oral presentation internal medicine

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

Open access
Published: 24 May 2023

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

Brendan Appold 1 ,
Sanjay Saint 1 , 2 ,
David Ratz 2 &
Ashwin Gupta 1 , 2

BMC Medical Education volume 23 , Article number: 377 ( 2023 ) Cite this article

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

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

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

Conclusions

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

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

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

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

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

Overview: comparing EAP to SOAP

Settings and participants

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

Data collection methods and processes

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

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

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

Statistical analyses

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Availability of data and materials

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

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Acknowledgements

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

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Brendan Appold, Sanjay Saint & Ashwin Gupta

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Contributions

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

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Correspondence to Ashwin Gupta .

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

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Competing interests

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

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Supplementary Information

Additional file 1:.

Appendix A. Exemplar Transcripts (EAP, SOAP).

Additional file 2:

Appendix B. Survey Instrument.

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Appold, B., Saint, S., Ratz, D. et al. Comparing oral case presentation formats on internal medicine inpatient rounds: a survey study. BMC Med Educ 23 , 377 (2023). https://doi.org/10.1186/s12909-023-04292-3

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The Oral Case Presentation

Letter to the Editor
Published: 25 April 2022
Volume 38 , page 1076, ( 2023 )

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Andrew P. J. Olson MD 1 ,
Laura Zwaan PhD 2 &
Joseph Rencic MD 3

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Dear Editor,

We read with great interest the paper by Rodin et al. 1 that describes an approach to preparing for oral presentations during clinical education experiences. We applaud the authors’ comprehensive approach and the development of a tool that early learners will find useful in decreasing the non-germane cognitive load of preparing for and then delivering case presentations, which are both a source of significant stress but also an incredibly important learning opportunity.

While we share the authors’ enthusiasm for innovation in this space, we have two suggestions that, if considered, could substantially improve the uptake and potentially the effectiveness of this intervention.

First, it has become clear that the Electronic Health Record (EHR) is “where it happens” in modern health care. Input, searching, retrieval, and provenance of clinical information in the EHR are fundamental processes in which modern learners (and practitioners) must be competent. Thus, this tool and other similar tools may be best developed within the EHR, emphasizing entry, search, and retrieval of information from the highest fidelity and most efficient areas of the EHR possible. While such “external brains” are helpful, teaching health care professionals to harness the power of the EHR is the way of the future, as the authors mention.

Second, we agree that it is important to encourage presenters to prepare a differential diagnosis for each patient using a formal rubric. However, the approach could be improved by adopting evidence-based strategies that have shown to improve diagnostic performance. While the VINDICATE and other systems-based approaches are oft-discussed, the literature supports use of structured reflection tools in improving diagnostic performance of present and future cases . 2 , 3 Structured reflection tools have consistently shown to improve learning and increase diagnostic accuracy in experimental settings using clinical vignettes . 4 , 5 The approach encourages the prioritization and appraisal of potential diagnoses with special attention to features that “don’t” fit rather than developing an exhaustive, non-prioritized list of esoteric diagnoses . 5 Such a strategy could easily be incorporated into the authors’ proposed tool.

Incorporating these evidence-based modifications could improve both student learning and diagnostic performance.

Rodin, R., Rohailla, S. & Detsky, A.S. The Oral Case Presentation: Time for a “Refresh”. J GEN INTERN MED 36, 3852–3856 (2021). https://doi.org/10.1007/s11606-021-06964-6

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Prakash S, Sladek RM, Schuwirth L. Interventions to improve diagnostic decision making: a systematic review and meta-analysis on reflective strategies. Med Teach 2019;41:517–24. https://doi.org/10.1080/0142159X.2018.1497786

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Norman GR, Monteiro SD, Sherbino J, et al. The causes of errors in clinical reasoning: cognitive biases, knowledge deficits, and dual process thinking. Academic Medicine 2017;92:23–30.

Mamede S, Schmidt HG, Penaforte JC. Effects of reflective practice on the accuracy of medical diagnoses. Medical Education 2008;42:468–75. https://doi.org/10.1111/j.1365-2923.2008.03030.x

Mamede S, van Gog T, Sampaio AM, et al. How can students’ diagnostic competence benefit most from practice with clinical cases? The effects of structured reflection on future diagnosis of the same and novel diseases. Academic Medicine 2014;89:121–7. https://doi.org/10.1097/ACM.0000000000000076

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Andrew P. J. Olson MD

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Laura Zwaan PhD

Department of Medicine, Boston University School of Medicine, Boston, MA, USA

Joseph Rencic MD

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Olson, A.P.J., Zwaan, L. & Rencic, J. The Oral Case Presentation. J GEN INTERN MED 38 , 1076 (2023). https://doi.org/10.1007/s11606-022-07611-4

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

1) Know your audience

It is always a good idea to structure your talk so that anyone in the audience can understand what you are presenting. A good scientist should be able to present complex, scientific ideas, no matter how technical, in a simple, easy to follow manner. Complexity is not a necessity, it is an annoyance.

