Additionally, following a standardized approach makes it easier for you to stay organized, develop a rhythm, and lessens the chance that you’ll omit elements.

Specific types of presentations

There are a number of common presentation-types, each with its own goals and formats. These include:

  • Daily presentations during work rounds for patients known to a service.
  • Newly admitted patients, where you were the clinician that performed the H&P.
  • Newly admitted patients that were “handed off” to the team in the morning, such that the H&P was performed by others.
  • Outpatient clinic presentations, covering several common situations.

Key elements of each presentation type are described below. Examples of how these would be applied to most situations are provided in italics. The formats are typical of presentations done for internal medicine services and clinics.

Note that there is an acceptable range of how oral presentations can be delivered. Ultimately, your goal is to tell the correct story, in a reasonable amount of time, so that the right care can be delivered. Nuances in the order of presentation, what to include, what to omit, etc. are relatively small points. Don’t let the pursuit of these elements distract you or create undue anxiety.

Daily presentations during work rounds of patients that you’re following:

  • Organize the presenter (forces you to think things through)
  • Inform the listener(s) of 24 hour events and plan moving forward
  • Promote focused discussion amongst your listeners and supervisors
  • Opportunity to reassess plan, adjust as indicated
  • Demonstrate your knowledge and engagement in the care of the patient
  • Rapid (5 min) presentation of the key facts

Key features of presentation:

  • Opening one liner: Describe who the patient is, number of days in hospital, and their main clinical issue(s).
  • 24-hour events: Highlighting changes in clinical status, procedures, consults, etc.
  • Subjective sense from the patient about how they’re feeling, vital signs (ranges), and key physical exam findings (highlighting changes)
  • Relevant labs (highlighting changes) and imaging
  • Assessment and Plan : Presented by problem or organ systems(s), using as many or few as are relevant. Early on, it’s helpful to go through the main categories in your head as a way of making sure that you’re not missing any relevant areas. The broad organ system categories include (presented here head-to-toe): Neurological; Psychiatric; Cardiovascular; Pulmonary; Gastrointestinal; Renal/Genitourinary; Hematologic/Oncologic; Endocrine/Metabolic; Infectious; Tubes/lines/drains; Disposition.

Example of a daily presentation for a patient known to a team:

  • Opening one liner: This is Mr. Smith, a 65 year old man, Hospital Day #3, being treated for right leg cellulitis
  • MRI of the leg, negative for osteomyelitis
  • Evaluation by Orthopedics, who I&D’d a superficial abscess in the calf, draining a moderate amount of pus
  • Patient appears well, states leg is feeling better, less painful
  • T Max 101 yesterday, T Current 98; Pulse range 60-80; BP 140s-160s/70-80s; O2 sat 98% Room Air
  • Ins/Outs: 3L in (2 L NS, 1 L po)/Out 4L urine
  • Right lower extremity redness now limited to calf, well within inked lines – improved compared with yesterday; bandage removed from the I&D site, and base had small amount of purulence; No evidence of fluctuance or undrained infection.
  • Creatinine .8, down from 1.5 yesterday
  • WBC 8.7, down from 14
  • Blood cultures from admission still negative
  • Gram stain of pus from yesterday’s I&D: + PMNS and GPCs; Culture pending
  • MRI lower extremity as noted above – negative for osteomyelitis
  • Continue Vancomycin for today
  • Ortho to reassess I&D site, though looks good
  • Follow-up on cultures: if MRSA, will transition to PO Doxycycline; if MSSA, will use PO Dicloxacillin
  • Given AKI, will continue to hold ace-inhibitor; will likely wait until outpatient follow-up to restart
  • Add back amlodipine 5mg/d today
  • Hep lock IV as no need for more IVF
  • Continue to hold ace-I as above
  • Wound care teaching with RNs today – wife capable and willing to assist. She’ll be in this afternoon.
  • Set up follow-up with PMD to reassess wound and cellulitis within 1 week

The Brand New Patient (admitted by you)

  • Provide enough information so that the listeners can understand the presentation and generate an appropriate differential diagnosis.
  • Present a thoughtful assessment
  • Present diagnostic and therapeutic plans
  • Provide opportunities for senior listeners to intervene and offer input
  • Chief concern: Reason why patient presented to hospital (symptom/event and key past history in one sentence). It often includes a limited listing of their other medical conditions (e.g. diabetes, hypertension, etc.) if these elements might contribute to the reason for admission.
  • The history is presented highlighting the relevant events in chronological order.
  • 7 days ago, the patient began to notice vague shortness of breath.
  • 5 days ago, the breathlessness worsened and they developed a cough productive of green sputum.
  • 3 days ago his short of breath worsened to the point where he was winded after walking up a flight of stairs, accompanied by a vague right sided chest pain that was more pronounced with inspiration.
  • Enough historical information has to be provided so that the listener can understand the reasons that lead to admission and be able to draw appropriate clinical conclusions.
  • Past history that helps to shed light on the current presentation are included towards the end of the HPI and not presented later as “PMH.” This is because knowing this “past” history is actually critical to understanding the current complaint. For example, past cardiac catheterization findings and/or interventions should be presented during the HPI for a patient presenting with chest pain.
  • Where relevant, the patient's baseline functional status is described, allowing the listener to understand the degree of impairment caused by the acute medical problem(s).
  • It should be explicitly stated if a patient is a poor historian, confused or simply unaware of all the details related to their illness. Historical information obtained from family, friends, etc. should be described as such.
  • Review of Systems (ROS): Pertinent positive and negative findings discovered during a review of systems are generally incorporated at the end of the HPI. The listener needs this information to help them put the story in appropriate perspective. Any positive responses to a more inclusive ROS that covers all of the other various organ systems are then noted. If the ROS is completely negative, it is generally acceptable to simply state, "ROS negative.”
  • Other Past Medical and Surgical History (PMH/PSH): Past history that relates to the issues that lead to admission are typically mentioned in the HPI and do not have to be repeated here. That said, selective redundancy (i.e. if it’s really important) is OK. Other PMH/PSH are presented here if relevant to the current issues and/or likely to affect the patient’s hospitalization in some way. Unrelated PMH and PSH can be omitted (e.g. if the patient had their gall bladder removed 10y ago and this has no bearing on the admission, then it would be appropriate to leave it out). If the listener really wants to know peripheral details, they can read the admission note, ask the patient themselves, or inquire at the end of the presentation.
  • Medications and Allergies: Typically all meds are described, as there’s high potential for adverse reactions or drug-drug interactions.
  • Family History: Emphasis is placed on the identification of illnesses within the family (particularly among first degree relatives) that are known to be genetically based and therefore potentially heritable by the patient. This would include: coronary artery disease, diabetes, certain cancers and autoimmune disorders, etc. If the family history is non-contributory, it’s fine to say so.
  • Social History, Habits, other → as relates to/informs the presentation or hospitalization. Includes education, work, exposures, hobbies, smoking, alcohol or other substance use/abuse.
  • Sexual history if it relates to the active problems.
  • Vital signs and relevant findings (or their absence) are provided. As your team develops trust in your ability to identify and report on key problems, it may become acceptable to say “Vital signs stable.”
  • Note: Some listeners expect students (and other junior clinicians) to describe what they find in every organ system and will not allow the presenter to say “normal.” The only way to know what to include or omit is to ask beforehand.
  • Key labs and imaging: Abnormal findings are highlighted as well as changes from baseline.
  • Summary, assessment & plan(s) Presented by problem or organ systems(s), using as many or few as are relevant. Early on, it’s helpful to go through the main categories in your head as a way of making sure that you’re not missing any relevant areas. The broad organ system categories include (presented here head-to-toe): Neurological; Psychiatric; Cardiovascular; Pulmonary; Gastrointestinal; Renal/Genitourinary; Hematologic/Oncologic; Endocrine/Metabolic; Infectious; Tubes/lines/drains; Disposition.
  • The assessment and plan typically concludes by mentioning appropriate prophylactic considerations (e.g. DVT prevention), code status and disposition.
  • Chief Concern: Mr. H is a 50 year old male with AIDS, on HAART, with preserved CD4 count and undetectable viral load, who presents for the evaluation of fever, chills and a cough over the past 7 days.
  • Until 1 week ago, he had been quite active, walking up to 2 miles a day without feeling short of breath.
  • Approximately 1 week ago, he began to feel dyspneic with moderate activity.
  • 3 days ago, he began to develop subjective fevers and chills along with a cough productive of red-green sputum.
  • 1 day ago, he was breathless after walking up a single flight of stairs and spent most of the last 24 hours in bed.
  • Diagnosed with HIV in 2000, done as a screening test when found to have gonococcal urethritis
  • Was not treated with HAART at that time due to concomitant alcohol abuse and non-adherence.
  • Diagnosed and treated for PJP pneumonia 2006
  • Diagnosed and treated for CMV retinitis 2007
  • Became sober in 2008, at which time interested in HAART. Started on Atripla, a combination pill containing: Efavirenz, Tonofovir, and Emtricitabine. He’s taken it ever since, with no adverse effects or issues with adherence. Receives care thru Dr. Smiley at the University HIV clinic.
  • CD4 count 3 months ago was 400 and viral load was undetectable.
  • He is homosexual though he is currently not sexually active. He has never used intravenous drugs.
  • He has no history of asthma, COPD or chronic cardiac or pulmonary condition. No known liver disease. Hepatitis B and C negative. His current problem seems different to him then his past episode of PJP.
  • Review of systems: negative for headache, photophobia, stiff neck, focal weakness, chest pain, abdominal pain, diarrhea, nausea, vomiting, urinary symptoms, leg swelling, or other complaints.
  • Hypertension x 5 years, no other known vascular disease
  • Gonorrhea as above
  • Alcohol abuse above and now sober – no known liver disease
  • No relevant surgeries
  • Atripla, 1 po qd
  • Omeprazole 20 mg, 1 PO, qd
  • Lisinopril 20mg, qd
  • Naprosyn 250 mg, 1-2, PO, BID PRN
  • No allergies
  • Both of the patient's parents are alive and well (his mother is 78 and father 80). He has 2 brothers, one 45 and the other 55, who are also healthy. There is no family history of heart disease or cancer.
  • Patient works as an accountant for a large firm in San Diego. He lives alone in an apartment in the city.
  • Smokes 1 pack of cigarettes per day and has done so for 20 years.
  • No current alcohol use. Denies any drug use.
  • Sexual History as noted above; has sex exclusively with men, last partner 6 months ago.
  • Seated on a gurney in the ER, breathing through a face-mask oxygen delivery system. Breathing was labored and accessory muscles were in use. Able to speak in brief sentences, limited by shortness of breath
  • Vital signs: Temp 102 F, Pulse 90, BP 150/90, Respiratory Rate 26, O2 Sat (on 40% Face Mask) 95%
  • HEENT: No thrush, No adenopathy
  • Lungs: Crackles and Bronchial breath sounds noted at right base. E to A changes present. No wheezing or other abnormal sounds noted over any other area of the lung. Dullness to percussion was also appreciated at the right base.
  • Cardiac: JVP less than 5 cm; Rhythm was regular. Normal S1 and S2. No murmurs or extra heart sounds noted.
  • Abdomen and Genital exams: normal
  • Extremities: No clubbing, cyanosis or edema; distal pulses 2+ and equal bilaterally.
  • Skin: no eruptions noted.
  • Neurological exam: normal
  • WBC 18 thousand with 10% bands;
  • Normal Chem 7 and LFTs.
  • Room air blood gas: pH of 7.47/ PO2 of 55/PCO2 of 30.
  • Sputum gram stain remarkable for an abundance of polys along with gram positive diplococci.
  • CXR remarkable for dense right lower lobe infiltrate without effusion.
  • Monitored care unit, with vigilance for clinical deterioration.
  • Hypertension: given significant pneumonia and unclear clinical direction, will hold lisinopril. If BP > 180 and or if clear not developing sepsis, will consider restarting.
  • Low molecular weight heparin
  • Code Status: Wishes to be full code full care, including intubation and ICU stay if necessary. Has good quality of life and hopes to return to that functional level. Wishes to reconsider if situation ever becomes hopeless. Older brother Tom is surrogate decision maker if the patient can’t speak for himself. Tom lives in San Diego and we have his contact info. He is aware that patient is in the hospital and plans on visiting later today or tomorrow.
  • Expected duration of hospitalization unclear – will know more based on response to treatment over next 24 hours.

