Keys to a Successful Presentation

Ben Bryner -- One of the most important skills you develop as a third-year medical student is presenting a patient. After interviewing and examining a patient, you’re expected to summarize or “present” your findings in a systematic way to your supervisor. You’ll do this thousands of times -- presenting to your attending after seeing a patient in clinic, to a resident after seeing a patient in the ER, etc. The presentation takes on the most importance, though, when you present a newly-admitted patient to your team on inpatient rounds. In that setting the presentation is not just a formal opportunity for the team to get on the same page about the care of a patient, but is usually the basis for a teaching opportunity.

A good guide to inpatient presentations can be found on http://www4.umdnj.edu/camlbweb/patient/presentation.html this site, and a guide specifically for presenting a patient in the ER can be found http://www.saem.org/inform/patient.pdf here; you’ll probably get specific instructions from your attendings and residents as well.

Here are my own suggestions. This isn’t a comprehensive guide, just a few lessons I’ve learned -- some of them the hard way:

1. Always present things in the right order. Your presentation is like a five-course meal: Your attending is expecting all the dishes to come out in the right order, and won’t appreciate it if you bring out the main course (the assessment and plan) before the soup (the past medical history). No tip for you!

2. Especially at first, the presentation should be practiced. This isn’t improv night, where you can get up on stage without an idea of what you’re going to say. Since you’ll be evaluated on your presentations, it’s worth putting some time into them. Usually it will be hard to find someone else to practice the presentation with, since everyone is running around before rounds trying to get ready themselves. However, you can usually sit down somewhere quiet and run through the things you’re going to say.

3. Be prepared for interruptions. You’ll often be asked for information out of order; answer the question and then jump back to the point where you were when interrupted (i.e. don’t skip anything just because you were interrupted).

4. Try to stay upbeat and engaging. This is not easy when you’re presenting someone post-call. But presentations are easy to tune out, so avoid delivering it in a monotone.

5. Look at your audience (the team), not a piece of paper. As you’re practicing the presentation in your mind, write down a few key points that you don’t want to forget, and use those as your reference for the presentation. Don’t use your notes from the interview, or your history-and-physical form to deliver your presentation, because you’ll find yourself reading directly off them. (Using one of those to read off lab values or specific quotes from a radiology report is fine, though.) Some attendings value a paper-free presentation more than others; but it’s always more interesting and easier to listen to a mostly-memorized presentation, so work towards that point.

6. Don’t get discouraged. Experienced residents make presentations look easy, but it’s something that takes a lot of practice. When people interrupt, ask you to repeat something, ask you do say something differently, ask you to speed up or slow down, don’t take it as criticism. People have definite preferences on how they like to hear presentations, so adapt to them and change it again on the next rotation as needed. Relax and just pretend you’re telling a story to a friend (but don’t use the word “like” all the time). My point here is that the more relaxed you are, the better your presentation will be.