Understand your purpose. This way you can get the point of your talk across appropriately and affectively by catering to your specific audience.

2) Be organized

Whether you are giving a 15 minute talk or a 45 minute talk, make sure you give yourself enough time to deliver all the information you want in a calm manner. Allocate time for questions/answers.
Be able to summarize your presentation in five minutes.
Be concise. Use your space wisely. Use illustrations. Check grammar, spelling, and lay out of each slide.
Keep an outline with you during the presentation; it will help you stay on track.
Prepare back up slides. These will come in handy if a question comes up about a topic that needs further explanation.

3) Presentation

Practice your talk enough so that you have flow, but no so much that you have the entire talk memorized. Memorizing your talk will bore you and your audience, as it will be monotonous.

4) Be professional

Know what you are presenting and be ready to answer question during and after the presentation. Do not answer questions vaguely. A knowledgeable scientist is specific and accurate with his/her information.
Dress up to present with confidence and respect for the audience and the science involved.
Be enthusiastic. Scientific talks can be boring, as often they are full of technical jargon. Be clear and talk simplistically.
Make sure the presentation is visually pleasing. Add pertinent graphics and use fewer words.

5) Be aware of technical problems.

Make sure the format you choose for your presentation is compatible with your style of speech. Also, be prepared for technical disasters just before your talk. Be able to give your talk in another format just in case your first choice (ex: PowerPoint presentation) fails to load.

Significance

Oral presentations are an excellent means of communicating basic science or clinical research. Unlike a poster presentation or a written manuscript, the audience during an oral presentation is more attentive as they are focused on the presenter. For the researcher, this is a rare opportunity to shine! In as few as five minutes, the researcher can convey scientific information and give a years worth work some meaning that can be useful to thousands of people. Of course, this also means that in as little as five minutes, the researcher can cause a great deal of confusion by giving a bad presentation.

Just as is the case with written manuscripts and poster presentations, oral presentations must also communicate research to include all aspects of the scientific method. There are, however, no rules as to what order and which format this should be done in. In order to deliver a successful talk, the presenter should be organized, prepared, and enthusiastic about the research being presented.

Design: A General Guideline

Regardless of whether you choose a PowerPoint presentation or transparencies to deliver your talk, here are some general guidelines to keep in mind when designing your presentation.

1) Title (include authors and affiliations)

2) Introduction (Background, Purpose, Hypothesis)

3) Method (A brief introduction to the methodology without too much technical Jargon)

4) Results (Use graphs/charts/table, Provide an extra slide/transparency with a summary of the results, Explain the results)

5) Conclusions/Discussion (Clear explanation of the results, Clinical implications)

6) Future work (Provide information on where the project is headed)

7) Acknowledgment

Presentation

There some people for whom public speaking is as natural as having a conversation with their friends. Conveniently, however, public speaking is an art that can be perfected with enough practice. Here some things to consider before and during the presentation:

Do not go over the time limit.
Speak clearly and concisely. Be coherent. Do not ramble, play with the pointer, or move around in circles.
Dress appropriately.
Make eye contact.
Make sure that each slide/transparency is not cluttered with too many points and ideas. Graphs, tables, and charts should be clearly labeled and easy to interpret.
Practice your talk, but do not memorize a script.
Be visually and orally interesting.
Answer questions in a calm, non-condescending manner; do not argue with or interrupt the questioner.
Be polite and graceful.
Give a presentation that is focused with one underlying message.

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

Brendan appold.

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

Sanjay Saint

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

Ashwin Gupta

Associated data.

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

Conclusions

Supplementary Information

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

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Overview: comparing EAP to SOAP

Settings and participants

Data collection methods and processes

Statistical analyses

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

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

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

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

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

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

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

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

Themes related to format preference

Acknowledgements

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

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Oral presentation resources, oral podium presentations.

If your abstract has been selected for an oral podium presentation at a local, regional or national meeting, the research chief resident and program director can offer you guidance to create your slides and prepare for your presentation. **We recommend that you practice giving your presentation to colleagues and chief residents for feedback well before the conference!** For all work done at GW, you should include the GW logo on your presentation.

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The following links discuss tips on presentation skills. Some of them are not from the science world, but they all provide insights on the elements that make a presentation bad, good, or great. You will also find them useful for other presentation situations: Chairman's Rounds, M&M, CPC, etc.