The holdover admission (presenting data that was generated by other physicians)

  • Handoff admissions are very common and present unique challenges
  • Understand the reasons why the patient was admitted
  • Review key history, exam, imaging and labs to assure that they support the working diagnostic and therapeutic plans
  • Does the data support the working diagnosis?
  • Do the planned tests and consults make sense?
  • What else should be considered (both diagnostically and therapeutically)?
  • This process requires that the accepting team thoughtfully review their colleagues efforts with a critical eye – which is not disrespectful but rather constitutes one of the main jobs of the accepting team and is a cornerstone of good care *Note: At some point during the day (likely not during rounds), the team will need to verify all of the data directly with the patient.
  • 8-10 minutes
  • Chief concern: Reason for admission (symptom and/or event)
  • Temporally presented bullets of events leading up to the admission
  • Review of systems
  • Relevant PMH/PSH – historical information that might affect the patient during their hospitalization.
  • Meds and Allergies
  • Family and Social History – focusing on information that helps to inform the current presentation.
  • Habits and exposures
  • Physical exam, imaging and labs that were obtained in the Emergency Department
  • Assessment and plan that were generated in the Emergency Department.
  • Overnight events (i.e. what happened in the Emergency Dept. and after the patient went to their hospital room)? Responses to treatments, changes in symptoms?
  • How does the patient feel this morning? Key exam findings this morning (if seen)? Morning labs (if available)?
  • Assessment and Plan , with attention as to whether there needs to be any changes in the working differential or treatment plan. The broad organ system categories include (presented here head-to-toe): Neurological; Psychiatric; Cardiovascular; Pulmonary; Gastrointestinal; Renal/Genitourinary; Hematologic/Oncologic; Endocrine/Metabolic; Infectious; Tubes/lines/drains; Disposition.
  • Chief concern: 70 yo male who presented with 10 days of progressive shoulder pain, followed by confusion. He was brought in by his daughter, who felt that her father was no longer able to safely take care for himself.
  • 10 days ago, Mr. X developed left shoulder pain, first noted a few days after lifting heavy boxes. He denies falls or direct injury to the shoulder.
  • 1 week ago, presented to outside hospital ER for evaluation of left shoulder pain. Records from there were notable for his being afebrile with stable vitals. Exam notable for focal pain anteriorly on palpation, but no obvious deformity. Right shoulder had normal range of motion. Left shoulder reported as diminished range of motion but not otherwise quantified. X-ray negative. Labs remarkable for wbc 8, creat 2.2 (stable). Impression was that the pain was of musculoskeletal origin. Patient was provided with Percocet and told to see PMD in f/u
  • Brought to our ER last night by his daughter. Pain in shoulder worse. Also noted to be confused and unable to care for self. Lives alone in the country, home in disarray, no food.
  • ROS: negative for falls, prior joint or musculoskeletal problems, fevers, chills, cough, sob, chest pain, head ache, abdominal pain, urinary or bowel symptoms, substance abuse
  • Hypertension
  • Coronary artery disease, s/p LAD stent for angina 3 y ago, no symptoms since. Normal EF by echo 2 y ago
  • Chronic kidney disease stage 3 with creatinine 1.8; felt to be secondary to atherosclerosis and hypertension
  • aspirin 81mg qd, atorvastatin 80mg po qd, amlodipine 10 po qd, Prozac 20
  • Allergies: none
  • Family and Social: lives alone in a rural area of the county, in contact with children every month or so. Retired several years ago from work as truck driver. Otherwise non-contributory.
  • Habits: denies alcohol or other drug use.
  • Temp 98 Pulse 110 BP 100/70
  • Drowsy though arousable; oriented to year but not day or date; knows he’s at a hospital for evaluation of shoulder pain, but doesn’t know the name of the hospital or city
  • CV: regular rate and rhythm; normal s1 and s2; no murmurs or extra heart sounds.
  • Left shoulder with generalized swelling, warmth and darker coloration compared with Right; generalized pain on palpation, very limited passive or active range of motion in all directions due to pain. Right shoulder appearance and exam normal.
  • CXR: normal
  • EKG: sr 100; nl intervals, no acute changes
  • WBC 13; hemoglobin 14
  • Na 134, k 4.6; creat 2.8 (1.8 baseline 4 m ago); bicarb 24
  • LFTs and UA normal
  • Vancomycin and Zosyn for now
  • Orthopedics to see asap to aspirate shoulder for definitive diagnosis
  • If aspiration is consistent with infection, will need to go to Operating Room for wash out.
  • Urine electrolytes
  • Follow-up on creatinine and obtain renal ultrasound if not improved
  • Renal dosing of meds
  • Strict Ins and Outs.
  • follow exam
  • obtain additional input from family to assure baseline is, in fact, normal
  • Since admission (6 hours) no change in shoulder pain
  • This morning, pleasant, easily distracted; knows he’s in the hospital, but not date or year
  • T Current 101F Pulse 100 BP 140/80
  • Ins and Outs: IVF Normal Saline 3L/Urine output 1.5 liters
  • L shoulder with obvious swelling and warmth compared with right; no skin breaks; pain limits any active or passive range of motion to less than 10 degrees in all directions
  • Labs this morning remarkable for WBC 10 (from 13), creatinine 2 (down from 2.8)
  • Continue with Vancomycin and Zosyn for now
  • I already paged Orthopedics this morning, who are en route for aspiration of shoulder, fluid for gram stain, cell count, culture
  • If aspirate consistent with infection, then likely to the OR
  • Continue IVF at 125/h, follow I/O
  • Repeat creatinine later today
  • Not on any nephrotoxins, meds renaly dosed
  • Continue antibiotics, evaluation for primary source as above
  • Discuss with family this morning to establish baseline; possible may have underlying dementia as well
  • SC Heparin for DVT prophylaxis
  • Code status: full code/full care.

Outpatient-based presentations

There are 4 main types of visits that commonly occur in an outpatient continuity clinic environment, each of which has its own presentation style and purpose. These include the following, each described in detail below.

  • The patient who is presenting for their first visit to a primary care clinic and is entirely new to the physician.
  • The patient who is returning to primary care for a scheduled follow-up visit.
  • The patient who is presenting with an acute problem to a primary care clinic
  • The specialty clinic evaluation (new or follow-up)

It’s worth noting that Primary care clinics (Internal Medicine, Family Medicine and Pediatrics) typically take responsibility for covering all of the patient’s issues, though the amount of energy focused on any one topic will depend on the time available, acuity, symptoms, and whether that issue is also followed by a specialty clinic.

The Brand New Primary Care Patient

Purpose of the presentation

  • Accurately review all of the patient’s history as well as any new concerns that they might have.
  • Identify health related problems that need additional evaluation and/or treatment
  • Provide an opportunity for senior listeners to intervene and offer input

Key features of the presentation

  • If this is truly their first visit, then one of the main reasons is typically to "establish care" with a new doctor.
  • It might well include continuation of therapies and/or evaluations started elsewhere.
  • If the patient has other specific goals (medications, referrals, etc.), then this should be stated as well. Note: There may well not be a "chief complaint."
  • For a new patient, this is an opportunity to highlight the main issues that might be troubling/bothering them.
  • This can include chronic disorders (e.g. diabetes, congestive heart failure, etc.) which cause ongoing symptoms (shortness of breath) and/or generate daily data (finger stick glucoses) that should be discussed.
  • Sometimes, there are no specific areas that the patient wishes to discuss up-front.
  • Review of systems (ROS): This is typically comprehensive, covering all organ systems. If the patient is known to have certain illnesses (e.g. diabetes), then the ROS should include the search for disorders with high prevalence (e.g. vascular disease). There should also be some consideration for including questions that are epidemiologically appropriate (e.g. based on age and sex).
  • Past Medical History (PMH): All known medical conditions (in particular those requiring ongoing treatment) are listed, noting their duration and time of onset. If a condition is followed by a specialist or co-managed with other clinicians, this should be noted as well. If a problem was described in detail during the “acute” history, it doesn’t have to be re-stated here.
  • Past Surgical History (PSH): All surgeries, along with the year when they were performed
  • Medications and allergies: All meds, including dosage, frequency and over-the-counter preparations. Allergies (and the type of reaction) should be described.
  • Social: Work, hobbies, exposures.
  • Sexual activity – may include type of activity, number and sex of partner(s), partner’s health.
  • Smoking, Alcohol, other drug use: including quantification of consumption, duration of use.
  • Family history: Focus on heritable illness amongst first degree relatives. May also include whether patient married, in a relationship, children (and their ages).
  • Physical Exam: Vital signs and relevant findings (or their absence).
  • Key labs and imaging if they’re available. Also when and where they were obtained.
  • Summary, assessment & plan(s) presented by organ system and/or problems. As many systems/problems as is necessary to cover all of the active issues that are relevant to that clinic. This typically concludes with a “health care maintenance” section, which covers age, sex and risk factor appropriate vaccinations and screening tests.

The Follow-up Visit to a Primary Care Clinic

  • Organize the presenter (forces you to think things through).
  • Accurately review any relevant interval health care events that might have occurred since the last visit.
  • Identification of new symptoms or health related issues that might need additional evaluation and/or treatment
  • If the patient has no concerns, then verification that health status is stable
  • Review of medications
  • Provide an opportunity for listeners to intervene and offer input
  • Reason for the visit: Follow-up for whatever the patient’s main issues are, as well as stating when the last visit occurred *Note: There may well not be a “chief complaint,” as patients followed in continuity at any clinic may simply be returning for a visit as directed by their doctor.
  • Events since the last visit: This might include emergency room visits, input from other clinicians/specialists, changes in medications, new symptoms, etc.
  • Review of Systems (ROS): Depth depends on patient’s risk factors and known illnesses. If the patient has diabetes, then a vascular ROS would be done. On the other hand, if the patient is young and healthy, the ROS could be rather cursory.
  • PMH, PSH, Social, Family, Habits are all OMITTED. This is because these facts are already known to the listener and actionable aspects have presumably been added to the problem list (presented at the end). That said, these elements can be restated if the patient has a new symptom or issue related to a historical problem has emerged.
  • MEDS : A good idea to review these at every visit.
  • Physical exam: Vital signs and pertinent findings (or absence there of) are mentioned.
  • Lab and Imaging: The reason why these were done should be mentioned and any key findings mentioned, highlighting changes from baseline.
  • Assessment and Plan: This is most clearly done by individually stating all of the conditions/problems that are being addressed (e.g. hypertension, hypothyroidism, depression, etc.) followed by their specific plan(s). If a new or acute issue was identified during the visit, the diagnostic and therapeutic plan for that concern should be described.

The Focused Visit to a Primary Care Clinic

  • Accurately review the historical events that lead the patient to make the appointment.
  • Identification of risk factors and/or other underlying medical conditions that might affect the diagnostic or therapeutic approach to the new symptom or concern.
  • Generate an appropriate assessment and plan
  • Allow the listener to comment

Key features of the presentation:

  • Reason for the visit
  • History of Present illness: Description of the sequence of symptoms and/or events that lead to the patient’s current condition.
  • Review of Systems: To an appropriate depth that will allow the listener to grasp the full range of diagnostic possibilities that relate to the presenting problem.
  • PMH and PSH: Stating only those elements that might relate to the presenting symptoms/issues.
  • PE: Vital signs and key findings (or lack thereof)
  • Labs and imaging (if done)
  • Assessment and Plan: This is usually very focused and relates directly to the main presenting symptom(s) or issues.

The Specialty Clinic Visit

Specialty clinic visits focus on the health care domains covered by those physicians. For example, Cardiology clinics are interested in cardiovascular disease related symptoms, events, labs, imaging and procedures. Orthopedics clinics will focus on musculoskeletal symptoms, events, imaging and procedures. Information that is unrelated to these disciples will typically be omitted. It’s always a good idea to ask the supervising physician for guidance as to what’s expected to be covered in a particular clinic environment.

  • Highlight the reason(s) for the visit
  • Review key data
  • Provide an opportunity for the listener(s) to comment
  • 5-7 minutes
  • If it’s a consult, state the main reason(s) that the patient was referred as well as who referred them.
  • If it’s a return visit, state the reasons why the patient is being followed in the clinic and when the last visit took place
  • If it’s for an acute issue, state up front what the issue is Note: There may well not be a “chief complaint,” as patients followed in continuity in any clinic may simply be returning for a return visit as directed
  • For a new patient, this highlights the main things that might be troubling/bothering the patient.
  • For a specialty clinic, the history presented typically relates to the symptoms and/or events that are pertinent to that area of care.
  • Review of systems , focusing on those elements relevant to that clinic. For a cardiology patient, this will highlight a vascular ROS.
  • PMH/PSH that helps to inform the current presentation (e.g. past cardiac catheterization findings/interventions for a patient with chest pain) and/or is otherwise felt to be relevant to that clinic environment.
  • Meds and allergies: Typically all meds are described, as there is always the potential for adverse drug interactions.
  • Social/Habits/other: as relates to/informs the presentation and/or is relevant to that clinic
  • Family history: Focus is on heritable illness amongst first degree relatives
  • Physical Exam: VS and relevant findings (or their absence)
  • Key labs, imaging: For a cardiology clinic patient, this would include echos, catheterizations, coronary interventions, etc.
  • Summary, assessment & plan(s) by organ system and/or problems. As many systems/problems as is necessary to cover all of the active issues that are relevant to that clinic.
  • Reason for visit: Patient is a 67 year old male presenting for first office visit after admission for STEMI. He was referred by Dr. Goins, his PMD.
  • The patient initially presented to the ER 4 weeks ago with acute CP that started 1 hour prior to his coming in. He was found to be in the midst of a STEMI with ST elevations across the precordial leads.
  • Taken urgently to cath, where 95% proximal LAD lesion was stented
  • EF preserved by Echo; Peak troponin 10
  • In-hospital labs were remarkable for normal cbc, chem; LDL 170, hdl 42, nl lfts
  • Uncomplicated hospital course, sent home after 3 days.
  • Since home, he states that he feels great.
  • Denies chest pain, sob, doe, pnd, edema, or other symptoms.
  • No symptoms of stroke or TIA.
  • No history of leg or calf pain with ambulation.
  • Prior to this admission, he had a history of hypertension which was treated with lisinopril
  • 40 pk yr smoking history, quit during hospitalization
  • No known prior CAD or vascular disease elsewhere. No known diabetes, no family history of vascular disease; He thinks his cholesterol was always “a little high” but doesn’t know the numbers and was never treated with meds.
  • History of depression, well treated with prozac
  • Discharge meds included: aspirin, metoprolol 50 bid, lisinopril 10, atorvastatin 80, Plavix; in addition he takes Prozac for depression
  • Taking all of them as directed.
  • Patient lives with his wife; they have 2 grown children who are no longer at home
  • Works as a computer programmer
  • Smoking as above
  • ETOH: 1 glass of wine w/dinner
  • No drug use
  • No known history of cardiovascular disease among 2 siblings or parents.
  • Well appearing; BP 130/80, Pulse 80 regular, 97% sat on Room Air, weight 175lbs, BMI 32
  • Lungs: clear to auscultation
  • CV: s1 s2 no s3 s4 murmur
  • No carotid bruits
  • ABD: no masses
  • Ext; no edema; distal pulses 2+
  • Cath from 4 weeks ago: R dominant; 95% proximal LAD; 40% Cx.
  • EF by TTE 1 day post PCI with mild Anterior Hypokinesis, EF 55%, no valvular disease, moderate LVH
  • Labs of note from the hospital following cath: hgb 14, plt 240; creat 1, k 4.2, lfts normal, glucose 100, LDL 170, HDL 42.
  • EKG today: SR at 78; nl intervals; nl axis; normal r wave progression, no q waves
  • Plan: aspirin 81 indefinitely, Plavix x 1y
  • Given nitroglycerine sublingual to have at home.
  • Reviewed symptoms that would indicate another MI and what to do if occurred
  • Plan: continue with current dosages of meds
  • Chem 7 today to check k, creatinine
  • Plan: Continue atorvastatin 80mg for life
  • Smoking cessation: Doing well since discharge without adjuvant treatments, aware of supports.
  • Plan: AAA screening ultrasound

Presentation Skills Toolkit for Medical Students

New section.

