The Oral Case Presentation: What Internal Medicine Clinician–Teachers Expect From Clinical Clerks

Abstract

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.