The real entertainment gimmick is the excitement, drama and mystery of the subject matter. People love to learn something, they are "entertained" enormously by being allowed to understand a little bit of something they never understood before. One must have faith in the subject and in people's interest in it. Otherwise just use a Western to sell telephones! The faith in the value of the subject matter must be sincere and show through clearly. All gimmicks, etc. should be subservient to this. They should help in explaining and describing the subject, and not in entertaining. Entertaininment will be an automatic byproduct."

- Richard Feynman , Letter to Mr. Ralph Brown, Advisory Board in Connection with Programs on Science (in Perfectly Reasonable Deviations from the Beaten Track)

The oral case presentation: what internal medicine clinician-teachers expect from clinical clerks

Affiliation.

1 Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA. [email protected]
PMID: 21240785
DOI: 10.1080/10401334.2011.536894

Background: The oral case presentation (OCP) is a fundamental communication skill that frequently is taught as part of internal medicine clerkships. However, little is known about the optimal content for an OCP.

Purpose: We hypothesized that internal medicine clinician-teachers have common expectations regarding OCPs by 3rd-year medical students.

Methods: We administered a 42-item survey to 136 internal medicine faculty members at 5 U.S. medical schools who spent at least 8 weeks as "ward attending" in the 2005-6 academic year, or spent at least 4 weeks as a "ward attending" and had an administrative role in medical education. We asked about the relative importance of 14 potential attributes in a 3rd-year medical student OCP using a 6-point Likert scale. We also asked about their expectations for the length of a new patient presentation. Mean responses from the 5 schools were compared using chi-squared, analysis of variance (ANOVA), and t testing, as appropriate.

Results: We received 106 responses (78% response rate). Of our respondents, 45% were hospitalists and 80% self-identified as "clinician-educators." Some aspects of the OCP were rated as more important than others (p<.001) Six items, including aspects of the history of present illness, organization, and structuring the presentation to "make a case" were rated as important or very important by more than 70% of respondents. Fewer than 10% of respondents believed that inclusion of a complete review of systems or detailed family history were important. Few differences were seen between institutions. Faculty expected that OCPs should take 9.9±5.4 min, with faculty at one institution having significantly different expectations than all others (15.9±6.4 min vs. 7.8±2.8, p<.001).

Conclusions: Internal medicine clinician teachers from 5 U.S. medical schools share common expectations for OCPs.

Analysis of Variance
Chi-Square Distribution
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R. Aggarwal 1 ,
C. Charles-Schoeman 2 ,
J. Schessl 3 ,
Z. Bata-Csorgo 4 ,
M. Dimachkie 5 ,
Z. Griger 6 ,
S. Moiseev 7 ,
C. V. Oddis 8 ,
E. Schiopu 9 ,
J. Vencovský 10 ,
I. Beckmann 11 ,
T. Levine 12 ,
E. Clodi 13 ,
A. T. Proderm Investigators 14
1 University of Pittsburgh, Rheumatology, Pittsburgh, United States of America
2 UCLA Health, Rheumatology, Los Angeles, United States of America
3 Friedrich Baur Institute, University of Munich, Neurology, Munich, Germany
4 University of Szeged, Faculty of Medicine, Dermatology, Szeged, Hungary
5 Univeristy of Kansas, Medical Center, Neurology, Kansas City, United States of America
6 University of Debrecen, Department of Internal Medicine, Debrecen, Hungary
7 First Moscow State Medical University, Department of Internal Medicine, Moscow, Russian Federation
8 University of Pittsburgh, Rheumatology, Piitsburgh, United States of America
9 Michigan Medicine, Rheumatology, Ann Arbor, United States of America
10 Charles University, Rheumatology, Prague, Czech Republic
11 Octapharma PPG, Clinical R&D, Vienna, Austria
12 Phoenix Neurological Associates, Neurology, Phoenix, United States of America
13 Octapharma PPG, Global Medical & Scientific Affairs, Vienna, Austria
14 Hospitals in different countries worldwide, Rheumatology-Dermatology-Neurology, Vienna, Austria

Background: Dermatomyositis (DM) is a rare chronic systemic autoimmune disease with characteristic skin rash and progressive proximal muscle weakness. Current therapies encompass corticosteroids and other immunosuppressants and intravenous immunoglobulins (IVIg), however, none of these therapies are proven by randomized controlled phase 3 studies. There have been no large randomized clinical trials supporting the efficacy and safety of IVIg in DM.

Objectives: The ProDERM study aimed to evaluate the efficacy and safety/tolerability of IVIg in DM patients in a double-blind, randomized, placebo-controlled, international multi-center, phase III clinical trial.

Methods: The trial consisted of a double-blind, placebo-controlled First Period (16 weeks), in which adult patients with definite or probable DM (according to Bohan and Peter criteria) were randomized 1:1 to either high dose IVIg (2g/kg every 4 weeks) or placebo. Patients on placebo and patients without clinical worsening while on IVIg treatment entered the open label Extension Period (24 weeks) and received 2g/kg IVIg infusions every 4 weeks. To be included, subjects must have active disease with a manual muscle testing-8 (MMT-8) score < 142/150. Patients who showed clinical worsening (defined according to Oddis et al, 2013 - with slight adaptation) at 2 consecutive visits between week 8 and week 16 were switched to the alternate treatment arm.

Primary endpoint was the proportion of responders in the IVIg vs. placebo arm at week 16, where response was defined per 2016 ACR/EULAR Myositis response criteria of at least minimal improvement [Total Improvement Score (TIS) ≥ 20 points)] and without clinical worsening at 2 consecutive visits up to week 16.

Results: A total of 95 adult DM patients (mean age: 53 years; 75% females; 92% Caucasian) were enrolled, with 47 and 48 randomized to IVIg and placebo, respectively. Baseline clinical characteristics (including medical history and prior DM medication) were balanced between the 2 arms.

The study met the primary endpoint at week 16, with the proportion of responders being significantly higher in the IVIg group (37/47; 78.7%) as compared to the placebo group (21/48; 43.8%; p-value 0.0008; Table 1 ).

View inline

Total Improvement Score – Analysis of Proportion of Responders at Week 16 (Full Analysis Set, N=95)

In the analysis of responders per improvement category at Week 16, a 45.2% higher response rate for at least moderate improvement (TIS ≥n40 points; p < 0.0001) and a 23.6% higher response rate for at least major improvement (TIS ≥060 points; p < 0.0062) was observed in the IVIG group as compared to the placebo group.

The mean (SD) TIS was significantly higher in IVIg group [48.4 (24.4)] than in placebo arm [21.6 (20.2)] at week 16 ( Fig 1 ).

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After switching to IVIG in the Extension Period the placebo group attained a similar response rate at Week 40 as did the IVIg treated patients at Week 16, i.e approx. 70% for minimal improvement.

In line with the overall primary endpoint, secondary end points including all of the sub-components of TIS except muscle enzyme (MMT-8, MD global, Extramuscular global, patient global, HAQ,) as well as CDASI (Cutaneous Dermatomyositis Disease Area and Severity Index), also showed statistically significant improvement under IVIg treatment compared to placebo treatment.

The safety and tolerability profile of IVIg was consistent with previously reported safety outcomes for IVIg administration.

Conclusion: This is the first large international phase III randomized, placebo-controlled trial demonstrating the efficacy and safety of IVIg as a treatment for patients with DM.

References: [1]Oddis, C. V. et al. Arthritis Rheum (2013), 65, 314–324

Acknowledgements: Acknowledgments to all participating investigators, centers and patients and their families

Disclosure of Interests: Rohit Aggarwal Consultant of: Q32, Alexion, Argenx, AstraZeneca, BMS, Boehringer Ingelheim, Corbus, Csl Behring, EMD Serono, Janssen, Kezar, Mallinckrodt, Kyverna, Octapharma, Orphazyme, Pfizer., Grant/research support from: BMS, Mallinckrodt, Pfizer, EMD Serono, Christina Charles-Schoeman Consultant of: Pfizer, Abbvie, Octapharma, Gilead, Regeneron-Sanofi, Grant/research support from: Bristol Myers Squibb, Pfizer, Abbvie, Octapharma, Joachim Schessl Speakers bureau: Octapharma, Grifols, CSL Behring, Consultant of: Octapharma, Zsuzsanna Bata-Csorgo Speakers bureau: Novartis, Sanofi-Genzyme, Ewopharma, Consultant of: Sanofi-Genzyme, Novartis, Ewopharma, Mazen Dimachkie Consultant of: ArgenX, Catalyst, Cello, CSL-Behring, EcoR1, Kezar, Momenta, NuFactor, Octapharma, RaPharma/UCB, RMS Medical, Sanofi Genzyme, Shire Takeda, Spark Therapeutics and UCB Biopharma., Grant/research support from: Alexion, Alnylam Pharmaceuticals, Amicus, Biomarin, Bristol-Myers Squibb, Catalyst, Corbus, CSL-Behring, GlaxoSmithKline, Genentech, Grifols, Kezar, Mitsubishi Tanabe Pharma, Novartis, Octapharma, Orphazyme, Ra Pharma/UCB, Sanofi Genzyme, Sarepta Therapeutics, Shire Takeda, Spark Therapeutics, UCB Biopharma, Viromed/Healixmith., Zoltán Griger Speakers bureau: Abbvie, CSL-Behring, Eli-Lilly, Roche, Boehringer Ingelheim, Consultant of: Octapharma, Sergey Moiseev: None declared, Chester V Oddis Consultant of: EMD Serono; Alexion Pharmaceuticals, Inc, Grant/research support from: Genentech (Clinical trial support); Bristol Myers Squibb (Clinical trial support), Elena Schiopu Consultant of: Octapharma, Grant/research support from: Octapharma, Janssen (Johnson & Johnson), BMS, Pfizer, Abbvie, Jirˇí Vencovský Speakers bureau: Abbvie, Biogen, MSD, Pfizer, Roche, Sanofi, UCB, Consultant of: Abbvie, Boehringer, Eli Lilly, Octapharma, Gilead, Irene Beckmann Employee of: Octapharma, Todd Levine Shareholder of: Corinthian Reference Labs, CND Life Sciences, Consultant of: Grifols, Octapharma, Alexion, Elisabeth Clodi Employee of: Octapharma PPG, Vienna Austria, and the ProDERM Investigators: None declared

