Quantitative analysis of the outpatient oral case presentation

Abstract

Objective:To measure the content of oral outpatient case presentations and to assess the correlation of objective assessments of this content with subjective ratings provided by the clinic attending physician.

Design:Blinded assessment via audiotape of 36 oral case presentations of new patient evaluations by 23 medical residents.

Setting:Outpatient general medical clinic.

Participants:Duke University Medical Center medical residents during their outpatient rotation.

Measurements and main results:Important deficiencies were found in oral case presentation content. Specifically, psychosocial data were often missing (employment history was mentioned in 28% of presentations; illicit drug use, in 17%; household social structure, in 11%; sexual history, in 6%). An assessment and a plan were mentioned only 56% and 69% of the time, respectively. No correlation was seen between an objective “content score” and the attending physician’s subjective rating of the quality of the presentation (r=0.09).

Conclusions:1) The outpatient case presentation can be quantitatively assessed in a simple, straightforward manner; 2) outpatient case presentations have important deficiencies in content; and 3) preceptors’ evaluations of case presentations may be based upon factors other than content of the presentation.