verbal skills

[VenusinFurs]

Ummmm

So I have gotten the feedback again and again that I need to improve my verbal communication, i.e. that my presentations are not very good. There are many reasons this happens. I sometimes feel intimidated. I sometimes get stumped as to what I am going to say next, particularly when I get to the assessment and plan. Sometimes I just don't know the answer. I have slowly been improving by developing strategies to cope, but the whole feeling of being terrified still hasn't passed and I still stumble every time I have a new attending or I'm on a new service and I feel like it takes me far too long to even begin to find my groove (and even at my best, I'm not the smoothest)

I am at the end of third year! What do I do? I mean, I think I know about as much as everyone else, less than some. But I don't want to be killed in residency, I really don't.

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[OveractiveBrain]

Ummmm

So I have gotten the feedback again and again that I need to improve my verbal communication, i.e. that my presentations are not very good. There are many reasons this happens. I sometimes feel intimidated. I sometimes get stumped as to what I am going to say next, particularly when I get to the assessment and plan. Sometimes I just don't know the answer. I have slowly been improving by developing strategies to cope, but the whole feeling of being terrified still hasn't passed and I still stumble every time I have a new attending or I'm on a new service and I feel like it takes me far too long to even begin to find my groove (and even at my best, I'm not the smoothest)

I am at the end of third year! What do I do? I mean, I think I know about as much as everyone else, less than some. But I don't want to be killed in residency, I really don't.

1. First of all, presentations are about distribution of information. If you don't have the facts, you cant present them. Make sure you have the facts.

2. Any presentation is about telling a story the person wants to hear. That means, make it interesting. Its not about just getting teh information out (THANK THE GODS! I SAID IT!) its about getting the information out so that they actually hear you.

3. Cheat human nature. Make eye contact. Eliminate Uhms and Ahs. Silence is OK while you swallow or breathe. Practice in front of a mirror. Make eye contact with yourself. Do not break it. Focus on your inflections... remember its NOT about getting the information out, its HOW you get it out.

4. Know your diseases (masterful presentations). If you are SOAPing someone with CHF. What actually matters? BP, HR, I/O, Edema, Lung Sounds. Thats it. The fact that the person thought they had to fart but couldn't at 233 am DOESNT belong in your presentation. The fact that the cardiologist said to increase the Lasix to 80 bid does. The fact that the CHFer's neuro exam was STILL CN II-XII intact on day four, doesn't matter. Are you even doing a neuro exam every day? Should you? The art of presentations, beyond #3, is leaving out the shit you dont need.

To review:
1. have data accurately collected and in a manner that is easily accessible
2. tell the information in a manner someone wants to hear it
3. Eye contact, no uhs and uhms, speak with confidence (mirror practice)
4. Leave out the stuff you dont need (advanced skill)

 

[OveractiveBrain]

Ummmm

So I have gotten the feedback again and again that I need to improve my verbal communication, i.e. that my presentations are not very good. There are many reasons this happens. I sometimes feel intimidated. I sometimes get stumped as to what I am going to say next, particularly when I get to the assessment and plan. Sometimes I just don't know the answer. I have slowly been improving by developing strategies to cope, but the whole feeling of being terrified still hasn't passed and I still stumble every time I have a new attending or I'm on a new service and I feel like it takes me far too long to even begin to find my groove (and even at my best, I'm not the smoothest)

I am at the end of third year! What do I do? I mean, I think I know about as much as everyone else, less than some. But I don't want to be killed in residency, I really don't.

Also, when you're carrying 10 patients, and its month 5, and you've been doing it so long your patient log is now 3 moleskins full, I PROMISE it will just naturally improve

 

[235009]

1. First of all, presentations are about distribution of information. If you don't have the facts, you cant present them. Make sure you have the facts.

2. Any presentation is about telling a story the person wants to hear. That means, make it interesting. Its not about just getting teh information out (THANK THE GODS! I SAID IT!) its about getting the information out so that they actually hear you.

3. Cheat human nature. Make eye contact. Eliminate Uhms and Ahs. Silence is OK while you swallow or breathe. Practice in front of a mirror. Make eye contact with yourself. Do not break it. Focus on your inflections... remember its NOT about getting the information out, its HOW you get it out.

4. Know your diseases (masterful presentations). If you are SOAPing someone with CHF. What actually matters? BP, HR, I/O, Edema, Lung Sounds. Thats it. The fact that the person thought they had to fart but couldn't at 233 am DOESNT belong in your presentation. The fact that the cardiologist said to increase the Lasix to 80 bid does. The fact that the CHFer's neuro exam was STILL CN II-XII intact on day four, doesn't matter. Are you even doing a neuro exam every day? Should you? The art of presentations, beyond #3, is leaving out the shit you dont need.

To review:
1. have data accurately collected and in a manner that is easily accessible
2. tell the information in a manner someone wants to hear it
3. Eye contact, no uhs and uhms, speak with confidence (mirror practice)
4. Leave out the stuff you dont need (advanced skill)

i don't completely agree with #2 and 3. i do agree that it has to be organized and tell a story but noone will fault you for using notes you wrote yourself as an MS3 to stay organized and coherent. i found that writing notes helped me a great deal when presenting...it makes sure you dont forget anything and keeps you on track so you're not jumping all over the place with the info.

 

[VenusinFurs]

Thanks, you guys.

I think the practicing in front of the mirror thing is key.

 

[dally1025]

As other people have mentioned- print/photocopy your notes so you can reference it as you present. if you have already written it out it makes it stick so you're not trying to think of what you're going to say next. it takes a little time but if i don't do it i find myself forgetting to say important things and it ends up a disorganized mess. you should never read it off verbatim but just use it as a guide to glance down on occasion.

 

[OveractiveBrain]

As other people have mentioned- print/photocopy your notes so you can reference it as you present. if you have already written it out it makes it stick so you're not trying to think of what you're going to say next. it takes a little time but if i don't do it i find myself forgetting to say important things and it ends up a disorganized mess. you should never read it off verbatim but just use it as a guide to glance down on occasion.

Lets be clear... referencing your note is to look up a particular number, like the blood pressure was high last night, but only once, it got up to..."160 systolic" but the other times it was normal. But I'll tell you, if you're telling a story someone wants to hear, you won't have this issue. You will know the potassium is low, the systolic pressure was a little high, and the edema is better. Thats what you say. What did you need to reference? Nothing. Now, this is negated if its an old timer who doesnt trust you and wants you to read off the labs, but who does that anymore?

Reading your note is painful, and makes your presentation WORSE. You all can disagree all you want. Making eye contact and NOT using your notes makes you look good. Reading your note makes you look unprepared and boring.

As the number of medical students who have originally failed, then gradually succeeded with my aid may attest, I PROMISE I'm right. Promise.

 

[235009]

Lets be clear... referencing your note is to look up a particular number, like the blood pressure was high last night, but only once, it got up to..."160 systolic" but the other times it was normal. But I'll tell you, if you're telling a story someone wants to hear, you won't have this issue. You will know the potassium is low, the systolic pressure was a little high, and the edema is better. Thats what you say. What did you need to reference? Nothing. Now, this is negated if its an old timer who doesnt trust you and wants you to read off the labs, but who does that anymore?

Reading your note is painful, and makes your presentation WORSE. You all can disagree all you want. Making eye contact and NOT using your notes makes you look good. Reading your note makes you look unprepared and boring.

this is excellent advice.......for a fourth year med student or resident ....but terrible advice for a third year who's just starting out. the vast majority of attendings will want a third year to give them data to back up their claims, they may even want blood pressure and hear rate ranges. once they get to know you and trust you more they might allow you to just summarize such things. also it's far better to read your note and tell a coherent story with all the necessary information than be stumbling through a presentation with no notes. putting together a coherent presentation is hard so use whatever method you need to when you're starting out then you can gradually wean away the notes and do it without them. Noone walks in and does what OveractiveBrain is suggesting from day 1 ...you have to work up to it, hence this is pretty crappy advice to give to someone who is struggling with the basics.

 

[KnuxNole]

Also keep in mind that for a 3rd year in their first rotation, has probably never presented a real patient before. And also, different attendings have different styles

Attending A wants you to say vitals are WNL, only pertinent positives on PE, HPI is focused and only mentioning FHx/SoHx if pertinent

Attending B wants to see everything, because "when you're grown up you can get away with it"

Attending C wants a focused History, but wants everything for the vitals, and wants great details on the PE, because they believe "if you don't say no TTP, I don't believe you actually checked his belly".

Attending D wants to know every lab value, how many dogs they own, how often they have sex, what type of sex toys they use, etc.