HOW TO PRESENT
ON ROUNDS
C
Katie Diamo nd- Falk, MD
Maine Medical Center
February 28
What worries you?
• On a piece of paper write 1-2 things you are
doing well
• What are 1-2 things you know you could do
better? Write them down on the same side of
paper below the things you are doing well.
SOAP format
• Use this not just for notes – use it for your
presentation to keep organized
• If this is the first time you are presenting your
patient/first day with your team/attending
hearing about patient, you need to talk about
presentation and then information since
admission as part of the “subjective”
Subjective
• Past Medical History – if not pertinent to presentation can include it in your
1 line overview
• Family history – can just say no pertinent family history, however, also
include negative history that is pertinent (seizures, hx of sudden death in
infancy, maternal HIV, etc.)
• Social history- only include if pertinent
• ROS – this should generally be included in your subjective without
separating out when describing verbally
• Key things to ask your patient every day and be able to share with your
subjective: last bowel movement, any concerns about urination, fevers,
nausea/vomiting, pain, changes
Objective
• Vital signs (before rounds check the normal ranges for age)
• Weight (when was last day obtained and change from birth/admission/etc.)
• I/O – if available for intake PO/IV, output urine, vomiting, tubes/drains
• Know what type of IVF
• Exam: always include the following…
• General appearance
• CV
• Pulmonary
• GI
• Neuro
Objective
• Labs: look them up before rounds and have them recorded in
chart so that you can easily reference them (look for them even
if you don’t think you ordered them, could have been added
overnight)
• only share the pertinent labs (if unsure if pertinent, ask attending
what part of labs they want (MCH – is this relevant?)
• state what is “abnormal” ex. low sodium of 128 – then explain
ddx/plan in A/P
• Imaging: look at the imaging yourself before rounds so that you
are prepared to give your impression (can be augmented by
radiology’s impression)
A/P
• Start with Assessment: this is a one liner again
• Then break it down by problem (or organ system depending on rotation)
• State each problem in terms of priority/severity (what is highest risk for
morbidity/mortality first)
• Explain your differential: if things have been ruled out based on your
tests it is okay to say that at this point (may not need to repeat full
differential every day); can use words like “most likely, possible,
unlikely”
• What is your planned work up for the day
• What medication/management are staying the same
• Include chronic/home problems succinctly
Disposition
• Last thing in a presentation :
• if admitting, which team/ward should patient
go to
• Ready for discharge? Where will they go?
• Barriers to discharge?
• Nice to then highlight key things you are
doing/changing for management that day
Practice
• Practice your presentation out loud
• Present to a mirror, peer
• Present to a non-medical family member to work on avoiding jargon
• No one knows if you practiced for 5min or 5h – practice until you can present a
patient comfortably and efficiently (try timing yourself)
• Ask for feedback on your presentations, evaluate yourself
Better Presentation
What did you learn/what will
you change?
• Write down 2 things on the other side of
you paper that you learned/will change to
improve your presentations