https://doi.org/10.1136/annrheumdis-2021-eular.1389

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Dear colleagues, The organizing committee of ECIM-2015 is proud to announce that the Congress have been successfully finished. The report from the congress can be found here . We would like to thank all the speakers and participants for the active participation. It was a great pleasure to welcome all of you in Russia and we hope to see you in Moscow again.

Dear Colleagues, We are pleased to inform you that the 14th European Congress of Internal Medicine was granted with up to 13 European CME credits (ECMEC) by the European Accreditation Council for Continuing Medical Education (EACCME).

President of European Federation of Internal Medicine (EFIM) Frank Bosch

Dear Colleagues!

It’s a great pleasure and honor for us to invite all professionals and young internists to the 14-th European Congress of Internal Medicine (ECIM). It will take place in Moscow, Russia, October 14-16, 2015. ECIM-2015 is a scientific Congress during which a lot of new research is being presented and discussed among scientists and practitioners from all over Europe and many other countries of the World. We are delighted to welcome you to Moscow, one of the most beautiful cities in the world. The Russian Scientific Medical Society of Internal Medicine (RSMSIM) was established more than 100 years ago to bring together leading national experts in the field of internal medicine. Since its foundation, the Society of Internal Medicine considers that its main purpose is the continuous professional education of medical practitioners in our country.

The European Federation of Internal Medicine (EFIM) was created in 1996 and represents all the internists (around 30.000) in Europe. In this congress a wide range of topics relevant to Internists will be presented and discussed. The learning formats will be diverse and will include clinical symposia, updates in various specialties of medicine, keynote lectures, oral presentations and poster sessions We are planning an exciting Congress that is not to be missed and hope that you will make definitive plans to participate. Your contribution is important for us. We are looking forward to meet you in Moscow.

Finally, this will be a great opportunity to meet general internists from all over Europe, and share the joys and preoccupations of our fantastic discipline, which is still at the very core of clinical medicine.

President EFIM Frank Bosch Interview

President of Russian Scientific Medical Society of Internal Medicine Anatoly Martynov

It’s a great pleasure and honour for us to invite all professionals and young internists to the 14-th European Congress of Internal Medicine (ECIM). It will take place in Moscow, Russia, October, 14-16, 2015. ECIM-2015 is a scientific Congress during which a lot of new research is being presented and discussed among scientists and practitioners from all Europe and many other countries of the World. We are delighted to welcome you to Moscow, one of the most beautiful cities in the world.

The Russian Scientific Medical Society of Internal Medicine (RSMSIM) was established more than 100 years ago to bring together leading national experts in the field of internal medicine. Since foundation, the Society of Internal Medicine considers that its main purpose is the continuous professional education of medical practitioners in our country.

You must admit that this problem is not easy to be solved. Internal medicine is a huge, almost infinite information field. It is really hard, especially for our young colleagues, to be aware of all important and new achievements concerning this topic. That’s why we are always striving to help them.

We will do our best to make the program of the Congress be interesting, and first of all, useful for all professionals in the field of internal medicine. There are some scheduled reports on a wide range of issues with which you might face in their clinical practice. We are planning an exciting Congress that is not to be missed and hope that you will make definitive plans to participate it. Your contribution is important for us, and all submissions are handled via our homepage.

We are looking forward to meet you in Moscow. Hope we will have an unforgettable Congress in 2015 all together, and we are eager to meet you in the wonderful city of Moscow!

President RSMSIM Anatoly Martynov Interview

Dobro pozhalovat’! Welcome!

Graduate School

Fyodor d. urnov: pioneering gene editing for medical breakthroughs.

A trailblazer in the field of therapeutic genome editing, Fyodor D. Urnov’s research focuses on developing medicines for devastating genetic diseases.

Fyodor Urnov image in front of a staircase

Fyodor D. Urnov ‘96 Ph.D. is Professor of Molecular Therapeutics in the Department of Molecular and Cell Biology at the University of California, Berkeley and Director of Technology and Translation at the Innovative Genomics Institute (IGI). He co-developed the toolbox for human genome and epigenome editing, co-named the term “genome editing”, and was on the team to advance the first-in-human applications in a clinic.

Urnov also helped identify the genome editing target for the first medicine approved to treat sickle cell disease and beta-thalassemia. A major goal for the field of genome editing and a key focus of Urnov's work is expanding access to CRISPR therapies (which modify genomes) for genetic diseases to those most in need.

He will receive the Horace Mann Medal at the Doctoral Ceremony during Brown University’s Commencement weekend.

Prior to attending Brown, Urnov completed his undergraduate studies in biology at Moscow State University in Russia. He then joined the Molecular and Cell Biology and Biochemistry (MCB) department at Brown where he earned his doctoral degree. His dissertation work focused on the DNA structure and chromatin dynamics of one of the scarce origins of replication that are thoroughly understood, initiating DNA synthesis prior to cellular division. He worked in the lab of Susan Gerbi, the George Eggleston Professor of Biochemistry and founding chair of the MCB department.

Urnov credits his pioneering work on gene editing to the doctoral training he received at Brown. Urnov then completed postdoctoral training at the National Institutes of Health before joining Sangamo BioSciences, a biotech firm in the San Francisco bay area as a Senior Scientist and Team Leader.

At every stage of his career, Urnov’s exceptional work has been marked by medical breakthroughs and awards. One of the most groundbreaking biological advancements in recent years involves the ability to safely and precisely modify DNA sequences within genes - gene editing. This innovation began with the development of proteins designed to selectively bind to specific DNA sequences and enact targeted alterations. These proteins, known as "zinc-finger nucleases" or ZFNs, have paved the way for transformative research in genetic engineering.

In 2005 at Sangamo, Urnov spearheaded a pivotal study showcasing the efficacy of ZFNs to precisely target a disease-causing sequence in the genome and correct it. The study was published in the journal Nature. The field of therapeutic genome editing, which Urnov co-named, was thus born. This paper marked the inaugural instance of mutation correction in human cells. The study demonstrated remarkably efficient repair (i.e. editing) of a mutated gene linked to severe combined immune deficiency, underscoring the potential of gene editing technology in addressing genetic disorders - potential that has recently started to be realized.

After this initial publication, interest in using gene editing technology exploded. Stuart Orkin, the David G. Nathan Distinguished Professor of Pediatrics at Harvard Medical School and Investigator at the Howard Hughes Medical Institute collaborated with Urnov to use gene editing to cure sickle cell disease (SCD) and beta-thalassemia (both inherited blood disorders), ushering in the first CRISPR gene editing clinical trial for a genetic disease, treating both SCD and thalassemia patients. In both of these inherited diseases, the gene for making beta-hemoglobin is disrupted.

“Fyodor Urnov has been a visionary in the field of gene manipulation and editing, and is widely recognized both for his scientific contributions and his remarkable skill in communicating the work to other scientists and the public,” shares Orkin.

The outcome of the clinical trials have thus far been transformative for the around 100 patients involved; all have been symptom-free after gene editing. Based on these results the FDA has approved this approach as the first-ever gene-editing based medicine - a medicine for which a key foundation was the work Urnov did in collaboration with Orkin.

Urnov’s other collaborations at Sangamo led to the deployment of genome editing in human pluripotent stem cells (hPSCs) for basic science and translational applications. Examples include applied gene editing to Down syndrome and in vivo therapeutics for Huntington’s disease and Alzheimer’s dementia.

In 2019 Urnov moved to the University of California, Berkeley, where he took on the challenge of building CRISPR Cures research and development teams for genetic diseases of the blood and the brain, genetic disorders of the immune system, radiation injury, cystic fibrosis, and neurological disorders.

Urnov explains gene editing technology in a New York Times article from December of 2022.

“Gene editing relies on a molecular machine called CRISPR, which can be instructed to repair a mutation in a gene in nearly any organism, right where that “typo” occurs. Impressively versatile, potential applications for CRISPR range from basic science to agriculture and climate change. In medicine, CRISPR gene editing allows physicians to directly fix typos in the patients’ DNA. And so much substantive progress has been made in the field of genetic medicine that it’s clear scientists have now delivered on a remarkable dream: word-processor-like control over DNA.”

As Urnov explains in this piece, a wealth of regulatory hurdles and healthcare economics challenges have, to date, prevented gene editing from making a greater impact. Urnov shares, “the invention of CRISPR gene editing gave us remarkable treatment powers, yet no one should do a victory lap. Scientists can rewrite a person’s DNA on demand. But now what? Unless things change dramatically, the millions of people CRISPR could save will never benefit from it. We must, and we can, build a world with CRISPR for all.”

An effort to bring us closer to that world is now the centerpiece of Urnov’s professional life. His work currently focuses on developing scalable, affordable platforms to engineer gene editing cures on-demand for severe disorders of childhood. Urnov directs a unique academia-industry partnership, the IGI-Danaher Beacon for CRISPR Cures, that is advancing to the clinic innovative treatments for inborn errors of immunity that cause severe diseases of infancy.

Urnov has made an impact at UC Berkeley and IGI beyond his research. As the Covid-19 pandemic commenced, he assumed the task of organizing resources to set up a nonprofit diagnostic clinical laboratory at IGI for swift testing of the SARS-CoV-2 coronavirus. The objective was to offer greater throughput, faster results, and enhanced accuracy compared to existing commercial options - and provide such testing for free to communities most in need.

As described in Walter Isaacson’s best selling book, The Codebreaker , Urnov emerged as a pivotal figure in this initiative, playing a significant role in resource mobilization encompassing equipment, personnel, and funding - and ultimately providing over 500,000 free COVID tests to individuals in socioeconomically disadvantaged communities when for-profit testing laboratories failed at the task.

Not only is Urnov renowned in the field of gene editing, but his list of publications, teaching ability, and public speaking acumen is also exceptional. Urnov has authored more than 100 scientific publications and is an inventor on 87 published patents related to genome editing and targeted gene regulation technology. His 2005 Nature paper has been cited over 2000 times, and a subsequent paper he wrote for Nature Reviews Genetics has been cited over 2500 times. Many of his other papers have been cited over 1000 times.

“Fyodor is a world class researcher at the forefront of arguably the most exciting and important biomedical research advance in our lifetimes – genome editing – because he is perhaps the most engaging orator I have ever heard speak, because he is a scholar of truly extraordinary depth and breadth of knowledge in biomedicine, and because he is a dedicated and highly effective teacher and mentor,“ shares David Drubin, Ernette Comby Chair in Microbiology and a professor of Cell and Development in the Department of Molecular and Cell Biology at UC Berkeley.

Urnov is also known for being a dynamic public speaker and teacher and is much sought after. Urnov credits his experience as a graduate student instructor here at Brown for his interest in teaching, starting with watching faculty at Brown, including George Eggleston Professor of Biochemistry, Susan Gerbi and Professor of Molecular Biology, Cell Biology and Biochemistry Kenneth Miller, in his first stint as a graduate student instructor.

Urnov’s awards, not surprisingly, are quite notable. As far back as his time at Brown he was selected for the Barry J. Rosen Memorial Award For High Achievement In Molecular Biology and the President’s Award for Excellence in Teaching.

In 2014 he was named as one of “The World’s Most Influential Scientific Minds” by Thomson Reuters and received a Fellows Award for Research Excellence from the National Institutes of Health.