The ability to design and deliver an effective presentation is an important skill for all learners to develop. The Undergraduate Medical Education Section of the Group on Educational Affairs developed this toolkit as a resource for medical students and health professions trainees as you learn to create and give effective presentations in the classroom, in the clinical setting, and at academic meetings and conferences. In this toolkit, you’ll find helpful resources on developing and delivering formal lectures and presentations, poster and oral abstract presentations, patient presentations, and leading small group sessions.

Please note: Availability of resources may change over time. To suggest edits or updates, email  [email protected] .

On this page:

Formal lectures and presentations, posters and abstracts, patient presentations.

  • Leading Small Groups

Traditional academic presentations in medicine and the biomedical sciences are necessarily dense with complex content. Thus, slides tend to be wordy, and presenters may use their slides as cue cards for themselves rather than as tools to facilitate learning for their audience. With the necessary resources, medical students (and presenters at all levels) can better identify appropriate learning objectives and develop presentations that help learners meet those objectives. Organization of content, clarity of slide design, and professional delivery are all essential components to designing and giving effective formal presentations.

Achieving all of these elements can make creating and delivering a formal presentation challenging. The strategies and resources below can help you develop a successful formal presentation.

Infographic with steps for formal lectures and presentations

View long description of infographic .

Strategies for success

  • Define the objectives of the presentation. Always define learning objectives for each of your lectures to make it clear what knowledge or skills the audience should acquire from your presentation. The best learning objectives define specific, measurable, or observable knowledge or skill gains. Furthermore, consider how to communicate the importance of the topic to your audience and how information should be arranged to best communicate your key points.
  • Design an effective slide set. You should begin creating your slides only after defining your objectives and key points. The slides should support your talk but not be your talk. Keep slides simple. The audience should be able to review a slide and grasp key points quickly. Avoid lengthy text and distracting decorative fonts, clip art, graphs, and pictures. If additional wording or images are necessary, consider handouts or alternative methods of sharing this information. Lastly, design your slide deck to emphasize the key points, revisiting your outline as necessary, and summarize concepts at regular intervals throughout your presentation to strengthen knowledge gains.  
  • Practice your performance. Effective public speaking starts with preparation and practice. Ensure there is enough time to create your lecture and a supporting slide deck. Know your lecture material and slides without prompts! Understand the audience and learning climate (the size and knowledge level of your audience) and be prepared for the venue (virtual, in-person, or both, lecture hall or classroom). Think about what effective audience engagement may look like and how to incorporate audience response systems, polling, etc., into the lecture.
  • Create a positive learning environment. Anticipate questions and allocate sufficient time to answer them. Always repeat the questions being asked for the audience’s benefit and to ensure your understanding. Some questions may be challenging, so be prepared and answer honestly. It is acceptable not to know an answer.
  • Demonstrate professionalism in presenting. Exhibit professionalism by being punctual and having appropriate time management. Remember that mistakes happen; be kind to yourself and remain calm and collected. Be enthusiastic: If you can enjoy the experience, so will your audience. Finally, be open to feedback following your presentation. 

Additional resources

Below is a collection of resources that further address the elements of creating and delivering a formal presentation. Each resource addresses a specific presentation skill or set of skills listed above and can be used to develop your understanding further. 

  • Healthy Presentations: How to Craft Exceptional Lectures in Medicine, the Health Professions, and the Biomedical Sciences (requires purchase, book). This illustrated book is a practical guide for improving scientific presentations. It includes specific, practical guidance on crafting a talk, tips on incorporating interactive elements to facilitate active learning, and before-and-after examples of improved slide design. (Skills addressed: 1-3)
  • American College of Physicians: Giving the Podium Presentation (freely available, website). This guide includes recommendations related to presentation delivery, including tips on what to wear, how to prepare, answering questions, and anticipating the unexpected. (Skills addressed: 3-5)
  • The 4 Ps of Giving a Good Presentation (freely available, PDF). This simple guide on public speaking from the University of Hull covers such topics as positive thinking, preparing, practice, and performing. (Skills addressed: 3-5)
  • Zoom Guides (freely available, website). This website from the University of California, San Francisco is one of many great resources created by universities for presenting on a virtual platform, specifically Zoom. (Skills addressed: 3-5)
  • Writing Learning Objectives (freely available, PDF). This excellent resource from the AAMC defines Bloom’s Taxonomy and provides verbiage for creating learning objectives. (Skill addressed: 1)
  • Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83 (freely available, article). This AMEE Guide explains and explores the more commonly used adult learning theories and how they can be used to enhance learning. It presents a model that combines many of the theories into a flow diagram that can be followed by those planning a presentation. (Skill addressed: 1)
  • Assertion-Evidence Approach (freely available, website). This approach to slide design incorporates clear messaging and the strategic combination of text and images. (Skill addressed: 2)
  • Multimedia Learning (requires purchase, book). This book outlines the learning theories that should guide all good slide design. It is an accessible resource that will help presenters of all levels create slide decks that best facilitate learning. (Skill addressed: 2)
  • Collaborative Learning and Integrated Mentoring in the Biosciences (CLIMB) (freely available, website). This website from Northwestern University shares slide design tips for scientific presentations. Specific tips include simplifying messages and annotating images and tables to facilitate learning. (Skill addressed: 2)
  • Clear and to the Point (freely available, online book). This book describes 8 psychological principles for constructing compelling PowerPoint presentations. (Skill addressed: 2)

Return to top ↑

Presenting the results of the research projects, innovations, and other work you have invested in at regional and national meetings is a tremendous opportunity to advance heath care, gain exposure to thought leaders in your field, and put your evidence-based medicine and communication skills into practice in a different arena. Effective scientific presentations at meetings also provide a chance for you to interact with an engaged audience, receive valuable feedback, be exposed to others’ projects, and expand your professional network. Preparation and practice are integral to getting the most out of these experiences.  

The strategies and resources below will help you successfully present both posters and abstracts at scientific meetings. 

Infographic with steps for creating posters and abstracts

Strategies for success  

  • Identify a poster’s/abstract’s purpose and key points . Determine the purpose of sharing your work (feedback vs. sharing a new methodology vs. disseminating a novel finding) and tailor the information in your poster or abstract to meet that objective. Identify one to three key points. Keep in mind the knowledge and expertise of the intended audience; the amount of detail that you need to provide at a general vs. specialized meeting may vary. 
  • Design an effective poster . Design your poster to follow a logical flow and keep it uncluttered. The methods and data should support your conclusions without extraneous information; every chart or image should serve a purpose. Explicitly outline the key takeaways at the beginning or end.  
  • Present in a conversational, informal style . Imagine you are explaining your project to a colleague. The purpose of your work and key points should guide your presentation, and your explanation of the methods and data should link to your conclusions. Be prepared to discuss the limitations of your project, outline directions for future research, and receive feedback from your audience. Treat feedback as an opportunity to improve your project prior to producing a manuscript.  

Additional resources  

These resources support the development of the skills mentioned above, guiding you through the steps of developing a poster that frames your research in a clear and concise manner. The videos provide examples that can serve as models of effective poster and abstract presentations. 

  • How to design an outstanding poster (freely available, article). This article outlines key items for laying out an effective poster, structuring it with the audience in mind, practicing your presentation, and maximizing your work’s impact at meetings. (Skills addressed: 1-3) 
  • Giving an Effective Poster Presentation (freely available, video). This video shows medical students in action presenting their work and shares strategies for presenting your poster in a conversational style, preparing for questions, and engaging viewers. (Skills addressed: 2,3) 
  • Better Scientific Poster (freely available, toolkit). This toolkit includes strategies and templates for creating an effective and visually interesting scientific poster. Virtual and social media templates are also available. (Skill addressed: 2)

As with all presentations, it can be very helpful to practice with colleagues and/or mentors before the meeting. This will allow you to get feedback on your project, style, and poster design prior to sharing it with others outside of your institution. It can also help you prepare for the questions you may get from the audience.  

Patient presentation skills are valuable for medical students in the classroom and in the care of patients during clinical rotations. Patient presentations are an integral part of medical training because they combine communication skills with knowledge of disease manifestations and therapeutic strategies in a clinical scenario. They are used during active learning in both the preclinical and clinical phases of education and as students advance in training and interact with diverse patients.  

Below are strategies for delivering effective patient presentations. 

Infographic with tips for patient presentations

  • Structure the presentation appropriately . The structure of your narrative is important; a concise, logical presentation of the relevant information will create the most impact. In the clinical setting, preferences for presentation length and style can vary between specialties and attendings, so understanding expectations is vital. 
  • Synthesize information from the patient encounter . Synthesis of information is integral for effective and accurate delivery that highlights relevant points. Being able to select pertinent information and present it in an efficient manner takes organization and practice, but it is a skill that can be learned.  
  • Deliver an accurate, engaging, and fluent oral presentation . In delivering a patient presentation, time is of the essence. The overall format for the presentation is like a written note but usually more concise. Succinctly convey the most essential patient information in a way that tells the patient’s story. Engage your listeners by delivering your presentation in an organized, clear, and professional manner with good eye contact. Presentations will go more smoothly with careful crafting and practice. 
  • Adjust presentations to meet team, patient, and setting needs . Adaptability is often required in the clinical setting depending on attending preferences, patient needs, and location, making it imperative that you are mindful of your audience.  

The resources below provide samples of different types of patient presentations and practical guides for structuring and delivering them. They include tips and tricks for framing a case discussion to deliver a compelling story. Resources that help with adjusting patient presentations based on the setting, such as bedside and outpatient presentations, are also included. 

  • A Guide to Case Presentations (freely available, document). This practical guide from the Ohio State University discusses basic principles of presentations, differences between written and oral communication of patient information, organization, and common pitfalls to avoid. (Skills addressed: 1-3) 
  • Verbal Case Presentations: A Practical Guide for Medical Students (freely available, PDFs). This resource from the Augusta University/University of Georgia Medical Partnership provides a practical guide to crafting effective case presentations with an explanation of the goals of each section and additional tips for framing the oral discussion. It also provides a full sample initial history and physical examination presentation. (Skills addressed: 1-4) 
  • Patient Presentations in Emergency Medicine (freely available, video). This training video for medical students from the Society for Academic Emergency Medicine demonstrates how to tell a compelling story when presenting a patient’s case. The brief video offers handy dos and don'ts that will help medical students understand how best to communicate in the emergency department efficiently and effectively. These skills can also be applied to patient presentations in other specialties. (Skills addressed: 1-4) 

Additional information and support on effectively constructing and delivering a case presentation can be found through various affinity support and mentorship groups, such as the Student National Medical Association (SNMA), Latino Medical Student Association (LMSA), and Building the Next Generation of Academic Physicians (BNGAP). 

Leading Small Groups

For physicians, working within and leading small groups is an everyday practice. Undergraduate medical education often includes small group communication as well, in the form of problem-based learning groups, journal clubs, and study groups. Having the skills to form, maintain, and help small groups thrive is an important tool for medical students.   

Below are strategies to provide effective small group leadership. 

Infographic with steps for leading small groups

  • Outline goals/outcomes . Delineating the goals of a meeting ensures that everyone understands the outcome of the gathering and can help keep conversations on track. Listing goals in the agenda will help all participants understand what is to be accomplished. 
  • Establish ground rules . Establishing explicit procedural and behavioral expectations serves to solidify the framework in which the conversation will take place. These include items such as attendance and how people are recognized as well as the way group members should treat each other.   
  • Create an inclusive environment . In addition to setting expectations, group leaders can take steps to help all participants feel that their perspectives are valuable. Setting up the room so that everyone sits around a table can facilitate conversations. Having individuals introduce themselves can let the group understand everyone’s background and expertise. In addition, running discussions in a “round-robin style” (when possible) may help every person have an opportunity to express themselves. 
  • Keep discussions constructive, positive, and on task . As meetings evolve, it can be easy for conversations to drift. Reminding the group of goals and frequently summarizing the discussion in the context of the planned outcomes can help redirect meetings when needed. 
  • Manage virtual meetings . Online meetings present their own challenges. Adequate preparation is key, particularly working through technological considerations in advance. Explicitly discussing goals and ground rules is even more important in the virtual environment. Group leaders should be more patient with members’ response times and be especially diligent that all participants have an opportunity to be heard.   

The resources listed below outline additional helpful points, expanding on the skills described above and providing additional perspectives on managing small group meetings of different types. 

  • Communication in the Real World: Small Group Communication (freely available, online module). This chapter includes an overview of managing small groups, including understanding the types and characteristics, group development, and interpersonal dynamics. (Skills addressed: 3,4) 
  • Conversational Leadership (freely available, online book chapter). This short online resource provides guidance for determining group size and seating to best facilitate participation by all group members. (Skill addressed: 4) 
  • Tips on Facilitating Effective Group Discussion (freely available, PDF). This resource from Brown University provides tips for effective group facilitation, creating an environment conducive for discussions, keeping conversations positive, and managing common problems. Also included is a valuable list of references for further exploration. (Skills addressed: 1-4) 
  • Facilitating Effective Discussions: Self-Checklist (freely available, online checklist). This checklist from Brown University provides an easy-to-use, practical framework for preparing for, performing, and reflecting on small group facilitation. (Skills addressed: 1-4) 
  • Sample Guidelines for Classroom Discussion Agreements (freely available, PDF). These guidelines from Brown University give useful tips for managing classroom discussions, including when disagreements occur among group participants. (Skill addressed: 2) 
  • Fostering and assessing equitable classroom participation (freely available, online article). This online resource from Brown University includes methods to maximize group members’ participation in discussions and to communicate expectations. Also included is a valuable list of references for further exploration. (Skill addressed: 3) 
  • Facilitating small group learning in the health professions (freely available, online article). The aim of this paper published in BMC Medical Education is to provide students involved in peer/near peer teaching with an overview of practical approaches and tips to improve learner engagement when facilitating small groups. It includes a discussion of the roles of facilitators, strategies for fostering interactions among the group, and methods for resolving common problems. (Skills addressed: 1-4) 
  • Facilitating a Virtual Meeting (freely available, PDF). This infographic from the University of Nebraska Medical Center includes key points to consider when facilitating an online meeting, including technical considerations, preparation, and follow-up. (Skill addressed: 5) 
  • Most universities have a communication department with faculty who specialize in small group communication. You may also find that these individuals are a valuable resource. 

This toolkit was created by a working group of the Undergraduate Medical Education (UME) Section of the Group on Educational Affairs (GEA). 

Working Group Members

  • Geoffrey Talmon, MD, University of Nebraska Medical Center
  • Jason Kemnitz, EdD, University of South Dakota Sanford School of Medicine 
  • Lisa Coplit, MD, Frank H. Netter School of Medicine at Quinnipiac University 
  • Rikki Ovitsh, MD, SUNY Downstate College of Medicine
  • Susan Nofziger, MD, Northeast Ohio Medical University  
  • Amy Moore, MEd, Cleveland Clinic Lerner College of Medicine 
  • Melissa Cellini, MD, New York Medical College 
  • Richard Haspel, MD, Harvard Medical School 
  • Christine Phillips, MD, Boston University School of Medicine 
  • Arvind Suresh, Geisel School of Medicine at Dartmouth 
  • Emily Green, PhD, MA, Warren Alpert Medical School of Brown University 
  • Holly Meyer, PhD, MS, Uniformed Services University of the Health Sciences 
  • Karina Clemmons, EdD, University of Arkansas for Medical Sciences
  • Shane Puckett, EdD, University of South Florida 
  • Angela Hairrell, PhD, Burnett School of Medicine at Texas Christian University 
  • Arkene Levy Johnston, PhD, Kiran C. Patel College of Allopathic Medicine
  • Sarah Collins, PhD, UT Southwestern Medical Center 
  • Patrick Fadden, MD, Virginia Commonwealth University School of Medicine 
  • Lia Bruner, MD, Augusta University - University of Georgia Medical Partnership 
  • Jasna Vuk, MD, PhD, University of Arkansas for Medical Sciences 
  • Pearl Sutter, University of Connecticut School of Medicine 
  • Kelly Park, Baylor University Medical Center

Med School Insiders

How to Give an Excellent Medical Presentation

  • By Sulaiman Ahmad
  • July 22, 2019
  • Medical Student , Pre-med
  • Self-improvement

In medicine, we are constantly learning from each other. Professors stand in front of lecture halls to teach the fundamental knowledge needed to pass board exams and to treat our patients. Outside of the classroom, medical students, researchers, and physicians attend conferences to communicate ideas and update their colleagues with oral and poster presentations. In the clinic, students and resident physicians relay pertinent patient information to the physician in charge. Eventually, you will find yourself in front of an audience listening to your talk or an attending grading your clinical presentation. First, I will discuss what it takes to make an excellent presentation.  I will then finish this topic by providing guidelines for perfecting different types of presentations.

Critical Elements of an Excellent Presentation

 do some research.

Your audience will consider you an expert on the information you deliver. It is your job to achieve the expected level of comprehension of the topic. After choosing a topic, gather enough background information from diverse but appropriate sources (e.g., journals articles, relevant chapters in textbooks, personal discussion with subject matter experts, online videos).  Your research should provide you with a thorough understanding of the topic and a list of the important facts supporting your take-home message . Any gaps in your knowledge will become evident during your presentation. The goal is to develop confidence in your understanding of the topic and ability to share what you know.

Know Your Audience

Before putting your presentation together, take a moment to assess the baseline understanding of your expected audience . Ultimately your audience should walk away having learned something new. Try to figure out their collective interest, reasons for attending, and prior experience with the topic. Knowing your audience will allow you to focus on information that will keep them engaged and interested. For example, premed students have a different understanding of medical topics than medical students.  A presentation on the same subject should be different for both groups. If your listeners have different levels of expertise, take a moment to explain the fundamental concept, then build up the language and complexity to allow everyone to benefit from the information shared. Your audience is the reason why you are presenting.

Tell a Story

The human brain is wired to remember stories , especially if presented logically. A presentation is about the information shared, but it should also include the presenters’ passion, excitement, and personal style. All topics can be formatted to include characters, a description of the setting, plot, conflict, and a resolution. The story should allow the audience to take a journey with you. The hardest part is identifying the start and endpoint of your story and which details are needed. Make every word count by checking if it adds value to your narrative. Consider using metaphors, real examples, and descriptions that give life to your words .

Practicing your presentation is a vital step in developing an excellent presentation. You can memorize a script. However, memorization can reduce your connection with the audience. But in certain situations, scripts are quick and effective means of communicating important facts. Another approach is drafting bullet points of the main ideas and practicing the natural flow of information . This method allows your personality to shine on stage. To become comfortable speaking, start by practicing on your own . You can also record yourself with a cellphone or tablet and review the recording to evaluate your performance. Next, find a small group to present in front of and ask for their honest assessment . Eventually, your presentation will feel natural, and your stage presence will aid in communicating your main idea.

Q&A Session

Usually, your presentation does not end until after a question and answer session. Most presentations should include approximately five minutes in the end for the audience to ask questions . This part of the presentation allows you to clarify or further explain any part of your presentation. A question can also lead to expanding your presentation beyond what you originally planned to discuss . It is important for you to understand what is being asked and address the specific question directly. And if you do not have an answer, it is okay to admit that you do not know . Questions will force you to be creative and truly test your knowledge of the topic.

Different Types of Presentations

Presentations have many different forms, each with different goals; thus, each form requires a unique approach. In medicine, professors and clinician often provide students with lecture objectives and PowerPoint presentations that guide the students in their hour-long lecture. Conferences are a researcher’s platform to share their lab’s progress and conclusions. The last presentation I will go into is the clinical presentation a student typically performs for the physician in charge.

The main purpose of the lecture is to educate the attendees. We all have had great professors captivate our attention and other experiences that were a complete waste of time. But what makes some lectures better than others? The lecturer’s knowledge on the topic becomes obvious, and their stage presence confirms how comfortable they are with the topic.  If you are tasked with lecturing on a topic or a series, ensure that you have a solid understanding and address your learning objectives in the time allotted . The main concepts should be repeated multiple times throughout the lecture, followed by examples . Your PowerPoint slides should be limited to only main points and images that support your talking points. After difficult concepts are covered, ask questions to gauge your audience’s understanding . It is better to reemphasize a concept before building up to more complex learning objectives.

Research Presentation

Attending a conference is exciting, especially if you are representing your lab with an oral presentation.  It is an opportunity to share your research story, from the point of identifying a question to the process of reaching a conclusion. Realize your audience will include Primary Investigators, post-docs, and Ph.D. students that are also experts in the field . Attempt to grab the audience’s attention from the beginning by providing them with a reason to care. Then continue to explain how your study relates to the published work . After building up the background, address how you arrived at your research question. The most exciting part of your presentation should be explaining your conclusions and the path you took to get there. Finish up strong by discussing the implications of your findings and how they will have an impact in the field . The natural flow of information will come with practice and a deep understanding of your research topic. Presenting as a student usually leads to networking with professors and clinicians that can help you progress in your career.

Patient Presentation

Medical students learn how to take a patient’s history and perform a physical exam, but it is more challenging to reason through your clinical findings and subsequently present to an attending . Your clinical presentation style will change depending on the environment, medical department, and supervising physician . Upon joining a medical team, discuss the expectations and preference with each physician . It may be a good idea to draft a script that can get you started on organizing your patient presentation. The success of your presentation is correlated to your knowledge of the basic sciences and ability to critically assess the patient’s history and physical exam; the more you learn and read, the easier decision making and producing a plan becomes. Another important element is practicing your presentation style until it comes out naturally . Take the time to listen to your peers and experienced colleagues; learn from their mistakes and strengths . After concluding your presentation, ask for feedback and practice implementing the suggestions. You will be the eyes and ears for the physicians in charge, perfecting your patient presentation will help get the care the patients need while making everyone’s job a little easier.

Final remarks

There are some basic steps to achieving an excellent presentation: know the topic well, understand who you’re presenting to, develop a memorable story, and practice until it comes out naturally. A career in medicine is very versatile; you can be at the forefront of the next generation of physicians sharing your experiences or updating the science community with your research conclusions. At the minimum, you will be presenting the patient in the clinic. Thus, presenting is a skill every physician must master.

Sulaiman Ahmad

Sulaiman Ahmad

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Presentation skills: plan, prepare, phrase, and project

  • Related content
  • Peer review
  • Laura Brammar , careers adviser, C2 Careers
  • laura.brammar{at}careers.lon.ac.uk

In the third of her series on getting the dream job, Laura Brammar looks at giving an interview presentation

Many doctors have extensive experience of delivering presentations at conferences, during research projects, or to medical students during their training. Nevertheless, for many medical professionals having to deliver a presentation is still something they dread rather than relish. Equally, candidate presentations are becoming an established feature of selection and assessment for many roles within medicine.

Applicants may be asked to prepare and deliver a presentation as part of the interview process for anything from a salaried general practitioner post to a senior consultant post. For that reason alone, it’s vital to grasp the nettle and strengthen those presentation skills, which you can draw on throughout your medical career.

Break it down to just four P’s

To prepare most effectively for your presentation, you might find considering four main areas particularly useful: planning, preparation, phrasing, and projection.

Planning —A good presentation begins with the early stage of planning. Common complaints about ineffectual and dull presentations revolve around the apparent lack of structure shown by the presenter.

You will generally be given the topic of your presentation in advance. Topics vary, but they usually relate to your specialty—for example, “What do you see as the main current issues/future direction of this specialty?”—or link to contextual factors related to the role—“How, in your opinion, could the current system of X work more effectively?”

Think of the title as your research question or hypothesis and structure your presentation so that you answer that question directly. A simple but effective framework for any presentation is: tell them what you’re going to say, say it, and tell them what you’ve just said. Whether your presentation relates to the latest National Institute for Health and Clinical Excellence (NICE) guidelines for your specialty or a business plan in response to a proposed polyclinic, this structure will help keep your audience engaged and your presentation within the time limit.

Indeed, timing is crucial when giving a presentation. Most candidates are overambitious about what can be squeezed into just five to ten minutes. Be realistic about what you can achieve in the time limit and plan your presentation accordingly. As a rule of thumb, less is almost always more and remember to build in time for questions at the end.

Preparation —Having a clear structure can give you a useful framework that underpins your presentation. In a similar way, using particular resources to support your point can be a good method to employ during a presentation.

While the use of PowerPoint is becoming increasingly popular, in these circumstances you need to check before slaving over your slides. Remember that you are the focus of the presentation, not the screen; avoid distracting animations and excessive detail. Even if PowerPoint is an option you still need to plan for technological meltdowns; bring hard copies and overhead slides as a back-up.

You may consider it worth while to produce a brief summarising handout of the main points. Aim to distribute this before you begin so that you can create a clear and confident start, rather than compete with the rustle of paper as you try to introduce yourself.

Phrasing —Many candidates get anxious about the fact that they may “um” and “er” during a presentation. The vast majority of people feel nervous when they are presenting. Accept that and remember that, to an extent, it is what your audience will expect; from the selectors’ perspective, a completely laidback candidate might appear unmotivated and flippant. So while you want to aim for a fluid and articulate delivery, it’s not the end of the world if you occasionally need to pause between sentences. Indeed pauses can be an excellent way of emphasising your points and retaining your audience’s attention.

Essentially, use your structure to help you—for example, “First, I’d like to talk about . . .; next, let’s look at . . . ; and, finally, in summary . . ..”Also, be aware of your pace and volume.

Projection —Many people associate the term “presentation skills” with aspects of non-verbal communication, such as gestures and facial expression. Even when you feel nervous there are ways successfully to convey confidence to your audience. The following suggestions will help you to show a positive and calm attitude, which in turn will help you to maintain control over your presentation.

Breathe—If you are particularly nervous before you start, take a few moments to slow down your breathing; it may help to think about balancing the length of your inhalation and exhalation and breathe deeply and evenly.

Share your eye contact—If feasible, make eye contact with all your audience throughout your presentation; if you are presenting to a large group, make sure you address both sides of the room during your session.

Take time to pause—Use pauses to illustrate the structure of your session. Brief pauses can also help you to slow down your delivery and maintain the focus of your audience.

Project your voice—Check that those at the back can hear you before you start. Maintain your volume throughout and aim at projecting your voice to the back of the room.

Own the space—If possible, try not to stay stuck to one spot for the duration of the presentation. Clearly, now isn’t the time to try out gestures that feel unnatural or forced. However, convey your confidence through the way you stand and emphasise your message through your body language.

Smile—Despite feeling anxious, displaying a smile can make you feel more relaxed. Even better, it also gives your audience confidence in you and in your message.

Awkward audience moments

While you may have organised thoroughly your planning, preparation, phrasing, and projection, the one area you cannot control or necessarily predict is your audience’s reactions. Many people find the thought of their audience’s responses, especially during the question and answer session, far more terrifying than the presentation itself.

Here are a few suggestions for how to deal with some common difficult situations.

Random interruptions —If someone asks a question in the middle of your presentation, make a decision whether it would be appropriate to deal with it now or later. Don’t be forced to change your structure unless you believe it is really necessary. Acknowledge the question and reassure the person that there will be opportunities to discuss that later. Equally, if it is an unrelated or irrelevant question remember to acknowledge it but make it clear that such a topic isn’t going to be dealt with explicitly on this occasion. You can always offer to research that question for them at a later opportunity.

Audience looks bored —Many people feel they are poor presenters because their audiences can look distracted or even bored. The key thing here is to ask yourself if they are actually bored or whether they are just presenting you with a professional and impartial expression. In your clinical work you need to be able to focus on a task and not be distracted by personal emotional considerations or anxieties; this is no different. Treat the presentation as a professional exercise and move on.

