Tip to improve my presentations skills?

[My Name is Blakeeee]

Background information: when I presented, I stuck to what the patient came in with, what onset/duration to the c/o and associated symptoms such as type of pain/pain level and quality of the wound etc.., family & social hx if it was aligned with his visit, also mentioned any pertinent medications

So as the title states, what are some ways to become an efficient presenter to the attending on the floor? It was my first time a few weeks ago at a clinic run by students, and though the physician and who I was paired up with may have been nice about it, I know I was terrible, but I do want to improve before it starts counting against me/being graded for it.

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[Skarl]

Write out a script for your presentations and practice it over and over until you don't need to look down as much. In general, speak with confidence and quickly. I feel it's akin to a performance in many ways.

You'll get more of a hang about what to include/focus more on with clinical knowledge and more presentations. By choosing to focus on certain things over others you are signaling to the attending/team your clinical knowledge and reasoning.

 

[GoSpursGo]

Follow SOAP.

S=subjective, HPI including major comorbidities in the first line. PMH, past surgical, FH, Social.
O=vitals and exams
A=assessment
P=plan

The sweet spot is only including whatever is "pertinent." The problem is that medical students don't know what is and isn't pertinent, so they default to including everything. That is expected, and the only way to improve is to practice. This is why they are having you practice before you're getting graded for it.

Don't sweat it. Everyone was terrible once.

 

[123OkayGoogle]

Write it out and read from it lol. Maybe highlight or star the pertinent things you want to mention. But make eye contact every now and then as you read. Could even run thru important things with resident before presenting to attending

 

[cj_cregg]

Nobody here can give you better advice than a resident or attending you're working with who's willing to give you specific and detailed feedback on what you're doing well and what can be improved. Agree with the above advice that medical students are generally expected to provide very detailed presentations, because you're not expected to know what's relevant and what's not. Once I get to know a med student, their level of knowledge, and their trustworthiness in some cases lol, I'll start telling them they can pare down the physical exam to the abnormal things, etc.

 

[AlteredScale]

It depends on the context (surgical vs IM, hospitalist medicine vs MICU vs consultant). What I end up telling all the medical students is to really focus on the one liner. That needs to succinctly address pertinent PMHx, when they were admitted, what they were admitted for, and their hospital course (if consultant, restate the reason for consult). It will not only show that you have a comprehensive understanding of what's going on, but will remind you of where to lead off.

subjective: overnight events, then how they feel based on their main problem. So if admitted for CHF I want to know how they're breathing, how they're peeing. If its for GI bleed I want to know how their BMs have looked, if they got more blood. If its for cirrhosis I wanna know if they are confused or if they had their lactulose BMs.

objective: vitals. Ins and outs. labs and imaging. Labs should have a comparison if needed ("Cr is 0.9 from 1.4 yesterday, near their baseline). Do not interpret the labs here (no "has hyperbilirubinemia maybe from obstruction")

The assessment and plan should be ordered by big problems (CHF, DKA, Cellulitis) with a good amount of time spend describing their course, if they've responded to treatment, and what you want to do. Then other problems should be addressed succinctly (problem x is AF, PTA eliquis is held for ongoing GIB).

 

[deleted1065184]

Nobody here can give you better advice than a resident or attending you're working with who's willing to give you specific and detailed feedback on what you're doing well and what can be improved.

This is the comment I was looking for. Everybody else's advice is great too, but this is truly what has made a world of difference for me. I prefer asking the resident to the attending, partially because it impresses the atyendings more hehe.

I always ask the most senior resident how the attending on service likes presentations to go wrt order, flow, level of information detail, and depth of assessment & plan. It has single-handedly made the difference for me. SOAP is def the default, but there's so much variation within that and it also changes some depending on what type of service you're on. For example, when you're on a consult service, early on in the presentation it's best to explicitly state what your service is being consulted for. You don't bury the lede, you want the attending to be thinking about potential causes for the presentation from the beginning.

Also, attending preferences vary significantly. Last week, my attending was very much a "give me the bare bones, most necessary stuff" kinda person who'd ask clarifying details as needed. For him, explaining the story in a very logical, yet concise (within reason, some stories are complex) story was gold. For others, they want to hear it all and a very detailed assessment and plan, down to "NPO @ midnight for 6 am MRI".

The best way to know up front is to just ask the residents.

 

[My Name is Blakeeee]

Thanks, everyone, I will do my best to incorporate all the advice given and find the sweet spot of presenting!