Nil of Note
For the past 6 weeks, all rcsi’s third med students are attached to
clinical teams in Beaumont or Connoly Hospital.. i’ve attached to
infectious disease team, surgical team, and endocrinology team, and
i’ve met with so many senior doctors and patients.. the main essence in
this clinical attachment is to take history from the patients and then
to present it to the senior doctors.. the history taking part is quite
enjoyable for me, as i’m the person who’s like to chit chat
anyway….;) and all the patients are so sweet and nice.. the real
difficult part is too present the case history, ouch that’s so
mysteriously pain in the ass! seriously , i just couldnt understand
why, because in a logical induction, it should be easy since we just
need to report what’s the story.. but in the real world, that nice easy
logic doesnt happen at all..(well maybe sometimes on good days) . i’ve
received numerous comments from multiple senior doctors, hehe.. which
i’m happy to receive too, because i really need to build up my
presenting skills asap, before this coming osce in june.. well dr
shazly said i have the attitude but i’m a big gigly, huhu, and dr david
wants me to be more confident, and dr zubin said dont ask questions
while presenting the case.. i feel so stupid some times, as i think its
unusual to not acquiring the skill in overnight time.. but now i
realize that , it comes with practice and practice..to infinity,
nothing more..i’m improving now,thank god,and a few consultants even
gave me honest grade recently..phew…and then as i google to search
for few good websites for this case presentation, i stumbled upon this
journal, which kinda solved all my 6 weeks mystery.. hehe –> oh
really i’m gigly! is that a bad thing?? really!
Journal of General Internal Medicine
Learning Oral Presentation Skills
A Rhetorical Analysis with Pedagogical and Professional Implications
OBJECTIVE:
Oral
presentation skills are central to physician-physician communication;
however, little is known about how these skills are learned. Rhetoric
is a social science which studies communication in terms of context and
explores the action of language on knowledge, attitudes, and values. It
has not previously been applied to medical discourse. We used
rhetorical principles to qualitatively study how students learn oral
presentation skills and what professional values are communicated in
this process.
DESIGN:
Descriptive study.
SETTING:
Inpatient general medicine service in a university-affiliated public hospital.
PARTICIPANTS:
Twelve third-year medical students during their internal medicine clerkship and 14 teachers.
MEASUREMENTS:
One-hundred
sixty hours of ethnographic observation. including 73 oral
presentations on rounds. Discoursed-based interviews of 8 students and
10 teachers. Data were qualitatively analyzed to uncover recurrent
patterns of communication.
MAIN RESULTS:
Students and teachers
had different perceptions of the purpose of oral presentation, and this
was reflected in performance. Students described and conducted the
presentation as a rule-based, data-storage activity governed by "order"
and "structure." Teachers approached the presentation as a flexible
means of "communication" and a method for "constructing" the details of
a case into a diagnostic or therapeutic plan. Although most teachers
viewed oral presentations rhetorically (sensitive to context), most
feedback that students received was implicit and acontextual, with
little guidance provided for determining relevant content. This led to
dysfunctional generalizations by students, sometimes resulting in worse
communication skills (e.g., comment "be brief" resulted in reading
faster rather than editing) and unintended value acquisition (e.g.,
request for less social history interpreted as social history never
relevant).
CONCLUSIONS:
Students learn oral
presentation by trial and error rather than through teaching of an
explicit rhetorical model. This may delay development of effective
communication skills and result in acquisition of unintended
professional values. Teaching and learning of oral presentation skills
may be improved by emphasizing that context determines content and by
making explicit the tacit rules of presentation
a perfect conclusion!!!