Someone isn’t listening and is talking to someone nearby —Depending on your audience (senior consultants or medical students, for example) you may want to vary your specific response to this. However, a good technique with any audience is to pause in your delivery, look at the culprits while smiling, and wait for their attention before you start again. This is an effective (and non-aggressive) way of acknowledging that they are distracting both you and the rest of the group. That is usually all it takes to get their full attention. However, if they are persistent offenders maintain your professionalism and carry on regardless.

Questions you can’t answer —Sometimes the dread of the questions at the end of a presentation can overshadow the whole experience. Avoid this by framing your question and answer session with a reassurance that you’ll do your best to deal with any questions now and will guarantee to follow up any additional questions after the session. If you are asked a reasonable question which you genuinely can’t answer you may want to try the following:

Acknowledge that it’s a valid question

Invite any suggestions from the audience first

Admit that you can’t give a full answer at this moment; don’t bluff an answer

Offer to follow up a response and email the person later.

Remember that part of good medical practice is to know your limits and work within the parameters of your knowledge; it sounds far more confident and impressive to admit you can’t answer a question fully at this moment, rather than try to cobble together a poor answer and pretend you know.

Want to practise in a supportive environment?

The BMA Careers Service works with many individual medics who wish to improve their presentation skills through a tailormade practice presentation service. A bespoke practice presentation session, based on your actual material, can be excellent preparation for the real thing. During the session you can rehearse your presentation fully, practise answering focused questions, and gain immediate and constructive one to one feedback on your overall performance ( www.bma.org.uk/ap.nsf/Content/Hubcareersadvicefordoctors ).

Competing interests : None declared.

what are presentation in medicine

Effective Presentations: Optimize the Learning Experience With Evidence-Based Multimedia Principles [Incl. Seminar]

Effective presentation

Table of Contents

What is an effective presentation.

Professional education requires presentations, from a small discussion or a short video to speaking to a lecture hall with an audience of hundreds.  In fact, presentations are at the core of the educational process. With the effort to view all our educational efforts through an evidence-based lens, the construction of an effective presentation needs to undergo the same scrutiny. Whether a presenter intends to share plans, teach educational information, give updates on project progress, or convey the results of research, the extent to which the audience understands and remembers the presentation relies not only on the quality of the content but also the manner in which that content is presented. While the medium of the presentation may range from written content to graphics, videos, live presentations, or any combination of these and more, each of these mediums can be enhanced and made more effective by the use of evidence-based practices for presenting. Regardless of the medium, effective presentations have the same key features: they are appealing, engaging, informative, and concise. Effective presentations gain attention and captivate the audience, but most importantly, they convey information and ideas memorably.

With the integration of technology and online learning, educators have more opportunities than ever to present rich content that enhances and supports student learning. However, these opportunities can be intimidating to educators striving to engage students, as it can be daunting to create visually appealing and informative materials. Additionally, many educators feel pressured by the continued myth of learning styles: the widespread misconception that learning materials should match students’ visual, auditory, or kinesthetic “styles” to optimize learning (1). Despite being featured in many articles and discussions, there is no compelling evidence that matching educational content to learner’s style preferences increases educational outcomes. However, using multiple modes of delivery such as visuals, audio, and active learning has been shown to benefit all learners. In other words, no matter their stated preference, all learners benefit from a variety of media. Using evidence-based principles for multimedia content such as the principles found in Richard Mayer’s multimedia learning as well as the principles of graphic design and universal design supports learning and increases educational outcomes.

Why effective presentations work

What makes a presentation effective? Is an appealing and engaging presentation also an effective one? Research from cognitive science provides a foundation for understanding how verbal and pictorial information are processed by the learner’s mind during a presentation.

Mayer’s cognitive theory of multimedia learning

Based in cognitive science research, Mayer’s evidence-based approach to multimedia and cognition has greatly influenced both instructional design and the learning sciences. Mayer’s cognitive theory of multimedia learning comprises three learning principles: the dual channel principle, the limited capacity principle, and the active processing principle. Mayer’s cognitive theory of multimedia learning lays the theoretical foundation that underlies the practical applications to boost cognitive processes (2).

The dual channel principle proposes that learners process verbal and pictorial information via two separate channels (see figure below). Within each channel, learners can process limited amounts of information simultaneously due to limits in working memory, a phenomenon known as the limited capacity principle . In addition to these principles describing learning via the verbal and pictorial channels, the active processing principle proposes deeper learning occurs when learners are actively engaged in cognitive processing, such as attending to relevant information, creating mental schema to organize the material cognitively, and then relating to prior knowledge (3). These three principles work in tandem to describe the learning process that occurs when an audience of learners experiences a multimedia presentation.

Cognitive Load Theory, Adapted from Mayer (3) . Depicting how verbal and visual information is processed in dual channels through sensory, working, and long-term memory to create meaningful learning.

Mayers cognitive load theory

As learners listen to a lecture or watch a video, words and images are detected in the sensory memory and held for a very brief period of time. As the learners attend to relevant information, they are selecting words and images , which allows the selected information to move into the working memory where it may be held for a short period of time. However, working memory is limited to about 30 seconds and can only hold a few bits of information at a time. Organizing the words and images creates a coherent cognitive representation (schema) of these bits of information in the working memory. After the words and images are selected and then organized into schema, integrating these bits of information with prior knowledge from long term memory creates meaningful learning.

Cognitive Capacity . Three types of processing combine to determine cognitive capacity. To improve essential processing and generative processing, extraneous processing should be limited as much as possible .

Cognitive capacity

No matter how important the content may be, the capacity of learners to retain ideas from a single presentation is limited. The amount of information a learner can process as they select, organize, and integrate the ideas in a presentation relates to the cognitive load, which includes Essential, Extraneous, and Generative cognitive processing. Essential cognitive processing is required for the learner to create a cognitive representation of necessary and relevant information. This is the desired part of processing but should be managed to not overload the cognitive process. Extraneous processing refers to cognitive processing that does not contribute to learning and is often caused by poor design. Extraneous processing should be eliminated whenever possible to free up cognitive resources. Generative cognitive processing gives meaning to the material and creates deep learning. Learners must be motivated to engage and understand the information for this type of processing to occur.

Foundations in neuroscience

What we know about cognition and learning has been supported and informed by research in neuroscience (4). Neuroscience advances have also allowed us to gain deeper understanding into cognitive science principles, including those on multimedia learning. Researchers have been increasingly tracking learner eye movements to study learners’ attention and interest as a method of validating the impact of multimedia principles, and the results have supported the benefits of proper multimedia design on learner performance (5). Another avenue of research with great potential includes functional MRI (fMRI) readings or electroencephalography (EEG) (6). It has long been established that verbal and pictorial data is processed in different parts of the brain. More recently however, by examining changes in blood flow in different regions of the brain, researchers in Sweden were able to demonstrate that increased extraneous load could impact the effectiveness of learning, in line with the dual channel principle (7).

Evidence for effective presentations

Mayer’s multimedia principles.

Mayer’s Multimedia Principles.

Mayers multimedia learning principles

Mayer’s multimedia principles are a set of evidence-based guidelines for producing multimedia based on facilitating essential processing, reducing extraneous processing, and promoting generative processing (8). Mayer’s list of principles often includes fifteen principles, some of which have changed over time, and in a study conducted with medical students, the following nine principles were found to be particularly effective (3). The first three of these principles are used to reduce extraneous processing.

Principles for reducing extraneous processing:

  • Coherence principle: eliminate extraneous material 
  • Signaling principle: highlight essential material 
  • Spatial contiguity principle: place printed words near corresponding graphics

To illustrate these principles, we will use a lesson about the kidneys. The instructor wants to make diagrams of the anatomy to use during discussion. The coherence principle says to only include the information necessary to the lesson. Graphics such as clip art, information that does not relate to anatomy, or unnecessary music reduces cognitive capacity. The signaling principle says to highlight essential material; this might include putting important content in bold or larger font. Or, if the kidney is shown in situ , the rest of the anatomy may be shown in grayscale or a much lighter color to de-emphasize it. The spatial contiguity principle says to place printed words, such as the labels, near the graphics.

Reduce extraneous processing .  Do : keep labels next to diagrams, use only essential material, highlight essential material such as titles.  Don’t: separate labels from diagrams, include extra facts, or have excessive text on a slide, especially with no indication of what is most important.

Reducing extraneous processing

Principles for managing essential processing:

  • Pre-training principle: provide pre-training in names and characteristics of key concepts
  • Segmenting principle: break lessons into learner-controlled segments 
  • Modality principle: present words in spoken form

The next three principles are used to manage essential processing. If the kidney lesson moves into diseased states or diagnostics, the pre-training principle says that learners should be given information on any unfamiliar terminology before the lesson begins. To satisfy the segmenting principle , the learner should be able to control each piece of the lesson. For example, a “next” button may allow them to progress from pre-training to anatomy to diseased states and then diagnostics. The modality principle says that words should be spoken when possible. Voice-over can be used and text can be limited to essential material such as key definitions or lists.

Manage essential processing.   Do: Present terms and key concepts first, break lessons into user-controlled segments, and present words in spoken form.  Don’t: Give long blocks of text for students to read without priming students for key concepts.

Manage essential processing

Principles for fostering generative processing: 

  • Multimedia principle: present words and pictures rather than words alone 
  • Personalization principle: present words in conversational or polite style 
  • Voice principle: use a human voice rather than a machine voice

Mayer’s work also includes principles to increase generative processing. The multimedia principle is a direct result of the dual channel principle and limited capacity principle. Words and pictures together stimulate both channels and allow the memory to process more information than words alone. To adhere to the personalization principle to promote deeper learning, a case study is better presented as a story than a page of diagnostics and patient demographics. Finally, the voice principle says that a human voice is more desirable, so it is better to use the instructor’s voice when doing voice-overs rather than auto-generated readers.

Foster generative processing. Do: Present words and pictures, present words in conversational style, and use a human voice.  Don’t: Present text only, present words as a list of facts or overly technical language, or use a computer-generated voice.

Foster generative processing

Additional multimedia principles: 

  • Temporal contiguity principle: present words and pictures simultaneously rather than successively
  • Redundancy principle: for a fast paced lesson, people learn better from graphics and narration rather than graphics, narration, and text 
  • Image principle: people do not learn better if a static image of the instructor is added to the presentation

Additional principles include the temporal contiguity principle , which states that words and pictures should be shown simultaneously rather than successively. This also includes narration and images or animation. For example, if an animation demonstrates normal cell division, the narration should be given during the animation, not after. The redundancy principle states that people do not necessarily learn better if text is added to graphics and narration. The duplication of information creates extraneous processing as learners try to process print and spoken text. The image principle states that learners do not learn better if a static image of the instructor is added to a presentation. For example, if students are watching an animation with normal cell division, they do not learn better if an image of their instructor is placed next to the animation.

Additional principles for fostering generative processing: 

  • Embodiment principle: onscreen instructors should display high embodiment not low
  • Immersion principle: 3D virtual reality is not necessarily better than 2D presentations 
  • Generative activity principle: use generative learning activities during learning

In the newest edition of Mayer’s Multimedia Learning (8), three additional principles have been added. The embodiment principle states that onscreen instructors should display high embodiment rather than low embodiment, meaning they should use natural gestures, look at the camera as if making eye contact, and if drawing, show the image being drawn. If demonstrating something like a surgical procedure, a first-person perspective should be used so the learner sees the perspective of the person performing. Low embodiment would include standing still, lack of eye contact, and using a third-person perspective. The immersion principle states that 3D immersive virtual reality is not necessarily more effective than 2D presentations, such as on a computer screen. This is thought to be caused by the cognitive load on the learning involved in using 3D immersive technology but more studies are needed. Lastly, the generative activity principle states that learners should use generative learning activities while learning such as summarizing, mapping, drawing, imagining, self-testing, self-explaining, teaching, and enacting. These activities help learners cognitively select and organize new material and then integrate with prior knowledge.

Other Design Principles

Mayer’s design principles are functional but do not address aesthetics per se . Anyone can master the basic graphic design principles as discussed by Reynolds (9) to captivate and engage an audience. 

  • Create graphics that are designed for the back of the room. Whatever the venue, the person in the back needs to be able to see and gather information from the graphics. Ensure font size is appropriate, image size and clarity is sufficient, and that font type and spacing allow words to be seen clearly from a distance. For online materials, this principle may mean designing for the person who will be viewing on the smallest screen (such as a phone) rather than assuming viewers will use a large monitor (10).
  • Limit the types of fonts. Too many fonts or fonts that don’t coordinate well can make graphics seem jarring and unpleasant. Some programs will suggest font families that are appealing, and a safe guideline is to limit to two or three fonts maximum per graphic. 
  • Use contrasting colors. Colors that are too similar or using type on top of images that lack contrast can make type difficult to read. Color family suggestions can be found online or in software such as Powerpoint.

Graphic design principles.  Do: Use coordinating fonts and color schemes with contrasting colors.  Don’t: use multiple fonts, excessive colors, and/or non-contrasting colors that may be difficult to distinguish.

Graphic design principle

In addition to singular graphics or presentations, online course presentation makes a difference in how learners perceive and utilize a course. When designing online learning experiences, consider using guidelines such as Quality Matters to assess the functionality. Quality Matters rubrics look at key components that have been proven to facilitate learning by making navigation and presentation of course elements explicit. Key components include providing information on how to get started, including learning objectives, allowing learners to track their progress, and using learning activities and technology tools that support active learning. Navigation among course components should facilitate access to materials.

In addition to all of these principles, accessibility must be considered in all forms of presentation. In education, designing for accessibility can be guided by universal design principles . Some schools may even require all courses and materials to be fully accessible. Providing accessible options has been shown to benefit all learners, not just those with a documented need for accommodations (11). Some basic accommodations that should be offered in any class include offering media in multiple modes. For example, videos should have the option of captioning and/or access to a transcript, and photos and graphics should have captions that describe the image. Many learning management systems and software programs now have options to check for accessibility. Additionally, most schools can provide assistance in assessing and developing accessible materials.

Practical Applications for Presentations in Health Professions Education

Implementation in the classroom.

When planning how to present materials in the classroom, first consider the most effective form of presentation for the given information. It may be a Powerpoint, a video, a graphic, or a handout. Consider using a variety of media appropriate for the intended outcomes. Creating high quality materials may seem daunting, but quality content can be reused, shared, and has been shown to enhance student learning.

Powerpoint has been much maligned for overuse and abuse, but well-designed presentations can be remarkably effective (12). When designing in Powerpoint, limit the amount of text per slide. One rule to remember is the 5/5/5 rule: Use no more than 5 lines of text with 5 words each or 5 text-heavy slides in a row and try to avoid bullets (13). Graphics are preferable to text or tables when representing data, but graphs and labels should be kept as simple as possible using 2D graphics and simplified labels that are easy for viewers to see (14). When presenting, refrain from reading from the slides. Slides should highlight important concepts and provide visual aids, not present everything. In addition, keep Powerpoint and video presentations short; most listeners will lose attention in 6–10 minutes (15,16). Whenever possible, engage the audience by interspersing active learning elements. Between sections or topics, transition slides can be used to indicate pauses for activity or reflection or to cue students to changes in topic (14).

When planning a presentation, consider presenting some of the information online before class for students to review. This flipped classroom technique allows for more class to be spent using active learning and facilitates the presentation of multiple forms of media and accessible options. 

Implementation online

Videos often become an integral part of the online learning experience. To facilitate learning, consider the following tips for your own video production (17,18): 

  • Align the video with learning objectives and course outcomes. Focus on pertinent instructional points to reduce extraneous processing and thereby reduce cognitive load. 
  • Limit the length of videos and use interactive elements to promote active learning. To help maintain student engagement and deepen learning, include interactive elements such as discussions, quizzes or embedded questions to maintain student attention. 
  • Limit extraneous information, graphics, and sounds that do not pertain to the learning goals (19). Busy backgrounds, music, or animations that don’t contribute to understanding concepts unnecessarily add to a learner’s cognitive load.
  • When using existing videos, ensure the source is reliable and the video is high quality. Video production can take time, so using professional videos can be beneficial if they come from credible sources that target the learning objectives with up-to-date and accurate information.

Additionally, Schooley et al. (18) have proposed a 25-item quality checklist that can help educators create and curate high-quality videos. Many of the items in the checklist have been discussed here such as length, captioning, using relevant graphics, and self-assessment opportunities, but also included are other points an educator should consider, such as the offering learners the ability to download files and adjust playback speed as well as providing them with recommendations for further reading.

For a course in any modality, creating and curating content online can save time and facilitate student learning. As you consider what material to create and use for your courses, assess existing material using the guidelines above to determine if it could be made more beneficial to learners. Does it follow Mayer’s principles? Does it follow graphic design principles and universal design principles? Consider using a Quality Matters rubric to check the course design for best practices.

Recommendations

Educator’s perspective.

  • Use Mayer’s multimedia design principles to revise existing presentations and review new creations for simple changes that can make a big difference (12).
  • When delivering a presentation, start by discussing an unusual case, presenting an interesting story or an unexpected statistic, or explain how the topic impacts the listeners. This personalization will help gain their attention from the start (13).
  • When designing your own materials and graphics, “less is more” is often a good guideline: limit the amount of information on slides, limit the types of fonts, and limit the excessive use of colors (9,12).
  • Videos should be limited to 5–6 minutes when possible and avoid exceeding 10 minutes. Break up longer videos and intersperse interactive elements to keep students engaged (15–17).
  • When using technology and online delivery, universal design and accessibility considerations can be complicated. See if your school has an expert that can review your materials to ensure all students will benefit.

Student perspective

  • When creating presentations, reports, and charts, follow Mayer’s multimedia design principles to ensure your audience gets the most from your presentation.
  • Avoid copy/pasting but rather try and present concepts in an original way in order to augment your understanding of the material.
  • When looking at materials online, look for options such as captioning, transcripts, or audio buttons for accessing additional media output.
  • If a presentation is lengthy, pause and insert your own activities to help yourself stay focused. Taking notes, pausing for reflection, and self-quizzing can help deepen your learning and keep your mind from wandering.
  • If a variety of media aren’t offered, consider finding your own to supplement your learning. Credible sources with learning objectives that align with your course can augment your learning experience.

(Please select all that apply) 

1. When creating a graphic about the current status of heart disease in the US, which of the following would align with best practices?

a. Gaining the audience’s attention with a picture of your dog.

b. Using 3 colors that coordinate well on a contrasting background.

c. A 2D graph with simple labels rather than a table of data.

d. An image on the left with labels listed separately on the right.

e. An image next to a paragraph of text that you will read for the audience.

2. Which of the following are true about educational videos?

a. They need to be created by professionals to be high-quality.

b. They should be less than 10 minutes.

c. There should be an option for closed captioning or a written transcript.

d. Longer videos may be used but should be broken up with active learning elements.

e. Videos don’t need to align to objectives as long as they’re well-made.

3. Which of the following would be examples of Mayer’s multimedia principles?

a. Using a human voice rather than a machine voice.

b. Using formal language instead of conversational language.

c. Playing soothing music in the background of a video.

d. Providing new words and definitions before the presentation begins.

e. Putting important words in bold for emphasis.

4. Which of these would follow best practices for online content?

a. Creating a module where all the material is on one page for easy access.

b. Adding buttons for next, back, and table of contents options for students to navigate.

c. Breaking material into 7-minute videos with practice questions between them.

d. Adding fun clip art and cool images to the pages even if it doesn’t directly relate to the content.

e. Having text only because images are distracting.

Answers: (1) b,c. (2) b,c,d. (3) a,d,e. (4) b,c.

Online Seminar

This online seminar and its accompanying article will focus on the topic of Effective Presentations, which have a set of key qualities: they are appealing, engaging, informative, and concise. Effective presentations gain attention and captivate the audience, but most importantly, they convey information and ideas memorably and efficiently. Using evidence-based principles in educational multimedia can ensure the development of high-quality learning experiences. Our host, Dr. Peter Horneffer will be sharing with us some key multimedia concepts that can help facilitate the development and implementation of effective multimedia into the educational process.

Watch the seminar recording:

Would you like to learn more? Explore the Pulse Seminar Library.

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Meredith Ratliff

Meredith Ratliff is a doctoral student in Instructional Design and Technology at the University of Central Florida. Her research interests include evidence-based medical education, branching scenarios, and faculty development. She has received her B.S. and M.A.T. in Mathematics at the University of Florida and her MA in Instructional Design and Technology from UCF. She has been an Associate Faculty member in the mathematics department at Valencia College in Kissimmee, Florida for the past nine years. As part of the Learning Science team at Lecturio, she serves as an educational consultant helping to design and develop materials for medical educators.

Satria

Satria Nur Sya’ban is a doctor from Indonesia who graduated from Universitas Airlangga. While a student, he served as the president of CIMSA, a national medical student NGO, working on a diverse range of issues that included medical education and curriculum advocacy by medical students. Before graduating, he took two gap years to serve as a Regional Director, and subsequently as Vice-President, of the International Federation of Medical Students’ Associations (IFMSA)*, working on and developing various initiatives to better empower medical student organizations to make a change at the national level. At Lecturio, he serves as a Medical Education Consultant, supporting Lecturio in developing and maintaining partnerships with student organizations and universities in Asia, as well as providing counsel on how Lecturio can fit in existing teaching models and benefit students’ learning experience.

*IFMSA has been one of the leading global health organizations worldwide since 1951, representing over 1.3 million medical students as members spanning over 123 countries.

what are presentation in medicine

Adonis is a doctor from Lebanon who graduated from the University of Balamand. He was a research fellow at the Department of Emergency Medicine at the American University of Beirut Medical Center and has worked with the World Health Organization Regional Office of the Eastern Mediterranean. During his studies, Adonis served as the president of the Lebanese Medical Students’ International Committee (LeMSIC), a national medical student organization in Lebanon, and moved on to serve as the Regional Director of the Eastern Mediterranean Region of the IFMSA*. Among his roles as Regional Director, he focused on medical education advocacy, oversaw collaborations with external partners, and undertook several medical education projects and initiatives around the region. As a Medical Education Consultant at Lecturio, he advises the Lecturio team on how the platform can fit in existing teaching models and benefit students’ learning experience, develops and maintains partnerships with student organizations and universities in the MENA region, and conducts research on learning science and evidence-based strategies.

what are presentation in medicine

Sarah Haidar is an educator and educational specialist from Lebanon who has graduated with a BA in English Linguistics and a Secondary Teaching Diploma (T.D.) from  Haigazian University in Beirut, Lebanon. She has received her M.Ed. in Teaching English as a Second Language (TESOL)  from the Lebanese International University. She has been teaching ESL classrooms at the Deutsche Internationale Schule for four years. As part of the administrative team at the All American Institute of Medical Sciences (AAIMS), she is working on the design and implementation of a set of academic and administrative reforms that can help both faculty and students in their professional and academic endeavors. She has joined Lecturio to support the Learning Science team in the writing and communication based tasks that might be needed to announce and market their services and events that are targeted at medical educators. She is also supporting the Learning Science team with her perspective on educational and pedagogical topics that will inform the general audience of educators.

what are presentation in medicine

Sara Keeth is a Ph.D. and certified PMP (Project Management Professional) who graduated from the University of Texas at Dallas. As an educator, she has worked as a Teaching Fellow at  the University of Texas at Dallas, as a full-time professor at Richland College (now Dallas College’s Richland Campus), and has also taught at Austin College. Dr. Keeth has also worked as a consultant for Parker University’s Research Center and has a decade of experience as an operations manager for an advertising agency. As Senior Learning Science and Research Project Manager at Lecturio, she manages the Learning Science department’s activities, shares her education expertise and best practices for medical educators, and develops evidence-based content for both students and faculty.

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  • Brame CJ. Effective educational videos [Internet]. Vanderbilt University. [cited 2022 Jun 10]. Available from: https://cft.vanderbilt.edu/guides-sub-pages/effective-educational-videos/
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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 .
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  • Last Updated: Jul 19, 2023 10:52 AM
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How to Prepare an Outstanding Journal Club Presentation

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Rishi Sawhney; How to Prepare an Outstanding Journal Club Presentation. The Hematologist 2006; 3 (1): No Pagination Specified. doi: https://doi.org/10.1182/hem.V3.1.1308

Download citation file:

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Dr. Sawhney is a member of the ASH Trainee Council and a Fellow at the Medical University of South Carolina.

Journal club presentations provide a forum through which hematology trainees keep abreast of new developments in hematology and engage in informal discussion and interaction. Furthermore, honing presentation skills and mastering the ability to critically appraise the evidence add to our armamentarium as clinicians. Outlined here is a systematic approach to preparing a journal club presentation, with emphasis on key elements of the talk and references for electronic resources. Use of these tools and techniques will contribute to the success of your presentation.

I. ARTICLE SELECTION:

The foundation of an outstanding journal club presentation rests on the choice of an interesting and well-written paper for discussion. Several resources are available to help you select important and timely research, including the American College of Physicians (ACP) Journal Club and the Diffusion section of The Hematologist . McMaster University has created the McMaster Online Rating of Evidence (MORE) system to identify the highest-quality published research. In fact, the ACP Journal Club uses the MORE system to select their articles 1 . Specific inclusion criteria have been delineated in order to distinguish papers with the highest scientific merit 2 . Articles that have passed this screening are then rated by clinicians on their clinical relevance and newsworthiness, using a graded scale 3 . With the help of your mentors and colleagues, you can use these criteria and the rating scale as informal guidelines to ensure that your chosen article merits presentation.

II. ARTICLE PRESENTATION:

Study Background: This section provides your audience with the necessary information and context for a thoughtful and critical evaluation of the article's significance. The goals are 1) to describe the rationale for and clinical relevance of the study question, and 2) to highlight the preclinical and clinical research that led to the current trial. Review the papers referenced in the study's "Background" section as well as previous work by the study's authors. It also may be helpful to discuss data supporting the current standard of care against which the study intervention is being measured.

Study Methodology and Results: Clearly describe the study population, including inclusion/exclusion criteria. A diagrammatic schema is easy to construct using PowerPoint software and will help to clearly illustrate treatment arms in complex trials. Explain the statistical methods, obtaining assistance from a statistician if needed. Take this opportunity to verbally and graphically highlight key results from the study, with plans to expand on their significance later in your presentation.

Author's Discussion: Present the authors' conclusions and their perspective on the study results, including explanations of inconsistent or unexpected results. Consider whether the conclusions drawn are supported by the data presented.

III. ARTICLE CRITIQUE:

This component of your presentation will define the success of your journal club. A useful and widely accepted approach to this analysis has been published in JAMA's series "User's guide to the medical literature." The Centre for Health Evidence in Canada has made the complete full-text set of these user's guides available online 4 . This site offers review guidelines for a menu of article types, and it is an excellent, comprehensive resource to focus your study critique. A practical, user-friendly approach to literature evaluation that includes a worksheet is also available on the ASH Web site for your use 5 .

While a comprehensive discussion of scientific literature appraisal is beyond the scope of this discussion, several helpful tips warrant mention here. In assessing the validity of the study, it is important to assess for potential sources of bias, including the funding sources and authors' affiliations. It is also helpful to look for accompanying editorial commentary, which can provide a unique perspective on the article and highlight controversial issues. You should plan to discuss the trade-offs between potential benefits of the study intervention versus potential risks and the cost. By utilizing the concept of number needed to treat (NNT), one can assess the true impact of the study intervention on clinical practice. Furthermore, by incorporating the incidence rates of clinically significant toxicities with the financial costs into the NNT, you can generate a rather sophisticated analysis of the study's impact on practice.

IV. CONCLUSIONS, IMPLICATIONS, AND FUTURE DIRECTIONS:

Restate the authors' take-home message followed by your own interpretation of the study. Provide a personal perspective, detailing why you find this paper interesting or important. Then, look forward and use this opportunity to "think outside the box." Do you envision these study results changing the landscape of clinical practice or redirecting research in this field? If so, how? In articles about therapy, future directions may include moving the therapy up to first-line setting, assessing the drug in combination regimens or other disease states, or developing same-class novel compounds in the pipeline. Searching for related clinical trials on the NIH Web site 6  can prove helpful, as can consultation with an expert in this field.

Good journal club discussions are integral to the educational experience of hematology trainees. Following the above approach, while utilizing the resources available, will lay the groundwork for an outstanding presentation.

WEB BASED REFERENCES

www.acpjc.org

hiru.mcmaster.ca/more/InclusionCriteria.htm

hiru.mcmaster.ca/more/RatingFormSample.htm

www.cche.net/main.asp

www.hematology.org/Trainees

www.cancer.gov/clinicaltrials

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Effectiveness of Clinical Presentation (CP) Curriculum in teaching clinical medicine to undergraduate medical students: A cross-sectional study.

Saroj adhikari yadav.

1 Patan Academy of Health Sciences, Kathmandu, 44600, Nepal

Sangeeta Poudel

Swotantra gautam.

2 B P Koirala Institute of Health Sciences, Dharan, Nepal

Sanjay Kumar Jaiswal

Samikchya baskota, aaradhana adhikari, binod duwadi, nischit baral, sanjay yadav.

3 Institute of Medicine, Kathmandu, 44600, Nepal

Associated Data

Underlying data.

Figshare: CP Curriculum Raw data updated in Excel and PDF. https://doi.org/10.6084/m9.figshare.18666410.v1 10

This project contains the following underlying data:

  • - Analysis and Raw data.xlsx

Extended data

This project contains the following extended data:

  • - CP Questionnaire for Faculties.pdf
  • - CP Questionnaire for students.pdf
  • - CP Surprise exam Questionnaire.pdf

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

Peer Review Summary

Introduction:  The Clinical Presentation (CP) curriculum was first formulated in 1990 at the University of Calgary, Canada. Since then, it has been adopted at various medical schools, including Patan Academy of Health Sciences (PAHS), a state-funded medical school in a low-income country (LIC), Nepal. This study aims to evaluate the perceived effectiveness of the CP curriculum by students and faculty at PAHS, and test knowledge retention through a surprise non-routine exam administered to students. 

Method:  This is a cross-sectional study to evaluate the efficacy of the CP curriculum in teaching clinical medicine to the first batch of MBBS students of PAHS School of Medicine. Ethical approval was obtained from the Institutional Review Committee (IRC)-PAHS (Ref no std1505911069). Perceived effectiveness was evaluated using a set of questionnaires for faculty and students. A total of 33 students and 34 faculty filled the perception questionnaires. Subsequently, a questionnaire consisting of 50 Multiple Choice Questions (MCQs) from different clinical medicine disciplines was administered to test students’ knowledge retention. Out of 49 students, 38 participated in the surprise non-routine exam.  

Result:  A significantly higher number of faculty preferred the CP curriculum compared to the traditional system of teaching clinical medicine (16 vs 11, Kruskal Wallis: 0.023, ie. P-value < 0.05). A significantly higher number of the students liked and recommended CP curriculum in the clinical year of medical education (20 vs. 13 with p-value < 0.05). In the non-routine surprise exam, two thirds of the students scored 60% or above. 

Conclusion: Both faculty and students perceive that the CP curriculum system is an effective teaching and learning method in medical education, irrespective of their different demographic and positional characteristics. The students’ overall performance was good in surprise, non-routine exams taken without scheduling or reminders.

Introduction

Sir William Osler, considered the father of modern medicine, emphasized the teacher's role in helping students to observe and reason. He recommended abolishing the traditional lecture method of instruction. 1 Medical education is evolving in response to scientific advances and societal needs. 2 A well-organized comprehensive knowledge domain has practical implications in clinical problem solving, and appropriate teaching and learning methods play an important role in achieving the educational goals. 3

Clinical presentation (CP) is a relatively new and innovative approach to teaching medicine. CP engages medical students in their understanding of the disease process from clinical feature to diagnosis. Students begin studying abnormalities of complaints, examination, and laboratory findings; i.e., signs, symptoms, and laboratory investigations which a patient presents to the doctor with. Students then progress towards diagnosis. The underlying philosophy of the CP Curriculum is that: “The reaction of the human body to an infinite number of insults is always finite and stable over time”. 4 For example, if there is any attack on the respiratory system, whether infectious, inflammatory, immunological, traumatic, or iatrogenic; the respiratory system responds through coughing, cyanosis, chest pain, difficulty breathing, noisy breathing, or hemoptysis. 4 Thus, the CP Curriculum aims to help students understand the process of moving from “symptoms to diagnosis.”

The CP curriculum was first formulated in 1990 at the University of Calgary Faculty of Medicine in Canada. 5 The curriculum was adopted and redesigned based on local needs at various medical schools worldwide. Patan Academy of Health Sciences (PAHS), a state-funded medical school in Nepal, has adopted several new and innovative approaches in teaching and learning medicine. The CP Curriculum is one of the several approaches adopted by PAHS. 6

PAHS medical education team assumes that the CP curriculum is better than traditional lecture-based teaching. In this study we are testing the perceived effectiveness of students and faculty, and the level of knowledge among the students trained by the CP curriculum. The level of knowledge was assessed by marks scored by the students in a surprise non-routine exam without prior information. Perceived effectiveness was based on the thinking/perception of the students and faculty on the effectiveness of the CP curriculum. We assume the CP curriculum is at least not inferior to traditional lecture-based teaching.

Study design

This is a cross-sectional study that aims to evaluate the efficacy of the CP curriculum in teaching different disciplines of clinical medicine to undergraduate medical students of PAHS, which is currently the only medical school implementing the CP-curriculum in undergraduate medical education. A new Multiple-Choice Question (MCQ) based questionnaire was designed to evaluate the level of knowledge and two separate questionnaires were developed for faculty to evaluate perception about CP-curriculum.

Study population

All consenting medical students from 2016 of PAHS School of Medicine currently in clinical clerkship years and all clinical sciences faculty who had delivered at least one teaching-session with the CP curriculum to these students were included in the study. Consenting students were asked to fill the questionnaire together in class, whereas faculty were approached personally and asked to complete the questionnaires. Students and faculty who were part of the study team, those who didn’t provide consent, and those who participated in the pilot survey section of the questionnaire developed for this study were excluded. All 34 faculty completed the perception questionnaires, with zero non-response rate. Out of 49 students, 33 completed the perception questionnaires and 38 turned up to the surprise non-routine exam for assessment of knowledge retention.

Ethics and consent

This study was approved by the Institutional Review Committee (Ethical Committee) of Patan Academy of Health Sciences (PAHS), Kathmandu, Nepal (Ref No std1505911069). Written informed consent was obtained from all participants before completing the questionnaire. Students who gave verbal consent were asked to complete the questionnaire together in class. Faculty were approached personally and requested to complete the questionnaires. At the start of each questionnaire, a tick box was used for participants to indicate written consent. Participants were informed verbally and in writing that their names and identifiying information would be kept anonymous, and their data would only be used for research purposes.

Data collection

Three sets of questionnaires were used. The first set of questionnaires were designed to test the perceived effectiveness of the CP curriculum from the faculty perspective. It contained seven questions on background information (age, sex, job position, highest academic degree, etc) and 13 questions on perceived effectiveness.

Similarly, the second set of questionnaires for the students included 11 questions on background information and 15 questions on perceived effectiveness. The perception questionnaire had questions about effectiveness or satisfaction in regard to different aspects of the CP curriculum. Participants had to respond with a tick mark in a Likert scale ranging from one (strongly agree) to five (strongly disagree) for each question.

The third set of questionnaires tested the students' clinical knowledge and contained 50 MCQs from different clinical medicine disciplines. Based on curriculum of the university, there were seven MCQs each from surgery, medicine, pediatrics, obstetrics and gynecology, and two questions each from orthopedics, emergency medicine, general practice, otolaryngology, anesthesiology, dermatology, dentistry, psychiatry, radiology, ophthalmology, and forensic medicine. The questions were randomly selected from the question pool of the Examination section of university. The selected questions were randomly arranged, and a surprise non-routine written exam was conducted with this questionnaire. A maximum time of one hour was provided to solve these 50 questions.

These questionnaires were compiled and discussed in the research group and reviewed by the research advisors to establish content validity. Copies of all three questionnaires can be found under Extended data. 10 They were administered to randomly selected 15 students and 15 faculty in a pilot study to establish the face validity and feasibility. The students and faculty randomly selected for the pilot study were administered the questionnaires to complete. Then they were asked in detail about the questionnaire and any suggestions for revisions or editing needed. The pilot survey was not powered for statistical comparisons. Only a few grammatical corrections were made after review and feedback from the pilot study. Subsequently, the final study was conducted.

The faculty participants were also involved in the development of the CP curriculum at PAHS, hence, responder bias in favor of CP curriculum may be present in this study.

The data collected were digitalized using Epi-Info version 7 software. These raw data were exported to MS-Excel. The excel sheet is made available in the public domain for readers. 10 SPSS version 13.0 was used for statistical test and analysis. Shapiro-Wilk test was used first to test the normality. Non-parametric tests (Mann-Whitney and Kruskal Wallis) was used for normal distribution. Classical ANOVA for equal variance and Welch ANOVA for unequal variance were used after testing the homogeneity of variance, and post-hoc/tukey test was used for significant classical ANOVA results.

In this study, we calculated the total score via forced Likert scale, ranging from 1 (strongly agree) to 5 (strongly disagree) for each respondent determined as the dependent variable, and compared it with other variables i.e., background information. The total score of all the Likert scale questions was calculated, and the normality test was performed, keeping “total score” as the dependent variable. The full dataset can be found under Underlying data. 10

Response from faculty on perceived effectiveness of the CP curriculum

The data of the total score did not follow a normal distribution (Shapiro-Wilk Test, p < 0.05), so a non-parametric test was used to compare the dependent variable. We used Mann-Whitney and Kruskal Wallis tests for the variables containing two groups and more than two groups, respectively.

Among the 34 respondents from the faculty group, 24 (70.59%) were male, and 10 (29.41%) were female. 20 (58.82%) of the faculty respondents were lecturers, and the remaining 14 (41.18%) were senior professors, associate professors, and assistant professors. Out of the 34 respondents, 31 (91.18%) were involved in developing the CP curriculum at PAHS. However, 3 (8.82%) were involved in teaching the curriculum but not in developing the CP curriculum.

As many as 15 (44.12%) respondents favored the CP curriculum system over the traditional system, 11 (32.35%) preferred the traditional teaching system, and 8 (23.53%) preferred both. Overall, the faculty liked the CP curriculum more than the traditional system of teaching clinical medicine (Kruskal Wallis = 0.023, p-value < 0.05). The majority of faculty, 27 (79.41%), would suggest future students to join a medical school that implemented the CP curriculum system rather than the traditional system. Only 12 (35.29%) of them thought that the CP curriculum system should be the sole leading teaching and learning system in clinical medicine, meaning more faculty preferred a hybrid system of both the CP curriculum and the traditional system. However, these differences were not statistically significant (p-value > 0.05).

As shown in Table 1 , a significant number of faculty (p values > 0.05) perceive the CP curriculum to be more effective than the traditional system for teaching clinical medicine to undergraduate medical students. There is no significant difference in the perception of the effectiveness of the CP curriculum among faculty based on academic rank, gender, highest academic degree, or the institution of their residency training (p-value > 0.05). The median number of faculty who perceive the CP curriculum system to be more effective and suggest future students to study medicine in this system rather than the traditional system is higher. But, the difference was not statistically significant (p > 0.05). There was no significant difference in faculty foreseeing the CP curriculum as the leading method of teaching and learning medical education in the future (p > 0.05).

Response from students on perceived effectiveness of the CP curriculum

The normality test shows that the total score data follows a normal distribution (Shapiro-Wilk, p > 0.05) with a mean value of 50.57 with a standard deviation of 8.17. Therefore, we used a parametric test to compare the test variable with others. We subsequently tested for homogeneity of variance: we used classical ANOVA for equal variance, and Welch ANOVA for unequal variance. Finally, if significant classical ANOVA results were obtained, we used the post-hoc/tukey test.

There were 33 respondents, among which 23 (69.70%) were males, and 10 (30.30%) were females. The age group of respondents was between 20 to 30 years. A significantly higher number (20 i.e., 60.61%) of the respondents recommended studying in a medical school implementing CP curriculum (p < 0.05). No significant differences were seen between educational or geographical backgrounds and scholarship categories (p > 0.05) as shown in Table 2 .

Assessment for knowledge retention of the students

An hourly surprise non-routine written exam was conducted to test the knowledge of the students. A copy of this exam can be found under Extended data. 10 The exam included 50 MCQs from different disciplines of clinical medicine. The surprise test was conducted without prior reminders, and 38 out of 49 students participated. The findings, as outlined in Table 3 , show that 24 out of 38 (65.79%) of the students scored 60% or higher. The results demonstrate that approximately two-thirds of the students passed the surprise test, indicating good test performance.

The current study shows a higher preference for the CP curriculum by undergraduate medical students and faculty at PAHS for teaching and learning clinical medicine in medical school. These findings further substantiate previous reviews on the principles of teaching methods and the acceptability of the curriculum.

This curriculum was chosen in part because of confidence in the comprehensiveness of the knowledge it encompasses. Equally important was the organization of medical knowledge that this curriculum engenders: each clinical presentation is organized according to a variable number of causal diagnostic categories. Each of these categories is identified by a prototype. Exhaustive lists of diagnoses belonging to a given category are avoided. As students' clinical experiences increase and they encounter more diagnoses, the students can add them to the appropriate causal categories stored in their memories. How the diagnostic prototypes are presented allows students to identify the discriminating features within and between each. The process by which students can compare and contrast the distinctive features of each disease is facilitated. It is so because the CP curriculum is well organized and comprehensive. 3 , 7 Since the CP curriculum is simple to follow and to organize the learning content, students in the CP curriculum also reported less stress due to the volume and complexity of study materials and examinations. 7

Prior studies at the University of Calgary demonstrated a substantial effect size on students’ retention of basic science knowledge while participating in the CP curriculum. 8 Our study conducted on clinical clerkship year participants showed that two-thirds of students achieved 60% (passing scores) or more in the surprise non-routine exam, signifying a high retention of clinical discipline knowledge. Findings from the current study expand on the effectiveness of the curriculum across medical school years with respect to knowledge retention.

A study done among medical students utilizing the CP curriculum showed a favorable response to the use of schema in the CP curriculum. 9 In our study, we could not evaluate the use the schemas of CP to perform clinical assessment in order to reach the appropriate diagnosis. We recommend further studies in this respect. Additionally, long-term knowledge retention was not tested in our study, which could be another important area of investigation.

This study has several other limitations as well. The study was conducted at a single institution, thereby potentially reducing the overall generalizability of the findings. The faculty members recruited as participants for assessing the perceived effectiveness of the curriculum were also involved in the adaptation and development of curriculum at PAHS, hence, potentially increasing responder’s bias in the study by some degree. The cross-sectional nature of the study provides only a limited understanding of the effects of the curriculum over the long term.

Based on this study, we can conclude that both faculty and students perceive the CP curriculum system as an effective teaching and learning method in medicine, irrespective of their demographic and positional characteristics. The findings suggest higher knowledge retention in knowledge by implementing the CP curriculum during clinical clerkship years. Since the 1990s, CP Curriculum has been established as a multidimensional teaching-learning method in many medical school systems. In the evolving medical education world with rapid digitization, massive turnover of medical and education data, and increased use of remote learning methods, a deeper understanding of influencing variables will help effectively utilize this highly valued curriculum.

Data availability

Authors' contributions.

SAY, SKJ, AA, and BD conceptualized and designed the study. All 9 authors; SAY, SJ, SP, SG, SB, AA, BD, NB, and SY contributed to data analysis and interpretation. SAY and SP wrote the first draft of the article. All 9 authors, SAY, SP, SG, SJ, SB, AA, BD, NB, and SY critically revised the manuscript and approved the final version of manuscript for publication.

Acknowledgements

We thank Prof. Dr. Kedar Prasad Baral and Prof. (Associate) Shital Bhandary for their immense help during this research. We thank all respondent faculty and medical students of PAHS for participating in the study.

[version 1; peer review: 1 approved

Funding Statement

The author(s) declared that no grants were involved in supporting this work.

Reviewer response for version 1

1 Health Action and Research, Kathmandu, Kathmandu, Nepal

2 International Agency for Research on Cancer, Lyon, France

Dear author(s),

Thank you for your hard work on this research manuscript. Please find my comments/ queries below.

The research article deals with the effectiveness of Clinical Presentation (CP) curriculum in teaching clinical medicine to undergraduate medical students. CP curriculum is yet to be adopted in many low- and middle-income countries. The results show that the medical students and the faculty were satisfied with the CP curriculum and believed CP as a stand-alone method of teaching as well as in conjunction with traditional methods of teaching could benefit medical students.

Study design:

“This is a cross-sectional study that aims to evaluate the efficacy of the CP curriculum in teaching different disciplines of clinical medicine to undergraduate medical students of PAHS, which is currently the only medical school implementing the CP-curriculum in undergraduate medical education.”

  • Is PAHS the only medical school implementing the CP-curriculum in Nepal or worldwide?

Ethics and consent:

“Students who gave verbal consent were asked to complete the questionnaire together in class.”

  • Please elaborate on this sentence.
  • Was any faculty member present in the class?
  • Was the test compulsory or optional?
  • Did the students have the right to refuse the test or leave the test in between?

Data collection:

  • Was the questionnaire in English?
  • How long did the questionnaire take to complete?
  • How much time were the respondents given to complete the questionnaire?
  • What were the minimum and maximum possible scores (total or based on questionnaire sets)?

I hope the comments are useful and would enable the author(s) to strengthen this study.

Is the work clearly and accurately presented and does it cite the current literature?

If applicable, is the statistical analysis and its interpretation appropriate?

Are all the source data underlying the results available to ensure full reproducibility?

Is the study design appropriate and is the work technically sound?

Are the conclusions drawn adequately supported by the results?

Are sufficient details of methods and analysis provided to allow replication by others?

Reviewer Expertise:

Global health, gerontology, cancer

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Jayadevan Sreedharan

1 Department of Community Medicine, Gulf Medical University, Ajman, United Arab Emirates

Title: Effectiveness of Clinical Presentation (CP) Curriculum in teaching clinical medicine to undergraduate medical students: A cross-sectional study.

This study aimed to assess the perceived effectiveness of students and faculty and the level of knowledge among the students trained by the CP curriculum. The authors assume the CP curriculum is not inferior to traditional lecture-based teaching.

Are sufficient details of methods and analysis provided to allow replication by others?: 

It is not clear why the authors have given MCQ to the faculty (their score is given and statistical test done).

If applicable, is the statistical analysis and its interpretation appropriate?:

The authors mentioned in the article that "Classical ANOVA for equal variance and Welch ANOVA for unequal variance were used after testing the homogeneity of variance, and post-hoc/Tukey test was used for significant classical ANOVA results", where they have used this test is not clear in the manuscript.

The p-value is given in exact value; the importance of p-value is to check whether to accept the null or alternate hypothesis. In the methodology, they mentioned that p-value >0.05 is not significant. Then what more information do the readers get if they include the actual p-value? 

The sample size of this study is very small and the conclusion from this study can not be generalised to the entire population. 

The authors mentioned in the conclusion that "The findings suggest higher knowledge retention in knowledge by implementing the CP curriculum during clinical clerkship years" . How the authors reach this conclusion is unclear.

Epidemiology, Biostatistics, Medical education, Public health

Priyanka Panday

1 California Institute of Behavioral Neurosciences & Psychology, Fairfield, CA, USA

This article focuses on the importance of the clinical presentation (CP) curriculum in a particular institute (Patan Academy of Health Sciences (PAHS)) among medical students and faculty in terms of their preference and performance on a surprise non-routine exam. 

  • Cross-sectional study is appropriate as a study design for this article.
  • Relevant articles from 2020, 2019, and 2004 have been appropriately cited as references.
  • The methods used for data collection, as well as the result of the study has been elaborated in detail to ensure accuracy.
  • Results are presented in a tabular form and the conclusion derived coincides with the results indicating the effectiveness of the CP curriculum system as an effective teaching and learning method in medicine.
  • As far as the statistical analysis is concerned, it is not my area of expertise. However, p< 0.05 for response of effective implementation of the CP curriculum and the response from faculty is statistically significant.

I cannot comment. A qualified statistician is required.

Endocrine disorders, Heart conditions, Medications, COVID-19, Obstetric conditions, Epilepsy, HIV, etc.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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New study aims to define the progeria phenome

by Impact Journals LLC

New study: Defining the progeria phenome

Progeroid disorders are a heterogenous group of rare and complex hereditary syndromes presenting with pleiotropic phenotypes associated with normal aging. Due to the large variation in clinical presentation the diseases pose a diagnostic challenge for clinicians which consequently restricts medical research.

In a new study, researcher Cecilie Worm, and others from the University of Copenhagen and Insilico Medicine aimed to accommodate this challenge by compiling a list of known progeroid syndromes and calculating the mean prevalence of their associated phenotypes, defining what they term the " progeria phenome." The work is published in the journal Aging .

"In this study, we have utilized phenome explorations to define the phenotypes associated with progerias and to develop tools to diagnose patients and identify new progeroid syndromes," the authors write.

The data were used to train a support vector machine that is able to classify progerias based on phenotypes. Furthermore, this allowed the researchers to investigate the correlation of progeroid syndromes and syndromes with various pathogenesis using hierarchical clustering algorithms and disease networks.

They detected that ataxia-telangiectasia like disorder 2, spastic paraplegia 49 and Meier-Gorlin syndrome display strong association to progeroid syndromes, thereby implying that the syndromes are previously unrecognized progerias.

"In conclusion, our study has provided tools to evaluate the likelihood of a syndrome or patient being progeroid. This is a considerable step forward in our understanding of what constitutes a premature aging disorder and how to diagnose them," say the researchers.

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COMMENTS

  1. UC San Diego's Practical Guide to Clinical Medicine

    Presentations are the way in which we tell medical stories to one another. When you present, ask yourself if you've described the story in an accurate way. Will the listener be able to "see" the patient the same way that you do? Can they come to the correct conclusions? If not, re-calibrate.

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

    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.

  3. Presentation Skills Toolkit for Medical Students

    Traditional academic presentations in medicine and the biomedical sciences are necessarily dense with complex content. Thus, slides tend to be wordy, and presenters may use their slides as cue cards for themselves rather than as tools to facilitate learning for their audience.

  4. How to Give an Excellent Medical Presentation

    A presentation is about the information shared, but it should also include the presenters' passion, excitement, and personal style. All topics can be formatted to include characters, a description of the setting, plot, conflict, and a resolution. The story should allow the audience to take a journey with you.

  5. 6 Easy Steps to Create an Effective and Engaging Medical Presentation

    Presentations are an effective way of unveiling new findings within scientific communities, training peers and juniors on essential new measures, and advancing your medical career — but there's a great, and not so great, way of doing it.

  6. How to present patient cases

    The purpose of a case presentation is to communicate your diagnostic reasoning to the listener, so that he or she has a clear picture of the patient's condition and further management can be planned accordingly. 2 To give a high quality presentation you need to take a thorough history.

  7. Presentation skills: plan, prepare, phrase, and project

    Equally, candidate presentations are becoming an established feature of selection and assessment for many roles within medicine. Applicants may be asked to prepare and deliver a presentation as part of the interview process for anything from a salaried general practitioner post to a senior consultant post.

  8. 5 keys to help medical students sharpen their presentations

    4 things judges look for in medical poster presentations. Speak clearly: Don't be too quiet or speak in a monotone. Be sure to emphasize the most important parts of your presentation and pause between important points to let the data sink in. Be aware of body language: Smile, maintain an upright but relaxed posture, and avoid tapping your feet ...

  9. The 10-Minute Oral Presentation: What Should I Focus on?

    Little empirical evidence is available in the medical field defining the most important features of a scientific presentation. We sought to empirically identify what features of a scientific oral presentation experienced reviewers focus on when asked to identify the best features and areas to improve.

  10. Effective Presentations in Medical Education

    Available from: The purpose of this article is to introduce effective presentations, which have a set of key qualities: they are appealing, engaging, informative, and concise. Effective presentations gain attention and captivate the audience, but most importantly, they convey information and ideas memorably. Using evidence-based principles in ...

  11. PDF Guidelines for Oral Presentations

    The oral presentation is a critically important skill for medical providers in communicating patient care wither other providers. It differs from a patient write-up in that it is shorter and more focused, providing what the listeners need to know rather than providing a comprehensive history that the write-up provides.

  12. The art of presenting

    The oral case presentation is a time-honoured tradition whereby a trainee presents a new admission to the attending physician. We describe the presentation styles of students, residents and staff physicians and offer pointers on how to present like stereotypical members of each group.

  13. Rowan Medical Libraries Guides: Tools for the Patient Presentation: The

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

  14. How to Prepare an Outstanding Journal Club Presentation

    This component of your presentation will define the success of your journal club. A useful and widely accepted approach to this analysis has been published in JAMA's series "User's guide to the medical literature." The Centre for Health Evidence in Canada has made the complete full-text set of these user's guides available online 4. This site ...

  15. PDF Reviving the medical lecture: practical tips for delivering effective

    Engage your audience in a debate by asking an audience member showing answer A why they did not choose B, and another member answer why they chose A, etc. Everyone is engaged and paying attention. 2. Sharing pauses give the audience time to think and chat about the lecture topic.

  16. Useful Websites

    Useful Websites. Stanford University Medical School : 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.

  17. Effectiveness of Clinical Presentation (CP) Curriculum in teaching

    Clinical presentation (CP) is a relatively new and innovative approach to teaching medicine. CP engages medical students in their understanding of the disease process from clinical feature to diagnosis. ... -sectional study that aims to evaluate the efficacy of the CP curriculum in teaching different disciplines of clinical medicine to ...

  18. Acute medical presentations

    Front Matter. Section 1 Patients and their treatment. Section 2 Background to medicine. Section 3 Cell biology. Section 4 Immunological mechanisms. Section 5 Principles of clinical oncology. Section 6 Old age medicine. Section 7 Pain and palliative care. Section 8 Infectious diseases.

  19. Good Powerpoint Presentation in Medicine

    Blog Good Powerpoint Presentation in Medicine Powerpoint PPT Last modified: Dec 12, 2017 Recommended guidelines for a good medical presentation are: 1. Color: Dark words (black/blue) on light background or vice-versa Color schemes constant throughout the presentation Avoid red-text or lines 2. Font and Text content:

  20. Presentation (medical)

    In medicine, a presentation is the appearance in a patient of illness or disease—or signs or symptoms thereof—before a medical professional. In practice, one usually speaks of a patient as presenting with this or that. Examples include:

  21. Patient Presentations in Emergency Medicine EMRA

    EMRA and CDEM launched " Patient Presentations in Emergency Medicine ," a training video for medical students. Demonstrating how to tell a compelling story when presenting a patient's case, this brief video offers hand do's and don'ts on how to communicate efficiently and effectively in the ED.

  22. Self-presentation in medicine: How language patterns ...

    Altogether, while the prior linguistic concepts and dimensions have not been applied to self-presentation in medicine, there is a rich foundation to expect that they should matter when physicians attempt to manage impressions as well. The first study evaluated the degree to which physicians self-present with such linguistic indicators to infer ...

  23. Free Medical Google Slides themes and PowerPoint templates

    Medical Presentation templates Create medical presentations with a professional design using our Google Slides and PowerPoint backgrounds. Talking about a case report or a breakthrough has never been easier. Health 2946 templates Disease 650 templates Breakthrough 449 templates Medical Center 315 templates Case Report 457 templates Filters Ads Ads

  24. Division of Hematology Presents: "Case Presentation" Grace Lee, MD

    Grace Lee, MD (Asst Prof of Medicine, Div of Hematology) This weekly conference is held each Tuesday from 8-9 a.m. and includes case-based presentations on a wide variety of topics in hematology. In general, discussion will cover inpatient and outpatient problems, with an emphasis on including primary radiographic data, clinical laboratory ...

  25. New study aims to define the progeria phenome

    In a new study, researcher Cecilie Worm, and others from the University of Copenhagen and Insilico Medicine aimed to accommodate this challenge by compiling a list of known progeroid syndromes and ...