hey guys dr. decide here from osmosis
I'm the chief medical officer and it's
great to see you guys again I'm excited
today we're gonna talk about something
pretty important to me I say pretty
important actually as I think about it's
it's actually extremely important it's
how people present themselves through
oral communications so how you're
actually sharing a case how you're
describing a patient either to another
physician a nurse
maybe someone in the healthcare team but
also how you think about patients as
well
so I'm gonna give you three tips on how
I think you can do a really stellar job
with your oral presentations as you go
go through your clinical practice so
before I get started I want to remind
you it's really important to me that you
like this video that you also leave a
comment on a tip that you think is
important in terms of how to keep it
good oral presentations my first tip
I've three my first one is set
expectations with the one-liner
again set expectations with your
one-liner so what's the one-liner well
that's like where you basically take an
entire story and try to extract out the
bits that you think are most relevant
per person to to hear so I'm going to
give you some examples the first example
is a three-year-old with cough and fever
for four days and what you want to do
with that one-liner is you want to
provoke some thoughts right so if I say
a three-year-old with cough and fever
for four days what sort of thoughts
should be jumping your head you know for
me as a pediatric infectious disease
doctor I think Oh viral pneumonia that's
the most common thing in a
three-year-old that's had coffin fever
for four days what if I changed it to
three year old with coffin fever for
four weeks
so all I've changes instead of three
days or four days it's four weeks
well now I'm thinking no this is not a
viral pneumonia this is more likely to
be what may be pertussis maybe it's a
turbo Colossus maybe it's a really bad
bacterial pneumonia maybe it's a foreign
body aspiration you know anything like
that would last for much longer and so
again you know just changing that four
days to four weeks really dramatically
changes what I'm thinking and so what
what I want with your one-liner is to
kind of set expectations from the kinds
of things people should be thinking
about in their heads let me give you
another example and this is across time
so instead of like the initial
presentation let's say I give a
one-liner maybe a little bit later so
here's another one a three-year-old with
the right middle lobe pneumonia on
antibiotic day four of seven well now
you say okay this is not some let's just
coming in this is someone that's already
been admitted so they're probably pretty
sick and then they had a right middle
lobe pneumonia so presumably bad a chest
x-ray or chest CT and they're on
antibiotics so we think it's bacterial
and they're on day four of seven so I'm
guessing they may be over the worst of
it maybe the first three days were
really bad and hopefully as I go to see
this patient they're kind of on the mend
maybe getting a little bit better I
would hope maybe still having fevers but
hopefully not as high I would assume I'm
ready to see a patient that's maybe
getting better but was pretty sick now
what about this right a three year old
status post right middle lobe pneumonia
three weeks ago here for follow-up now
that's a different one later I'm
expecting okay this is totally well
should be really happy
I'm guessing their outpatient and I'm
hoping that there are no residual
symptoms left are totally fine back to
school eating well mom thinks that
they're doing great dad thinks that
they're doing great you know that sort
of story so that's what you do it
through one liner again you're that the
first step is set expectations with the
one liner make sure that the person is
thinking what you want them to think in
terms of what the patient is doing
number two present a story now tip
number two for an oral presentation you
want to present a story the first one
was set expectations were through one
liner but then if you're gonna
double-click and someone's like no tell
me the whole story tell me what's going
on present this case then you want to
make sure you tell it as a story meaning
use chronology use time order and make
sure that slows naturally that there's
cause and then effect so I'm gonna give
you a quick example and and I'm not
gonna tell you the diagnosis a 55 year
old man who started noticing
intermittent episodes of knee pains
starting about a year ago the episodes
were happening about every month or so
and each one was excruciating lee
painful making it really hard to sleep
even leaving a bed sheet on the knee
made the pain worse
they were triggered by sitting for long
periods of time and especially when he
was dehydrated and not taking a lot of
water the pain was triggered by certain
foods like eating meat and would improve
when he ate lots of vegetables and
fruits particularly cherries the pain
would last for a few days and would
slowly improve day by day so what does
that diagnosis sound like to you
understanding of this is a story I'm
telling a narrative I'm telling it from
the patient's perspective there are
certain features I'd thrown that right
like it improves with cherries he's
dehydrated
it's excruciating ly painful even having
a bed sheet was really painful so you
really get us a good sense of kind of
the extremity pain that this person is
feeling and that it's happening kind of
recurrently it's in bouts it comes and
it goes lasting a few days at a time but
it's been lasting for about a year so
those are all key pieces to figure out
what's going on but again you want to
tell it as a story you want pieces kind
of jumbled around and out of place
number three this is something I rarely
rarely ever hear but remember the end of
the story so what I mean by that is a
lot of times people tell the story but
then they don't usually take the time to
kind of look it up look up how things
ended so for example how is that patient
doing that was in critical care you know
a month later two months later are they
doing well are they back to school are
they healthy are they happy
are they having ongoing you know
psychiatric problems are they having
ongoing challenges readjusting to to
their life at home what is it like in
terms of stigma maybe it's a patient
that had a a stoma you know is it weird
having that are they having trouble
making friends all those things as a
person readjust to their life back home
as a medical student you oftentimes or
even as a resident think about people
just acutely you know as they get sick
but of course these people reenter
society ranch at their life and in terms
of oral presentations I can't tell you
how valuable it is to me when a med
student or resident says hey you know
what I followed up on that patient that
we discharged a month ago and I just
called him at home and they're doing
really well or I saw them in clinic
again and they actually got readmitted
for whatever you know to me that's the
last part of the story and I know an
oral president
we usually don't think of that we just
say okay what is what's happened what
happened and what's happening now but
but there is a third part of the story
which is the end of the story so I want
you to kind of remember that and and do
due diligence and look that part up
because it'll help you as a physician to
make sure you understand the full arc of
what happens to people and so that the
next patient you see that has you know
that story represented was gout and that
has terrible gout you can say you know
what we had a patient with down a 55
year old man terrible knee pain ended up
in gout and we treated him and he ended
up doing really well actually
long term did very well didn't have any
problems that could be true for you as
well so I really encourage you again the
three the three tips set expectations
with your one-liner present a story when
you're presenting orally and then go
back and look things up and then share
that story with people let people know
all that patient ended up doing really
well or that patient ended up getting
readmitted so that people understand the
end of the story as well and that's
important I'd love to see what comments
and tips you have take care guys bye bye
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