COMMENTS

UC San Diego's Practical Guide to Clinical Medicine
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.
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.
How To Present a Patient: A Step-To-Step Guide
You should begin every oral presentation with a brief one-liner that contains the patient's name, age, relevant past medical history, and chief complaint. ... (2-3 minutes), while pediatric and family medicine presentations tend to be similar in length to internal medicine presentations. Tailor your presentations accordingly.
PDF Oral Case Presentation
Oral Case Presentation Guidelines for 3rd year Medicine Clerkship. A. Purpose of case presentation - to concisely summarize 4 parts of your patient's presentation: (1) history, (2) physical examination, (3) laboratory results, and (4) your understanding of these findings (i.e., clinical reasoning). The oral case presentation is a story that ...
The Oral Case Presentation: Time for a "Refresh"
Abstract. Despite enormous changes in medicine over the last 50 years, the oral presentation of newly admitted patients remains a core activity in academic teaching hospitals. With increased pace and complexity of care, it is time to refresh this tradition, as its efficiency and utility in contemporary practice are open to question.
Evaluating Oral Case Presentations Using a Checklist
Oral communication between physicians plays a vital role in patient care. 1, 2 The oral case presentation (OCP) is a common vehicle for such communication, and its importance has been recognized by the Clerkship Directors in Internal Medicine, 3, 4 the Association of American Medical Colleges, 5 and the Accreditation Council for Graduate Medical Education. 6 The published literature, however ...
Overshadowed by Assessment: Understanding Trainee and Superv
The oral case presentation (OCP) is an essential part of daily clinical practice in internal medicine (IM) and a key competency in medical education. It is not known how supervisors and trainees perceive OCPs in workplace-based learning and assessment.
Developing Oral Case Presentation Skills: Peer and Self-Evaluations as
Oral case presentation is an essential skill in clinical practice that is decidedly varied and understudied in teaching curricula. We developed a curriculum to improve oral case presentation skills in medical students. As part of an internal medicine clerkship, students receive instruction in the elements of a good oral case presentation and ...
Comparing oral case presentation formats on internal medicine inpatient
Background Oral case presentations - structured verbal reports of clinical cases - are fundamental to patient care and learner education. Despite their continued importance in a modernized medical landscape, their structure has remained largely unchanged since the 1960s, based on the traditional Subjective, Objective, Assessment, Plan (SOAP) format developed for medical records. We ...
Learning Oral Presentation Skills
Oral presentation skills are central to physician-physician communication, but little is known about how these skills are learned. ... Twelve third-year students on their internal medicine clerkship at the University of California, San Francisco (UCSF)/San Francisco General Hospital and 14 teachers (8 residents and 6 attendings) were observed ...
The Oral Case Presentation: What Internal Medicine Clinician-Teachers
Background: The oral case presentation (OCP) is a fundamental communication skill that frequently is taught as part of internal medicine clerkships.However, little is known about the optimal content for an OCP. Purpose: We hypothesized that internal medicine clinician-teachers have common expectations regarding OCPs by 3rd-year medical students. ...
The Oral Case Presentation
Journal of General Internal Medicine Aims and scope Submit manuscript ... We read with great interest the paper by Rodin et al. 1 that describes an approach to preparing for oral presentations during clinical education experiences. We applaud the authors' comprehensive approach and the development of a tool that early learners will find ...
(PDF) The Oral Case Presentation: What Internal Medicine Clinician
The oral case presentation (OCP) is a fundamental communication skill that frequently is taught as part of internal medicine clerkships. However, little is known about the optimal content for an OCP.
The Oral Case Presentation: What Internal Medicine Clinician-Teachers
Internal medicine clinician teachers from 5 U.S. medical schools share common expectations regarding OCPs by 3rd-year medical students, including aspects of the history of present illness, organization, and structuring the presentation to "make a case. Background: The oral case presentation (OCP) is a fundamental communication skill that frequently is taught as part of internal medicine ...
Oral Presentations
Oral Presentations: Tips, Significance, Design, Guidelines & Presentation. Tips. 1) Know your audience. what you are presenting. A good scientist should be able to present complex, scientific ideas, no matter how technical, in a simple, easy to follow manner. Complexity is not a necessity, it is an annoyance. Understand your purpose.
Full article: The oral case presentation: toward a performance-based
Green EH . From SOAPS to SAFER: a model for teaching and evaluating oral case presentations. Paper adapted from a workshop conducted at the Society for General Internal Medicine (2004, 2005) and Clerkship Directors of Internal Medicine (2004). 2006.
Comparing oral case presentation formats on internal medicine inpatient
An anonymous, electronic survey (Qualtrics, Provo, UT) was created to assess student and resident experience with and preference between EAP and SOAP oral case presentation formats during inpatient internal medicine rounds (Additional file 2: Appendix B). Ten domains were assessed via 5-point Likert scale (1 [strongly disagree] to 5 [strongly ...
Oral Presentation Resources
Oral podium presentations. If your abstract has been selected for an oral podium presentation at a local, regional or national meeting, the research chief resident and program director can offer you guidance to create your slides and prepare for your presentation. **We recommend that you practice giving your presentation to colleagues and chief ...
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Overview and General Information about Oral Presentation

Specific types of presentations

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

The Brand New Patient (admitted by you)

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

Outpatient-based presentations

The Brand New Primary Care Patient

The Follow-up Visit to a Primary Care Clinic

The Focused Visit to a Primary Care Clinic

The Specialty Clinic Visit

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

Conclusions

Settings and participants

Data collection methods and processes

Statistical analyses

Availability of data and materials

Acknowledgements

Author information

Contributions

Corresponding author

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Consent for publication

Competing interests

Additional information

Supplementary Information

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BMC Medical Education

The Oral Case Presentation

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

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

Sanjay Saint

Ashwin Gupta

Conclusions

Supplementary Information

Settings and participants

Data collection methods and processes

Statistical analyses

Acknowledgements

Authors’ contributions

Availability of data and materials

The Internal Medicine Current Residents

The oral case presentation: what internal medicine clinician-teachers expect from clinical clerks

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