You look down at your notes, organized perfectly from the Subjective information down to the Plan, and feel your palms sweating. Your heart starts to race, your breathing becomes heavier and more laborious. You feel the collective gaze of the clinical staff – physicians, nurses, pharmacists and technicians – focused intently on you. Suddenly the presentation you had so meticulously and repetitively run through in your head has vanished, and you simply stand there, knowing you’re responsible for the delivery of crucial information for the continued care of your patient without even the slightest idea of where or how to begin. This is your third year of medical school.
For even the most practiced and confident public speakers, presenting on rounds to a multidisciplinary care team is a daunting task. The limited time in which you are expected to collect and interpret information, then synthesize it and formulate a plan for each one of your patients is challenging for every student as they transition into their clinical training. While the preclinical phase of school prepares you for data interpretation, physical exam maneuvers and (hopefully) formulating a plan, there is very little training in the method of delivery of this information to the care team. Students can feel overwhelmed and nervous, oftentimes unable to showcase their knowledge in front of the team and to other professionals simply because they haven’t had the time to train themselves in delivery. And who can blame them? Much of medical students’ time in the preclinical years is spent in isolation, in small groups or in classrooms either absorbing information or regurgitating it. The transition is tough for many reasons, but one in particular is that the act of presenting is just as much a practice in sales as it is a practice in showcasing your knowledge. You may know exactly what is clinically wrong with your patient, and perhaps even what to do about it, but it ultimately falls on you to convince the team that your plan is appropriate and reasonable for the patient. To put it simply, you may have the best product, but you don’t know how to sell it.
We have created a short list of action items that you should follow for each presentation you deliver, no matter what the circumstance. Included are some extra resources to provide context and tools for being the best presenter you can be:
Go through the presentation on a sheet of paper, keep it organized, and try to run through it in your head a few times. Don’t be afraid to ask residents if you can practice it with them before rounds! They are there to teach and to help you as well. The more practiced and polished your presentation is, the more fluid it will sound when you step up to present it. It’s important to have a good rubric to follow for patient presentations. This goes for Poster/PowerPoint presentations as well. You can never practice too many times, particularly when you are presenting in front of a large audience. Practice does in fact make perfect.
Engage Your Audience
One of the greatest pitfalls of medical student presentations, from the wards to the podium, is their lack of engagement. When students are clearly reading off a computer slide, or off the paper they have scribbled notes on, they are directing their energy towards inanimate objects instead of the people who are listening. It may seem simple, but the more you make eye contact, gesture toward and speak directly to your team members who are listening to you, the more it will feel like a conversation rather than a presentation. This will be mutually beneficial when done correctly. This TED Talk elaborates on various vocal/postural tactics to keep your audience engaged.
Speak at your own pace
This cannot be emphasized enough. Even though you will experience varying rounding styles (Surgery rounding is an organized race against the clock), there is no shame in taking the time to present your interpretation of data and deliver a plan on your terms. Our rate of speech often follows the rate of our heartbeat, gradually increasing as we feel the pressure of the team and of our innate desire to be perfect.
Above all else, be confident and put your nickel down
The luxury of being a medical student is that if you are wrong, your plan will not come to fruition. It does not reach the patient. There are virtually no consequences. In fact, if you have good reasoning and data to back up your plan, even if it’s wrong nonetheless, you may still be praised for it. What your attendings, fellows and residents are looking for is conviction. Are you taking this case seriously, and have you demonstrated an understanding and appreciation of this patient’s presentation? This is what you are showcasing in your presentation. Be confident in yourself, and even more confident in your message.
Try following these principles before and during your presentations as a medical student in your pre-clinical phase of school. If you are already rotating on a clerkship, try this before your next presentation to your team. We think you’ll find your presentation will be more engaging and polished, and your audience will respond positively to it. It is never too late to begin working purposefully on your delivery during presentations – it will help you in the short term to impress your preceptors, and will pay dividends as you move up in your career and find yourself speaking to more audiences. This is the kind of investment that has serious long term gains, and will ensure that you stand out from your peers.
For more tools to help polish your public speaking and presenting skills, follow these links: